共查询到20条相似文献，搜索用时 204 毫秒
1.
Michelle Shayne MD Eva Culakova PhD MS Debra Wolff MS PCNP Marek S. Poniewierski MD MS David C. Dale MD Jeffrey Crawford MD Gary H. Lyman MD MPH 《Cancer》2009,115(22):5319-5328
BACKGROUND:
This prospective study evaluated patient and treatment characteristics that contributed to hematologic toxicity in older breast cancer patients treated with curative intent in the community setting.METHODS:
Data were collected on 1224 patients with stage I through III breast cancer, of whom 207 were aged ≥65 years (grading determined according to the American Joint Committee on Cancer staging system). Primary outcome measures included anemia, thrombocytopenia, severe neutropenia, febrile neutropenia, and both planned and actual relative dose intensity (RDI). Comparisons between older and younger patients regarding hematologic toxicity and reductions in RDI were based on univariate and multivariate logistic regression analyses.RESULTS:
The neutropenic complication rate in older patients (45.1%) was not significantly different from that in the younger patients (43.7%). There were also no significant differences in rates of anemia or thrombocytopenia. Approximately 34.0% of the older patients received RDI <85% compared with 20.0% among younger patients (P < .01). Fewer older patients received anthracycline‐based chemotherapy (64.3% compared with 83.8% in younger patients, P < .01). Fewer older patients received prophylactic white blood cell colony‐stimulating factor (18.4%) compared with younger patients (28.0%) (P < .01).Conclusions:
There were no significant differences noted with regard to chemotherapy‐related hematologic toxicities between older and younger breast cancer patients in this large prospective observational study. This may be explained, in part, by more frequent reductions in RDI and less frequent utilization of anthracyclines among older patients. Cancer 2009. © 2009 American Cancer Society. 相似文献2.
Dominic H. Moon Bhishamjit S. Chera Allison M. Deal Yue Wang Hyman B. Muss Noam A. VanderWalde 《Journal of Geriatric Oncology》2019,10(1):42-47
Objectives
The agreement between clinician- and patient-reported toxicities and their association with poor tolerance to therapy were assessed in an older population receiving curative radiotherapy (RT).Materials and Methods
Patients?≥?65?years old with newly-diagnosed head and neck or lung cancer receiving curative RT?±?chemotherapy were enrolled on a prospective, observational study. Agreement between clinician (CTCAEv4.02) and patient (PRO-CTCAE, EORTC QLQ-C30) report of toxicities were assessed at baseline, during treatment, and post-treatment. The association of clinician- and patient-reported symptoms with poor tolerance to therapy (defined as hospitalization, >3-day treatment delay, change in treatment regimen, or death) was assessed.Results
Among 45 patients, median age was 71, 60% had head and neck cancer, and 47% received concurrent chemotherapy with RT. In comparing CTCAE vs PRO-CTCAE, there was good agreement at baseline except for fatigue, anorexia, and pain, where clinicians under-reported the severity. The discrepancy increased during treatment with clinicians reporting lower severity in ≥50% of matched pairs for 4/10 symptoms assessed. At follow-up, clinicians under-reported severity in ≥50% of pairs for 7/10 symptoms. CTCAE vs EORTC QLQ-C30 mirrored these findings. Patient-reported symptoms of nausea and dysphagia at 2?weeks and clinician-observed symptoms of nausea and dysphagia at 4?weeks were associated with poor tolerance to therapy.Conclusion
Clinicians under-report toxicities during and after curative RT in older patients with head and neck or lung cancer. Select toxicities reported by patients early in treatment and clinicians later in treatment were associated with poor tolerance to cancer therapy, providing valuable complementary information. 相似文献3.
Barbara B. Germino Merle H. Mishel G. Rumay Alexander Coretta Jenerette Diane Blyler Carol Baker Anissa I. Vines Melissa Green Debra G. Long 《Journal of cancer survivorship》2011,5(1):82-91
Introduction
Younger breast cancer survivors often lead extremely busy lives with multiple demands and responsibilities, making them difficult to recruit into clinical trials. African American women are even more difficult to recruit because of additional historical and cultural barriers. In a randomized clinical trial of an intervention, we successfully used culturally informed, population-specific recruitment and retention strategies to engage younger African-American breast cancer survivors. 相似文献4.
Hitoshi Katai Mitsuru Sasako Haruhiko Fukuda Kenichi Nakamura Naoki Hiki Makoto Saka Hiroki Yamaue Takaki Yoshikawa Kazuyuki Kojima 《Gastric cancer》2010,13(4):238-244
Background
Although the number of patients undergoing laparoscopy-assisted distal gastrectomy (LADG) has been increasing, a prospective study with a sample size sufficient to investigate the benefit of LADG has never been reported. We conducted a multi-institutional phase II trial to evaluate the safety of LADG with nodal dissection for clinical stage I gastric cancer patients. 相似文献5.
Background
Sublobar resection is a potential alternative to lobectomy for elderly patients with early-stage non-small-cell lung cancer, with better short term outcomes and similar oncological outcomes. We aimed to compare sublobar resection and lobectomy in patients with clinical stage T1N0M0 non-small-cell lung cancer aged 70 years or older.Methods
We did this prospective, open label, randomised, controlled, multicentre, non-inferiority, phase 3 trial (STEPS; registered with the Chinese Thoracic Oncology Group, number CTON1504) comparing sublobar resection and lobectomy for treatment of elderly patients with early-stage non-small-cell lung cancer. Patients were aged 70 years or older, with preoperative thoracic CT showing suspected peripheral non-small-cell lung cancer, clinical stage IA, consolidation to maximum tumour diameter ratio of 0·5 or higher, and were eligible for sublobar resection with sufficient margin. Intraoperative eligibility criteria included histologically confirmed invasive non-small-cell lung cancer, pathological exclusion of suspected lymph node involvement, and feasibility of sublobar resection in terms of surgical margin requirement. Patients gave informed consent, completed 4-year mortality index and comprehensive geriatric assessment if necessary, and had both forced expiratory volume in 1 s and diffusing capacity of the lungs for carbon monoxide of 50% or more in pulmonary function tests. Patients were excluded if they had a previous history of thoracic surgery and malignant tumour history within the past 5 years. We expect a total of 339 patients to be randomly assigned to the two treatment groups and participants will be followed-up every 6 months for 3 years. The primary outcome is 3-year disease-free survival (with a non-inferiority margin of 15%). The study will develop in accordance to the Declaration of Helsinki. Ethical Committee approval (Peking University Institutional Review Board) was obtained on Oct 30, 2014, before registration (reference number IRB00001052-13053). This trial is registered with ClinicalTrials, number NCT02360761.Findings
As of Jan 29, 2016, 66 patients have been registered to the study; the accrual is slower than anticipated. One patient receiving sublobar resection died of a surgical complication.Interpretation
To our knowledge, the present study is the only prospective, multicentre, randomised, controlled trial to compare sublobar resection and lobectomy for elderly patients (≥70 years) with early-stage non-small-cell lung cancer.Funding
Medtronic Inc. 相似文献6.
Jens Huober Werner Fett Arnd Nusch Michael Neise Marcus Schmidt Arthur Wischnik Steffen Gerhardt Thomas Goehler Hans-Joachim Lück Andreas Rost 《BMC cancer》2010,10(1):2
Background
Pegylated liposomal doxorubicin (PLD) is active in metastatic breast cancer. This observational study evaluated the efficacy and safety of PLD in patients treated during routine clinical practice. 相似文献7.
Akira Ohkoshi Takenori Ogawa Ayako Nakanome Eiichi Ishida Ryo Ishii Kengo Kato Yukio Katori 《Surgical oncology》2018,27(3):490-494
Objective
Surgery for locally advanced oral cancer often requires wide resections of multiple subsites of the oral cavity, including the oral tongue, floor of the mouth, and lower gingiva, and it causes chewing and swallowing disorders. The aim of this prospective, observational study was to determine which subsites have a greater impact on chewing and swallowing disorders after surgery.Methods
A prospective, observational study was conducted involving 52 patients who underwent surgery for locally advanced oral cancer with free flap reconstruction. The patients' Functional Oral Intake Scale scores were measured before surgery and 1 and 3 months after surgery. Possible predictors of chewing and swallowing disorders were subjected to univariate analysis and multivariate logistic regression analysis. Age, sex, preoperative body mass index, clinical stage, extent of mandibular bone resection, floor of the mouth resection, total or subtotal glossectomy, laryngeal suspension, bilateral neck dissection, and postoperative radiation therapy were the variables evaluated.Results
Multivariate logistic regression analysis showed that both anterior or extensive mandibular bone resection and postoperative radiation therapy were independently associated with poor oral intake after surgery.Conclusions
The identified predictors will be helpful for better management of patients identified as being at high risk of chewing and swallowing disorders. 相似文献8.
Nadine J. McCleary Joleen Hubbard Michelle R. Mahoney Jeffrey A. Meyerhardt Daniel Sargent Alan Venook Axel Grothey 《Journal of Geriatric Oncology》2018,9(1):24-31
Objectives
While the risk of developing colorectal cancer increases with age, there are limited prospective data regarding best treatment in the older adult population. We launched a phase III trial to evaluate difference in treatment outcome for older adults (aged ≥ 70 years) with advanced colorectal cancer. Here we review the challenges faced and reasons for poor accrual to N0949.Materials and Methods
We describe the conceptualization, development and limited results of N0949, a randomized phase III study of fluoropyrimidine/bevacizumab with or without oxaliplatin (mFOLFOX7 or XELOX) as first line chemotherapy for metastatic colorectal cancer.Fluoropyrimidine was physician choice (e.g., 5-FU/LV or capecitabine).Results
Of the projected 380 patients, only 32 patients were enrolled between the study activation in January 2011 until its closure in September 2012. Reasons for poor accrual included eligibility criteria that were too stringent, discomfort with randomizing older patients to regimens of varying intensity without considering their physical fitness, and discomfort with the use of bevacizumab in the older patient population. Several efforts were mounted to design a rationale and age-appropriate study, consider toxicities and varying study practices, and be responsive to stakeholder feedback.Conclusions
Challenges were experienced in conducting the first prospective phase III study evaluating progression-free survival of older adults with advanced colorectal cancer receiving palliative chemotherapy with fluoropyrimidine/bevacizumab with or without oxaliplatin in the USA. Future efforts to evaluate treatment outcomes in the older adult population should reflect on lessons learned in this large national effort. 相似文献9.
Annette Ø Jensen Jacob B Jacobsen Mette Nørgaard Mellissa Yong Jon P Fryzek Henrik T Sørensen 《BMC cancer》2011,11(1):29
Background
Breast cancer (BrCa) is the most commonly diagnosed cancer among women in the industrialized world. More than half of women presenting with metastatic BrCa develop bone metastases. Bone metastases increase the risk of skeletal-related events (SREs), defined as pathological fractures, spinal cord compression, bone pain requiring palliative radiotherapy, and orthopaedic surgery. Both bone metastases and SREs are associated with unfavorable prognosis and greatly affect quality of life. Few epidemiological data exist on SREs after primary diagnosis of BrCa and subsequent bone metastasis. We therefore estimated the incidence of bone metastases and SREs in newly-diagnosed BrCa patients in Denmark from 1999 through 2007. 相似文献10.
Schroder Sattar Shabbir M.H. Alibhai Margaret Fitch Monika Krzyzanowska Natasha Leighl Martine T.E. Puts 《Journal of Geriatric Oncology》2018,9(1):47-52
Purpose
Little is known about the perspectives of older adults (OAs) with newly-diagnosed cancer on their experiences with cancer treatment decision-making. The objective of this study was to explore the factors that were important for accepting or refusing cancer treatment by older adults undergoing chemotherapy and/or radiation therapy.Patients and methods
A qualitative study using semi-structured interviews with 20 OAs aged ≥ 65 years with newly diagnosed cancer (< 6 months) receiving either curative or palliative chemotherapy and/or radiation or who had declined therapy. The COREQ reporting guideline was utilized.Results
The majority of patients accepted the recommended cancer treatment. Most OAs followed their oncologist's recommendation, but spoke of making their own decisions and felt confident about their decisions. Second opinions were not commonly sought. Themes emerged can be divided into two categories: 1) pertaining to cancer treatment decision-making, which includes: “Trust in oncologist”, “prolong life”, “expected outcomes of treatment”, “other people's experience”, skeptical about going online” and “assertion of independence”, and 2) pertaining to oncologist-patient interactions, which includes “communication”.Conclusion
Older patients largely followed their cancer specialists' treatment recommendations. Most patients were satisfied with their treatment decision and were confident in their decisions. Seeking of second opinions was rare. More needs to be done to address the communication gaps and support needs of this population. 相似文献11.
Raffaele Addeo Michele Caraglia Vincenzo Faiola Elena Capasso Bruno Vincenzi Liliana Montella Rosario Guarrasi Luigi Caserta Salvatore Del Prete 《BMC cancer》2007,7(1):18
Background
Brain metastases (BM) represent one of the most frequent complications related to cancer, and their treatment continues to evolve. We have evaluated the activity, toxicity and the impact on Quality of Life (QoL) of a concomitant treatment with whole brain radiotherapy (WBRT) and Temozolomide (TMZ) in patients with brain metastases from solid tumors in a prospective Simon two stage study. 相似文献12.
13.
Michael von Bergwelt-Baildon Michael J Hallek Alexander A Shimabukuro-Vornhagen Matthias Kochanek 《BMC cancer》2010,10(1):612
Background
Currently the majority of cancer patients are considered ineligible for intensive care treatment and oncologists are struggling to get their patients admitted to intensive care units. Critical care and oncology are frequently two separate worlds that communicate rarely and thus do not share novel developments in their fields. However, cancer medicine is rapidly improving and cancer is eventually becoming a chronic disease. Oncology is therefore characterized by a growing number of older and medically unfit patients that receive numerous novel drug classes with unexpected side effects. 相似文献14.
Sietske J Tamminga Angela GEM de Boer Jos HAM Verbeek Taina Taskila Monique HW Frings-Dresen 《BMC cancer》2010,10(1):345
Background
Compared to healthy controls, cancer patients have a higher risk of unemployment, which has negative social and economic impacts on the patients and on society at large. Therefore, return-to-work of cancer patients needs to be improved by way of an intervention. The objective is to describe the development and content of a work-directed intervention to enhance return-to-work in cancer patients and to explain the study design used for evaluating the effectiveness of the intervention. 相似文献15.
Kathleen Lang Jonathan R Korn David W Lee Lisa M Lines Craig C Earle Joseph Menzin 《BMC cancer》2009,9(1):227
Background
The purpose of this study was to estimate the relative impact of changes in demographics, stage at detection, treatment mix, and medical technology on 5-year survival among older colorectal cancer (CRC) patients. 相似文献16.
G. Kasymjanova M. Grossman T. Tran R.T. Jagoe V. Cohen C. Pepe D. Small J. Agulnik 《Current oncology (Toronto, Ont.)》2013,20(3):152-157
Background
Most lung cancer patients experience multiple symptoms related either to the disease or its treatment. The commonly reported symptoms are pain, depression, anxiety, nausea, and poor well-being. The aim of the present study was to evaluate the effect of acupuncture as a potential treatment modality in symptomatic lung cancer patients.Methods
This prospective observational study enrolled 33 lung cancer patients from the Peter Brojde Lung Cancer Centre between August 2010 and May 2012. All patients received 45-minute sessions of acupuncture, 1–2 times weekly for a minimum of 4 sessions. Symptom severity was assessed using the Edmonton Symptom Assessment System (esas) before and after completion of acupuncture.Results
The study cohort included 30 patients with non-small- cell lung cancer and 3 with small-cell lung cancer. Mean age was 62 years (range: 36–88 years); 17 of the patients were women. Most of the patients had advanced-stage cancer (73%) and good performance status (Eastern Cooperative Oncology Group 0–1: 88%). Of these patients, 67% received anticancer treatment (chemotherapy or radiotherapy, or both) with acupuncture. Of the remaining 10 patients, 8 received acupuncture after a complete surgical resection of their tumour, and because of their advanced age, 2 received acupuncture and best supportive care. The median number of acupuncture sessions was 7 (interquartile range: 4–13 sessions). Statistically significant improvements in pain, appetite, nausea, nervousness, and well-being were observed. A clinically important improvement (2 points on the esas) was reported by 61% of patients for pain and by 33% for well-being.A significant positive correlation between improved well-being and the number of acupuncture sessions was observed. This correlation remained significant even after controlling for treatment and narcotic use. Receiver operating characteristic analysis demonstrated that a minimum of 6 acupuncture sessions are required for a 70% chance of a clinically important improvement in well-being.Conclusions
The present study is the first to demonstrate that acupuncture may be an effective approach for improving symptoms—in particular, pain and well–being—in lung cancer patients. Acupuncture is a safe and minimally invasive procedure, and it is potentially useful even in patients undergoing anticancer treatment. 相似文献17.
Alice M. Couwenberg Fleur S.A. de Beer Martijn P.W. Intven Johannes P.M. Burbach Anke B. Smits Esther C.J. Consten Anandi H.W. Schiphorst Niels A.T. Wijffels Marnix A.J. de Roos Marije E. Hamaker Wilhemina M.U. van Grevenstein Helena M. Verkooijen 《Journal of Geriatric Oncology》2018,9(2):102-109
Objectives
As result of the aging population and increasing rectal cancer incidence, more older patients undergo treatment for rectal cancer. This study compares treatment course, postoperative complications, and quality of life (QOL) between older and younger patients with rectal cancer and evaluates the impact of postoperative complications on QOL in the elderly.Materials and Methods
Patients with rectal cancer participating in a prospective colorectal cancer cohort and referred for radiotherapy between 2013 and 2016 were included. QOL was assessed with the cancer questionnaire of the European Organisation for Research and Treatment of Cancer (EORTC QLQ-C30) before treatment and at three, six, and twelve months. Outcomes were compared between older patients (≥ 70 years) and younger patients (< 70 years) and stratified by presence of postoperative complications.Results
In total, 115 (33%) older patients and 230 (67%) younger patients were included. Compared to younger patients, older patients underwent significantly more often short-course radiation with delayed surgery (6.1% and 19.1% respectively) and less often chemoradiation (62.6% and 39.1% respectively), and were more likely to undergo a Hartmann procedure with permanent stoma (3.5% and 13.0% respectively) instead of sphincter-sparing surgery (43.9% and 29.6% respectively). Postoperative complication rates were similar (38.5% in older patients versus 34.7% in younger patients). Older patients had worse physical functioning at six and twelve months after diagnosis compared to younger patients. Presence of postoperative complications had a significant stronger impact on physical- and role functioning in older patients.Conclusion
Older patients undergo more often a tailored treatment approach for rectal cancer than younger patients. With this tailored approach, similar postoperative complication rates and QOL are achieved. However, postoperative complications have a larger negative impact on physical- and role functioning in older patients which indicates a need for better prediction of postoperative complications in the elderly. 相似文献18.
Ada Tosovic Anne-Greth Bondeson Lennart Bondeson Ulla-Britt Ericsson Johan Malm Jonas Manjer 《Breast cancer research : BCR》2010,12(3):R33
Introduction
The potential association between hypo- and hyperthyroid disorders and breast cancer has been investigated in a large number of studies during the last decades without conclusive results. This prospective cohort study investigated prediagnostic levels of thyrotropin (TSH) and triiodothyronine (T3) in relation to breast cancer incidence in pre- and postmenopausal women. 相似文献19.
Objective
The objective was to characterize the relationship between depression and incident cancer. Few studies have employed population-based prospective data on subtypes of cancer to address the question. 相似文献20.
Young age: an independent risk factor for disease-free survival in women with operable breast cancer
Wonshik?Han Seok?Won?Kim In?Ae Park Daehee?Kang Sung-Won?Kim Yeo-Kyu?Youn Seung?Keun?Oh Kuk?Jin?Choe Dong-Young?Noh