Efficacy of a global supportive skin care programme with hydrotherapy after non‐metastatic breast cancer treatment: A randomised,controlled study

This study investigated the efficacy of post‐treatment hydrotherapy as supportive care for management of persistent/long‐lasting dermatologic adverse events (dAEs) induced in breast cancer survivors by adjuvant therapy, and its impact on quality of life (QoL). Patients in complete remission after standardised (neo)adjuvant chemotherapy, surgery and radiotherapy combination treatment for infiltrating HR+/HER2‐breast carcinoma were enrolled in this randomised, multicentre controlled study 1–5 weeks after completing radiotherapy. The control group (CG, n = 33) received best supportive care and the treatment group (HG, n = 35) received 3‐weeks of specific hydrotherapy. The primary criterion was change in QoL (QLQ‐BR23) after hydrotherapy. Clinical grading of dAEs, cancer‐related QoL (QLQ‐C30), dermatologic QoL (DLQI) and general psychological well‐being (PGWBI) were assessed. Significant dAEs were found at inclusion in both groups (n = 261). Most items showed significantly greater improvement in the HG versus CG group: QLQ‐BR23 (breast [p = .0001] and arm symptoms [p = .0015], systemic therapy side effects [p = .0044], body image [p = .0139]), some dAE grading, DLQI (p = .0002) and PGWBI (p = .0028). Xerosis (88% of patients at inclusion) completely healed in all HG patients. Specific hydrotherapy is an effective supportive care for highly prevalent and long‐lasting dAEs occurring after early breast cancer treatment, including chemotherapy, and leads to improved QoL and dermatologic toxicities.     

Parents' preferences for the organisation of long‐term follow‐up of childhood cancer survivors

Parents take an important role in follow‐up of young cancer survivors. We aimed to investigate (1) parents' preferences for organisation of follow‐up (including content, specialists involved and models of care), and (2) parents' and children's characteristics predicting preference for generalist vs. specialist‐led follow‐up. We sent a questionnaire to parents of childhood cancer survivors aged 11–17 years. We assessed on a 4‐point Likert scale (1–4), parents' preferences for organisation of long‐term follow‐up. Proposed models were: telephone/questionnaire, general practitioner (GP) (both categorised as generalist for regression analysis); and paediatric oncologist, medical oncologist or multidisciplinary team (MDT) (categorised as specialists). Of 284 contacted parents, 189 responded (67%). Parents welcomed if visits included checking for cancer recurrence (mean = 3.89), late effects screening (mean = 3.79), taking patients seriously (mean = 3.86) and competent staff (mean = 3.85). The preferred specialists were paediatric oncologists (mean = 3.73). Parents valued the paediatric oncologist model of care (mean = 3.49) and the MDT model (mean = 3.14) highest. Parents of children not attending clinic‐based follow‐up (OR = 2.97, p = .009) and those visiting a generalist (OR = 4.23, p = .007) favoured the generalist‐led model. Many parents preferred a clinic‐based model of follow‐up by paediatric oncologists or a MDT. However, parents also valued the follow‐up care model according to which their child is followed up.     

Assessing psychological and supportive care needs in glioma patients – feasibility study on the use of the Supportive Care Needs Survey Short Form (SCNS‐SF34‐G) and the Supportive Care Needs Survey Screening Tool (SCNS‐ST9) in clinical practice

Neuro‐oncological patients experience high symptom and psychosocial burden. The aim was to test feasibility and practicability of the Supportive Care Needs Survey Short Form (SCNS‐SF34‐G) and the SCNS‐Screening Tool (SCNS‐ST9) to assess supportive care needs of neuro‐oncological patients in clinical routine. A total of 173 patients, most with a primary diagnosis of high‐grade glioma (81%), were assessed first using SCNS‐SF34‐G in comparison to two well‐established patient‐reported outcome measures, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQC30 + QLQ‐BN20) and Distress Thermometer (DT). In a follow‐up assessment, SCNS‐ST9 was used in a subgroup (n = 90). Questionnaires were completed either with personal guidance offered (group A) or by patients alone (group B). Feasibility was compared between instruments and groups for possible associations with patient and treatment‐related factors. Missing values occurred in similar frequencies in all instruments. Errors in completion occurred in SCNS‐SF34‐G in 20% and in SCNS‐ST9 in 16%; difficulties in completion were observed more often in SCNS‐SF34‐G and SCNS‐ST9 (39%) compared to DT and EORTC (13%, p < .001). Distress was found to be associated with difficulties in completion of SCNS (OR 1.4, [95% CI 1.1–1.9], p = .013). SCNS‐SF34 and SCNS‐ST9 are suitable tools for glioma patients as long as personal guidance is offered.     

Preferences for long‐term follow‐up care in childhood cancer survivors

Follow‐up care is important for childhood cancer survivors to facilitate early detection and treatment of late effects. We aimed to describe preferences for different organisational aspects and models of follow‐up care among Swiss childhood cancer survivors, and characteristics associated with preferences for different models. We contacted 720 survivors aged 18+ years, diagnosed with cancer after 1990 (age 0–16 years), registered in the Swiss Childhood Cancer Registry (SCCR), and Swiss resident, who previously participated in a baseline survey. They received questionnaires to assess attendance and preferences for follow‐up (rated on 4‐point scales, 0–3). Clinical information was available from the SCCR. Survivors (n = 314: response rate 43.6%; 47.8% still attended follow‐up) rated clinical reasons for follow‐up higher than supportive reasons (p < .001). They rated checking for cancer recurrence (mean = 2.78, SD = 0.53) and knowing about risks for my children most important (mean = 2.22, SD = 0.83). They preferred to attend a children's hospital (mean = 1.94, SD = 1.11), adult hospital (mean = 1.86, SD = 0.98) or general practitioner (mean = 1.86, SD = 1.01) rather than a central specialised late effects clinic (mean = 1.25, SD = 1.06, p < .001), and be seen by paediatric (mean = 2.24, SD = 0.72) or medical oncologist (mean = 2.17, SD = 0.69). Survivors preferred decentralised clinic‐based follow‐up, rather than one central specialised late effects clinic. Survivors' preferences should be considered to ensure future attendance.     

Inflammation‐ and angiogenesis‐related biomarkers are correlated with cancer‐related fatigue in colorectal cancer patients: Results from the ColoCare Study

Cancer‐related fatigue is one of the most common side effects of colorectal cancer treatment and is affected by biomedical factors. We investigated the association of inflammation‐ and angiogenesis‐related biomarkers with cancer‐related fatigue. Pre‐surgery (baseline) serum samples were obtained from n = 236 newly diagnosed colorectal cancer patients. Meso Scale Discovery assays were performed to measure levels of biomarkers for inflammation and angiogenesis (CRP, SAA, IL‐6, IL‐8, MCP‐1, sICAM‐1, sVCAM‐1, TNFα, VEGFA and VEGFD). Cancer‐related fatigue was assessed with the EORTC QLQ‐30 questionnaire at baseline and 6 and 12 months post‐surgery. We tested associations using Spearman's partial correlations and logistic regression analyses, adjusting for age, sex and body mass index. sICAM‐1 and VEGFD showed a significant positive correlation with cancer‐related fatigue at baseline and 6‐, and 12‐month follow‐up (sICAM‐1: r = 0.19, p = 0.010; r = 0.24, p = 0.004; r = 0.25, p = 0.006; VEGFD: r = 0.20, p = 0.006; r = 0.15, p = 0.06; r = 0.23, p = 0.01 respectively). Biomarkers of inflammation and angiogenesis measured prior to surgery are associated with cancer‐related fatigue in colorectal cancer patients throughout various time points. Our results suggest the involvement of overexpressed sICAM‐1 and VEGFD in the development of fatigue.     

The risk factors and prevalence of upper extremity impairments and an analysis of effects of lymphoedema and other impairments on the quality of life of breast cancer patients

This study aimed to determine the prevalence and identify the risk factors associated with upper extremity impairments (UEIs) in breast cancer patients and to investigate the degree to which these impairments and other characteristics influence quality of life (QoL). A total of 201 women over the age of 18 who underwent breast cancer treatment at least 6 months were included in this cross‐sectional study. All of the patients were evaluated for the presence of lymphoedema and any UEIs. UEIs divided into five subgroups: pain, restriction of shoulder range of motion (ROM), numbness and heaviness, loss of strength, and sensory deficit. QoL of the patients was evaluated by SF‐36. The prevalence of the upper extremity impairments was as follows: pain 31.8%, restriction of shoulder ROM 23.9%, numbness and heaviness 35.3%, loss of strength 8.5%, and sensory deficit 18.4%. Furthermore, lymphoedema was seen in 41.3% of patients. The multivariate model showed that lymphoedema is the only statistically significant risk factor that affects the development of UEIs (P = 0.001). However, it also revealed that lymphoedema (P = 0.001) and increased age negatively affect QoL, whereas prolongation of the follow‐up period has a favourable impact (P = 0.016). Therefore, lymphoedema diminishes QoL via an increased number of UEIs.     

Fear of cancer progression in patients with stage IA malignant melanoma

We aimed to determine the prevalence and importance of fear of cancer progression (FoP) in melanoma patients with stage IA tumours to assess psychosocial and demographic factors associated with severity of FoP and to determine the relationship of FoP and quality of life (QoL). One hundred and thirty‐six patients with stage IA melanoma completed the short version of the Fear of Progression Questionnaire (FoP‐Q‐SF), the Hospital Anxiety and Depression Scale (HADS) and the EORTC‐QLQ‐C30. We found a mean FoP‐Q‐SF sum score of 30.2 points (±8.4 points SD). In this study, 33% of patients reported high FoP at or above the cutoff‐value of 34 points. Higher FoP was found in women (p < 0.01), young (p = 0.03) and employed (p = 0.02) patients. Being confronted with a cancer diagnosis in closely related persons predicted higher FoP (p < 0.01). FoP correlated positively with the HADS anxiety (r = 0.50, p < 0.01) and depression scales (r = 0.26, p < 0.01) and negatively with the EORTC‐QLQ‐C30 global health state (r = −0.32, p < 0.01). FoP is considerably prevalent in low‐risk melanoma patients and associated with reduced QoL, cancer in related persons, women sex and participation in working life. Considerably high levels of FoP, even in patients with low‐risk malignancies, underline the need for psychosocial support and psychotherapeutic interventions for melanoma patients.     

Prognostic value of health‐related quality‐of‐life parameters in early‐stage breast cancer: an 8‐year follow‐up study

Objective: The purpose was to investigate whether self‐reported health‐related quality‐of‐life (HRQOL) parameters at time of diagnosis and/or 1‐year follow‐up are prognostic for disease‐free survival (DFS) in early‐stage breast cancer patients. Methods: Data from 195 women, diagnosed with early‐stage breast cancer, who had filled in the EORTC QLQ‐C30 and the Hospital Anxiety and Depression Scale (HADS) at time of diagnosis and 1 year after surgery, were analyzed. Results: After a median follow‐up of 8.2 years (range 0.09–9.45), 27 (14.1%) deaths and 22 (11.5%) recurrences were observed. Using Cox multivariate regression analysis, appetite loss reported 1‐year following surgery (HR 2.92, 95% CI 1.50–5.66), p=0.002) was significantly predictive for shorter DFS, even after controlling for age and depression. None of the clinical or biological prognostic factors was found to have a confounding effect. Conclusion: The findings indicate that loss of appetite probably is of prognostic value in addition to well‐recognized clinical and biological data, in early‐stage breast cancer. Copyright © 2010 John Wiley & Sons, Ltd.     

Prophylactic effect of lamivudine on chemotherapy‐induced hepatitis B virus reactivation in patients with solid tumour: A meta‐analysis

Hepatitis B virus (HBV) reactivation is a remarkable risk during the chemotherapy for solid tumour patients. Nucleos(t)ide analogues (NAs) are recommended as prophylaxis for the reactivation of HBV infection in some cancer patients prior to systemic chemotherapy. Therefore, we performed a meta‐analysis aiming to determine the efficacy of prophylactic lamivudine on prevention of HBV reactivation and its related negative outcomes among solid tumour patients with chronic HBV infection receiving systemic chemotherapy. The primary outcome was HBV reactivation, and the secondary outcomes were HBV‐related hepatitis, chemotherapy disruption, mortality and tyrosine‐methio‐nine‐aspartate‐aspartate (YMDD) mutations. Twelve original researches involving 1,101 patients were analysed in this study. The relative risk of HBV reactivation in patients with lamivudine prophylaxis was significantly lower than that without prophylaxis (RR = 0.17, 95% CL: 0.10‐0.29, p < .00001). Lamivudine prophylaxis reduced the relative risk of hepatitis (p < .00001), chemotherapy disruptions (p = .01) and mortality (p = .08) due to HBV reactivation. Lamivudine prophylaxis is effective in reducing HBV reactivation and its related negative outcomes, such as hepatitis and chemotherapy disruption and mortality among chemotherapeutic solid tumour patients with chronic HBV infection. Future studies should lay more emphasis on the early HBV screening, mode of treatment and duration of NAs prophylaxis among solid tumour patients receiving chemotherapy.     

Conditional survival and recurrence of remnant gastric cancer after surgical resection: A multi‐institutional study

The present study was designed to evaluate the dynamic survival and recurrence of remnant gastric cancer (RGC) after radical resection and to provide a reference for the development of personalized follow‐up strategies. A total of 298 patients were analyzed for their 3‐year conditional overall survival (COS3), 3‐year conditional disease‐specific survival (CDSS3), corresponding recurrence and pattern changes, and associated risk factors. The 5‐year overall survival (OS) and the 5‐year disease‐specific survival (DSS) of the entire cohort were 41.2% and 45.8%, respectively. The COS3 and CDDS3 of RGC patients who survived for 5 years were 84.0% and 89.8%, respectively. The conditional survival in patients with unfavorable prognostic characteristics showed greater growth over time than in those with favorable prognostic characteristics (eg, COS3, ≥T3: 46.4%‐83.0%, Δ36.6% vs ≤T2: 82.4%‐85.7%, Δ3.3%; P < 0.001). Most recurrences (93.5%) occurred in the first 3 years after surgery. The American Joint Committee on Cancer (AJCC) stage was the only factor that affected recurrence. Time‐dependent Cox regression showed that for both OS and DSS, after 4 years of survival, the common prognostic factors that were initially judged lost their ability to predict survival (P > 0.05). Time‐dependent logistic regression analysis showed that the AJCC stage independently affected recurrence within 2 years after surgery (P < 0.05). A postoperative follow‐up model was developed for RGC patients. In conclusion, patients with RGC usually have a high likelihood of death or recurrence within 3 years after radical surgery. We developed a postoperative follow‐up model for RGC patients of different stages, which may affect the design of future clinical trials.     

Effects and moderators of psychosocial interventions on quality of life,and emotional and social function in patients with cancer: An individual patient data meta‐analysis of 22 RCTs

Objective

This individual patient data (IPD) meta‐analysis aimed to evaluate the effects of psychosocial interventions (PSI) on quality of life (QoL), emotional function (EF), and social function (SF) in patients with cancer, and to study moderator effects of demographic, clinical, personal, and intervention‐related characteristics.

Methods

Relevant studies were identified via literature searches in 4 databases. We pooled IPD from 22 (n = 4217) of 61 eligible randomized controlled trials. Linear mixed‐effect model analyses were used to study intervention effects on the post‐intervention values of QoL, EF, and SF (z‐scores), adjusting for baseline values, age, and cancer type. We studied moderator effects by testing interactions with the intervention for demographic, clinical, personal, and intervention‐related characteristics, and conducted subsequent stratified analyses for significant moderator variables.Results: PSI significantly improved QoL (β = 0.14,95%CI = 0.06;0.21), EF (β = 0.13,95%CI = 0.05;0.20), and SF (β = 0.10,95%CI = 0.03;0.18). Significant differences in effects of different types of PSI were found, with largest effects of psychotherapy. The effects of coping skills training were moderated by age, treatment type, and targeted interventions. Effects of psychotherapy on EF may be moderated by cancer type, but these analyses were based on 2 randomized controlled trials with small sample sizes of some cancer types.

Conclusions

PSI significantly improved QoL, EF, and SF, with small overall effects. However, the effects differed by several demographic, clinical, personal, and intervention‐related characteristics. Our study highlights the beneficial effects of coping skills training in patients treated with chemotherapy, the importance of targeted interventions, and the need of developing interventions tailored to the specific needs of elderly patients.

     

Body composition and bone mineral density in breast cancer survivors and non‐cancer controls: A 12‐ to 15‐month follow‐up

While prognosis for breast cancer in women has improved, adverse side effects of treatments may negatively affect body composition and bone mineral density (BMD). This study assessed body composition and BMD changes in breast cancer survivors (BCS) (n = 10, 57.9 ± 5.7 years) and age‐matched women (non‐cancer, n = 10, 56.5 ± 4.3 years) over a 12‐ to 15‐month period via dual‐energy X‐ray absorptiometry. No differences were observed between groups at baseline except forearm BMD values were lower in BCS (BCS: 0.462 ± 0.070 g/cm²; Control: 0.539 ± 0.052 g/cm², p = .012). Body fat increased in both groups compared to baseline (BCS: 38.3–39.6 kg, p = .013; Control: 38.2–39.5 kg, p = .023) at the follow‐up. Significant decreases in BMD at the lumbar spine, femoral neck, total femur and ulna were observed in both groups. Breast cancer survivors had a greater decrease in left femoral neck BMD. While BCS demonstrated lower baseline forearm BMD values and a greater decrease in left femoral neck BMD, both groups showed an increase in body fat and decrease in forearm BMD. These findings support the implementation of interventions to improve body composition and BMD in both BCS and women without cancer.     

Cancer‐specific mortality of high‐risk prostate cancer after carbon‐ion radiotherapy plus long‐term androgen deprivation therapy

The treatment outcomes of patients with high‐risk localized prostate cancer (PC) after carbon‐ion radiotherapy (CIRT) combined with long‐term androgen deprivation therapy (LTADT) were analyzed, and compared with those of other treatment modalities, focusing on PC‐specific mortality (PCSM). A total of 1247 patients were enrolled in three phase II clinical trials of fixed‐dose CIRT between 2000 and 2013. Excluding patients with T4 disease, 608 patients with high‐risk or very‐high‐risk PC, according to the National Comprehensive Cancer Network classification system, who received CIRT with LTADT were evaluated. The median follow‐up time was 88.4 months, and the 5‐/10‐year PCSM rates were 1.5%/4.3%, respectively. T3b disease, Gleason score of 9–10 and percentage of positive biopsy cores >75% were associated with significantly higher PCSM on univariate and multivariate analyses. The 10‐year PCSM rates of patients having all three (n = 16), two (n = 74) or one of these risk factors (n = 217) were 27.1, 11.6 and 5.7%, respectively. Of the 301 patients with none of these factors, only 1 PCSM occurred over the 10‐year follow‐up (10‐year PCSM rate, 0.3%), and significant differences were observed among the four stratified groups (P <0.001). CIRT combined with LTADT yielded relatively favorable treatment outcomes in patients with high‐risk PC and very favorable results in patients without any of the three abovementioned factors for PCSM. Because a significant difference in PCSM among the high‐risk PC patient groups was observed, new categorization and treatment intensity adjustment may be required for high‐risk PC patients treated with CIRT.     

Questionnaire study of the dietary habits of breast cancer survivors and their relationship to quality of life (KROG 14‐09)

We evaluated the dietary habits of breast cancer survivors and investigated the relationship with quality of life (QoL), with 1,156 survivors recruited from 17 institutions. We used the Questionnaire Survey of Dietary Habits of Korean Adults (Q‐DH‐KOR) comprising 25 questions. The following indices were derived as follows: (1) quality of healthy dietary habits (Q‐HD)—eight questions on number of meals, regularity, quantity, duration, skipping breakfast, dinner with companion(s), overeating and late‐night snacks; (2) habits of nutritional balance (H‐NB)—questions on consuming five food categories (grains, fruits, proteins, vegetables and dairy products); and (3) habits of unhealthy foods (H‐UF)—questions on consuming three food categories (fatty, instant and fast foods). The times and regularity of meals, frequency of skipping breakfast, dinner with companion(s) and overeating were better in groups with high symptomatic and functional QoL. Symptomatic QoL positively affected Q‐HD and H‐NB (p < 0.001 and p = 0.024 respectively) and negatively affected H‐UF (p = 0.02). Breast cancer survivors more frequently ate from the fruit, protein and vegetable categories than did the control group, with lower H‐UF and higher Q‐HD values (p < 0.001 and p < 0.001 respectively). Our findings supported the relationship between QoL and dietary habit and showed healthier dietary habits of breast cancer survivors than controls.     

Tailored education enhances healthy behaviour self‐efficacy in childhood cancer survivors: A randomised controlled study with a 4‐month follow‐up

This study was to evaluate the acceptability and effectiveness of a tailored education on healthy behaviour self‐efficacy (HBSE) and health promotion lifestyle (HPL) for childhood cancer survivors. A two‐group, randomised study with repeated measures was conducted in Taiwan. Participants were randomly assigned to receive six 45–60 min individual education and follow‐up telephone counselling sessions (n = 34) or standard of care only (n = 35). Each participant was assessed with HBSE and HPL questionnaires and was evaluated at three time points (at baseline, and then 1 and 4 months after intervention). The attrition rate was 7.2%. HBSE and HPL scores increased across the three time points in the experimental group (all p < 0.05), except for the HBSE exercise subscale (p = 0.85). HBSE scores were significantly higher for the experimental group than for the control group after 4 months of intervention (F = 5.32, p = 0.02, η² = 0.25). No significant improvements in HBSE were observed over time in the control group. The intervention was acceptable and effective in promoting HBSE in childhood cancer survivors. Further empirical work is needed to reveal the effects of the intervention over a longer period of time and to improve patient engagement in exercise.     

Spiritual well‐being of Italian advanced cancer patients in the home palliative care setting

This study evaluates the spiritual well‐being (SpWB) in very advanced cancer patients assisted by the home palliative care program of ANT Foundation, a no‐profit Italian organisation. SpWB was assessed by the Functional Assessment of Chronic Illness Therapy–Spiritual Well‐Being Scale (FACIT‐Sp12), including Meaning, Peace, and Faith subscales. The quality‐of‐life (QoL) was evaluated by using the Functional Assessment of Cancer Therapy‐General scale. Questionnaires were distributed to 1,055 patients and 683 were compiled and evaluable for analysis. The mean scores of FACIT‐Sp12 as well as of QoL were notably lower than reference values for cancer survivors. The FACIT‐Sp12 score was higher in patients with less impaired Karnofsky Performance Status, fully participating in religious rituals and living in central Italy. A high Pearson's correlation was found between QoL and FACIT‐Sp12 (r = .60), Peace (r = .71) and Meaning (r = .52), while it was marginal for Faith (r = .27). The hierarchical regression analysis showed that FACIT‐Sp12 is a significant predictor of QoL. The study suggests that Italian patients with advanced cancer assisted by expert multi‐professional teams in the home palliative care setting have a low level of SpWB thereby highlighting the need for the integration of spiritual support as part of comprehensive cancer care.     

Improved long‐term survival in all Sanz risk patients of newly diagnosed acute promyelocytic leukemia treated with a combination of retinoic acid and arsenic trioxide‐based front‐line therapy

Limited data was available for long‐term follow‐up in newly diagnosed acute promyelocytic leukemia (APL) patients treated with all‐trans‐retinoic acid (ATRA) plus intravenously arsenic trioxide (ATO)‐based front‐line therapy. The aim of this work was to retrospectively analyze the long‐term survival rate and frequency of therapy‐related myeloid neoplasia (t‐MN) occurring in a large cohort of APL patients. A total of 760 newly diagnosed patients with APL between January 1999 and May 2016 were evaluated. The early death rate was 9.2% (70/760). Of the remaining 690 patients with complete remission, patients were grouped according to front‐line regimens: ATRA plus ATO with or without chemotherapy (ATO group) and ATRA with chemotherapy (non‐ATO group). The median duration of follow‐up was 7.5 years (1.0‐18.3 years). ATO group showed significant superior 10‐year estimated relapse‐free survival (RFS) up to 90.3% comparing with 65.5% in the non‐ATO group (P < 0.0001). In addition, the 10‐year estimated overall survival (OS) was 93.9% for patients in the ATO group and 89.1% for those in the non‐ATO group (P = 0.03). In the subgroup analysis, the RFS rate was also higher in ATO group comparing with non‐ATO group in both low‐to‐intermediate‐risk (94.2% vs 64.6%, P < 0.0001) and high‐risk subgroup (89.6% vs 74.7%, P = 0.04). Notably, the 3‐year RFS and OS rates in the chemotherapy‐free subgroup of the low‐to‐intermediate‐risk patients (n = 88) were 100% and 100%, respectively. In the entire cohort, a total of 10 patients developed secondary malignant neoplasms, including 7 patients with therapy‐related myeloid neoplasms (t‐MN). The estimated 5‐year cumulative incidence risk of t‐MN in the ATO and non‐ATO groups was 1.0% and 0.4%, respectively (P = 0.34). Thus, our data revealed that the long‐term outcome of patients treated with ATRA plus ATO‐based regimens was associated with continuing high efficacy in all Sanz risk patients with newly diagnosed APL.     

Health‐related quality of life associated with different cancer treatments in Chinese breast cancer survivors in Taiwan

We assessed the quality of life (QoL) associated with patient's characteristics and different cancer treatments among Chinese breast cancer survivors in Taiwan. A cross‐sectional survey was conducted in 2017 where 193 patients with hormone receptor‐positive/human epidermal growth factor receptor‐2‐negative metastatic breast cancer were recruited. Three QoL questionnaires were administered: European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ‐C30), its breast cancer supplementary measure (QLQ‐BR23) and EQ‐5D‐5L. Multiple linear regression was performed to assess the association between QoL and cancer treatments, with adjustment for patient's characteristics. The mean age of study participants was 55.52 years. Simple linear regression showed that cancer stage and receiving chemotherapy were significantly associated with QoL scores (p < 0.05). Significant adverse effects of chemotherapy on QoL were found among early‐stage cancer women (i.e., I or II), including poor cognitive and sexual functioning, and a higher symptom burden (i.e., dyspnoea, constipation, systematic therapy side effects). Multiple linear regression also revealed that receiving chemotherapy was significantly associated with poor QoL (e.g., lower functional health and higher symptom burden measured by the QLQ‐BR23), compared to none chemotherapy (p < 0.05). Receiving chemotherapy was associated with poor QoL, especially among early‐stage breast cancer patients.     

The effectiveness of exercise‐based rehabilitation to patients with myeloproliferative neoplasms—An explorative study

The aim of the study was to determine the impact of an interdisciplinary exercise‐based rehabilitation intervention on fatigue and quality of life (QOL) in patients with Philadelphia‐negative myeloproliferative neoplasms (MPNs). At the Danish Knowledge Centre for Rehabilitation and Palliative Care, a 5‐day interdisciplinary exercise‐based rehabilitation intervention was carried out on 48 patients with MPN. It was followed by 12 weeks of self‐exercising prior to follow‐up. Initially and at follow‐up, participants filled out validated questionnaires; Brief Fatigue Inventory, Multidimensional Fatigue Inventory, European Organization for Research and Treatment of Cancer Quality‐of‐Life questionnaire, Myeloproliferative Neoplasm Symptom Assessment Form and Hospital Anxiety and Depression Scale. Maximal oxygen uptake and muscular strength were tested as well. Paired t test was used to compare scores between baseline and follow‐up. In total, 45 participants (94%) completed the follow‐up. No significant differences were observed on fatigue or QOL when comparing baseline and follow‐up. Mean maximal oxygen uptake increased from 27.2 to 33.6 ml O₂ · kg⁻¹ ·min⁻¹ (p < 0.001). Handgrip strength (p = 0.01) and the 30‐s chair‐stand test (p < 0.001) improved as well. No changes were found regarding levels of fatigue and QOL. However, we observed a significant increase in the physical capacity. Our observations call for further studies investigating the effects of non‐pharmacological approaches in patients with MPN.