Developing a Scale for the Assessment of Fatigue in Pediatric Oncology Patients Aged 7-12 for Children and Parents

Background: This study was planned in an attempt to develop scales for the assessment of fatigue in pediatriconcology patients aged 7-12 as well as for their parents. Materials and Methods: In collecting the study data,we used the Child and Parent Information Form, Visual Fatigue Scale, Scale for the Assessment of Fatigue inPediatric Oncology Patients Aged 7-12 and the Scale for the Assessment of Fatigue in Pediatric Oncology PatientsAged 7-12 for Parents. We also used Pearson correlation analysis, the Cronbach Alpha coefficient, Factor Analysisand ROC Analysis for the study data. Results: In this study, the total Cronbach alpha value of the parent formwas 0.95, the total factor load was 0.52-0.95 and the total variance being explained was 85.7%. The cutoff pointof the parent form was 82 points. The total Cronbach alpha value of the child form was 0.98, the total factorload was 0.71-0.94 and the total variance being explained was 84.7%. The cutoff point of the child form was75 points. Conclusions: This study suggests that our scales for the assessment of fatigue in pediatric oncologypatients aged 7-12 and their parents are valid and reliable instruments.     

Developing a Scale for Quality of Life in Pediatric Oncology Patients Aged 7-12 - Children and Parent Forms

Background: This study was planned in an attempt to develop a scale for the quality of life in pediatriconcology patients aged 7-12, with child and parents forms. Materials and Methods: In collecting the studydata, we used the Child and Parent Information Form, Visual Quality of Life Scale, Scale for Quality of LifePediatric Oncology Patients Aged 7-12 and the Scale for the Quality of Life in Pediatric Oncology Patients Aged7-12 for Parents. We also used Pearson correlation analysis, the Cronbach alpha coefficient, factor analysis andROC analysis for the study data. Results: In this study, the total Cronbach alpha value of the parent form was0.96, the total factor load being 0.54-0.90 and the total variance explained was 82.5%. The cutoff point of theparent form was 93 points. The total Cronbach alpha value for the child form was 0.96, with a total factor loadof 0.55-0.91 and the total variance being explained was 78.3%. The cutoff point of the child form was 65 points.Conclusions: This study suggests that the Scale for Quality of Life in Pediatric Oncology Patients Aged 7-12Child and Parents Forms are valid and reliable instruments in assessing the quality of life of children.     

Therapeutic Scrapbooking: A Technique to Promote Positive Coping and Emotional Strength in Parents of Pediatric Oncology Patients

Therapeutic scrapbooking is an intervention being used with parents and caregivers of children with cancer. The purpose of the group is to promote hopefulness, mobilize internal strengths, and thereby enhance the parents’ and caregivers’ coping abilities to benefit pediatric oncology patients. Facilitators, licensed in medical social work, provide a safe environment for participants to verbalize their stories and share their distress. Scrapbooking is a “normal” activity without the negative stigma that a “support group” may carry, minimizing the reluctance to attend this supportive group. Outcome measurements indicate this therapeutic intervention achieves positive results.     

Reliability and Validity of Turkish Versions of the Child,Parent and Staff Cancer Fatigue Scales

This study was designed to adapt the Turkish versions of scales to evaluate fatigue in children with cancerfrom the perspectives of the children, parents and staff. The objective of this study was to validate “Child FatigueScale-24 hours” (CFS-24 hours), “Parent Fatigue Scale-24 hours” (PFS-24 hours) and “Staff Fatigue Scale-24hours” (SFS-24 hours) for use in Turkish clinical research settings. Translation of the scales into Turkish andvalidity and reliability tests were performed. The validity of the translated scales was assessed with languagevalidity and content validity. The reliability of the translated scales was assessed with internal consistency. Thescales were evaluated by considering the following: calculation of the Cronbach alpha coefficient for parallel formreliability with 52 pediatric cancer patients, 86 parents and 43 nurses. The internal consistency was estimatedas 0.88 for the Child Fatigue Scale-24 hours, 0.77 for the Parent Fatigue Scale-24 hours, and 0.72 for the StaffFatigue Scale-24 hours (Cronbach’s α). The Turkish version of the Child Fatigue Scale -24 hours, the ParentFatigue Scale -24 hours and the Staff Fatigue Scale -24 hours were judged reliable and valid instruments toassess fatigue in children and showed good psychometric properties. These scales should assist in understandingto what extent initiatives can minimize or eliminate fatigue. Our scales are recommended for further studies anduse in pediatric oncology clinics as routine measurements and nursing initiatives should be planned accordingly.     

Patterns of Participation in a Self-Help Group for Parents of Children with Cancer

Some parents of children with cancer participate in self-help groups to gain the support they need to deal with the stress and crises they experience. This article reports on a study of 95 participants and non-participants in one such group. The results showed that participants and non-participants did not differ on the bases of gender, education, income, or attitudes toward the medical system. However, parents who lived closer to the hospital, whose children had been diagnosed one to four years previously, and who reported a high degree of stress from their child's illness were more likely to participate in the group.     

Stress,Psychosocial Mediators,and Cognitive Mediators in Parents of Child Cancer Patients and Cancer Survivors: Attention and Working Memory Pathway Perspectives

Objective: This review examines stress and its consequences on attention and working memory, stress symptoms in parents of child cancer patients and survivors and long-term consequences of stress on cognitive processing in parents of child cancer survivors. Method: Eligible studies were experimental, meta-analyses, and qualitative (2000–2013) from Pubmed, Medline, the Cochrane Library, PsycArticles, and Google Scholar. Results: We identified 92 eligible papers. They showed that elevated stress can impede performances on tasks requiring attention and memory patterns. In pediatric oncology, parental stress increased shortly after diagnosis involving depression and anxiety. Consequences of stress on cognitive performances were observed mainly among depressed individuals. As regards parents of child cancer survivors, female gender, low Socioeconomic Status (SES), and innate traits of anxiety/anger predicted the development of PTSS. Conclusion: Evidence of stress on attention and working memory processes in parents of child cancer survivors is insufficiently developed.     

Reliability and validity of the Turkish version of the Memorial Symptom Assessment Scale in cancer patients

Aim: The Memorial Symptom Assessment Scale (MSAS) is a multidimensional tool developed to evaluate measure the prevalence, characteristics and distress of common symptoms related to cancer. A validated Turkish version has now become available. The aim of this study was to evaluate its reliability and validity Methods: One hundred-twenty patients were included into this study. The MSAS, The Rotterdam Symptom Checklist (RSCL), and Karnofsky Performance Status Scale (KPSS) were used for data collection. Content and criterion validities were examined. Reliability analyses of the MSAS were performed using internal consistency reliability and test-retest reliability. Results: The most frequently reported symptom (90%) was problems with sexual interest or activity. Item–total correlations ranged between 0.03 and 0.64. There was a high correlation between total MSAS and the RSCL (r=0.875, p<0.01). The internal consistency reliabilities of subscales of the MSAS and total MSAS were moderately high, with Cronbach alpha coefficients ranging from 0.71 to 0.84. The MSAS’s test - re-test reliability was 0.78. Conclusion: The MSAS for cancer patients was determined to be a valid and reliable instrument for the use in the Turkish population. It is recommended that the MSAS-Turkish version can be used as a tool for comprehensive symptom assessment in planning nursing care for cancer patients.     

Translation and Validation of the Activities of Daily Living Scale with Iranian Elderly Cancer Patients Treated in an Oncology Unit

Background: This study evaluated the validity and reliability of applying the Katz’s Activities of Daily Living(ADL) scale in an Iranian sample of elderly oncologic patients following initial cancer treatment. Materialsand Methods: The scale was translated with the forward-backward procedure to give an Iranian version. TheADL scale was then applied in a random sample of 400 oncologic patients aged 60 and older following initialcancer treatment. Assessment of the scale stability was twice, with a 14-days (two weeks) interval, to 30 (of the400) eligible elderly cancer patients in March 2012. To measure treatment effects, the index was run with 150patients in a three month recall, following oncology processing. Exploratory and confirmatory factor analysiswas performed for assessment of construct validity of the Katz’s ADL. Reliability was measured with internalconsistency (Cronbach’s alpha co-efficient), and test/retest (Spearman’s r value) of the instrument. Criterionvalidity was evaluated by comparing the Katz with Physical Function (PF) subscale of SF 36. Known-groupvalidity was approved by comparing of Katz’ ADL between quartile groups of PF subscale of SF 36. Results: Inour study the ADL demonstrated a high degree of internal homogeneity (Cronbach’s alpha 0.923). There was ahigh correlation between scores of two time measurement of Katz’s ADL (p value of two- related- samples testwas 0.3). Construct validity showed a correlation coefficient of 0.572 between the ADL and PF scores. In factoranalysis, 2 factors were extracted. Evidence for the reliability of the questionnaire was good and known groupvalidity was approved by significant differences of ADL score between quartiles of the PF subscale of SF36.Conclusions: The results suggest that the Iranian version of ADL applied for oncologic older adult patientsfollowing initial cancer treatment is a reliable and a valid clinical instrument and comparable to those reportedin other studies.     

Matrix Metalloproteinase-13 - A Potential Biomarker for Detection and Prognostic Assessment of Patients with Esophageal Squamous Cell Carcinoma

Background: Matric metalloproteinase (MMP) 13 gene expression is increased in esophageal squamous cell carcinomas (ESCCs) and associated with increasing tumor invasion, lymph node involvement and decreased survival rates. Levels of the circulating enzyme may be elevated and used as a marker of tumor progression. In this study, clinical application of MMP-13 serum levels was evaluated for early detection, prediction of prognosis and survival time of ESCC patients. Materials and Methods: Serum levels of MMP13 were determined by ELISA in 66 ESCC patients prior of any treatment and 54 healthy controls for comparison with clinicopathological data through statistical analysis with Man Whitney U and Log-Rank tests. In addition, clinical value of MMP13 levels for diagnosis was evaluated by receiver operating characteristic (ROC) test. Results: The serum level of MMP-13 in patients (>250 pg/ml) was significantly higher than in the control group (Conclusions: These findings indicate a potential clinical significance of serum MMP13 measurement for early detection and prognostic assessment in ESCC patients.     

紫素为主的化疗联合放疗增加乳腺癌患者放射性肺炎危险性的分析

目的：评价紫素为主的化疗联合放疗增加乳腺癌患者放射性肺炎的危险性。方法：回顾性分析276例行联合放化疗的乳腺癌患者放射性肺炎的发病率,其中215例患者为术后三野放疗,61例为保乳术后切线放疗,依照辅助化疗方案的不同分为3个组,即PA组（紫素与阿霉素）,CAF组（环磷酰胺,阿霉素,氟脲嘧啶）,CMF组（环磷酰胺,氨甲喋呤,氟脲嘧啶）,比较各组间放射性肺炎的发病率。结果：PA组放射性肺炎的发病率高于其它两组,而其他两组间比较差异无显著性。结论：紫素为主的化疗增加了乳腺癌患者放射性肺炎的发病危险。     

Impact of Adjuvant Chemoradiotherapy for Rectal Cancer on the Long-Term Quality of Life and Late Side Effects: A Multicentric Clinical Evaluation by the Turkish Oncology Group

Aim: Although preoperative chemoradiatherapy (CRT) has proven its benefits in terms of decreased toxicity,there is still a considerable amount of cases that do not receive postoperative CRT. Oncologists at differentgeographic locations still need to know the long-term effects of this treatment in order to manage patientssuccessfully. The current paper reports on long-term quality of life (QOL) and late side effects after adjuvant CRTin rectal cancer patients from 5 centers in Anatolia. Methods: Rectal cancer patients treated with postoperativeCRT with minimum 1-year follow-up and were in complete remission, were evaluated according to RTOG andLENT-SOMA scales. They were also asked to complete Turkish version of EORTC QLQ-C30 questionnaire andthe CR-38 module. Each center participated with the required clinical data. Results: Two hundred and thirtypatients with median age of 55 years participated and completed the study. Median follow-up time was 5 years.All patients received RT concomitant with chemotherapy. Common parameters that both increased functionalhealth scales and yielded better symptom scores were long term interval after treatment and sphincter-savingsurgery. In addition, surgery type and follow-up time were determined to be predictors of QOL scores and latetoxicity grade. Conclusion: Postoperative CRT was found to have a great impact on the long term QOL and sideeffects in rectal cancer survivors. The factors that adversely affect these are abdominoperineal resection andshorter interval. The findings may encourage life-long follow-up and cooperation with patients, which shouldbe mentioned during the initial counseling.     

18F-FDG PET/CT对淋巴瘤化疗疗效评估的临床应用进展

淋巴瘤通过化疗可以达到较高的治愈率。疗效评估对于疗效最大化、副作用最小化、适时调整化疗对策至关重要。18F-FDGPET／CT是反映肿瘤葡萄糖代谢功能的技术,能够较好地对淋巴瘤化疗疗效进行评估。本文对18F-FDG摄取的评价方法、18F-FDGPET／CT对不同病理类型淋巴瘤疗效的评估及化疗评价时机的选择进行综述。     

Imaging in Therapy Response Assessment and Surveillance of Lung Cancer: Evidenced-based Review With Focus on the Utility of 18F-FDG PET/CT

This review covers the state-of-the-art imaging in therapy assessment and surveillance of lung cancer with focus on the utility of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT). We review different qualitative and quantitative response assessment criteria in lung cancer, common pitfalls and atypical patterns of response to immunotherapy, and imaging features of common immune-related adverse events. In addition, the currently recommended imaging workup in surveillance of asymptomatic patients with non–small-cell and small-cell lung cancer and future developments will be discussed.     

Validation of the Turkish Versions of EORTC QLQ-C30 and BR23 Modules in Breast Cancer Patients

Purpose: To test the validity and reliability of The European Organization for Research and Treatment ofCancer (EORTC) core (QLQ-C30) and breast cancer module (QLQ-BR23) for Turkish breast cancer patients.Patients and Methods: A total of 127 patients treated with radiotherapy (RT) enrolled to this prospective study.EORTC QLQ-C30 and QLQ-BR23 modules applied to patients before initiation of RT and at follow-up period.Statistical analyses were performed by SPSS 13.0. Results: Questionnaires’ were found reliable and valid forTurkish breast cancer patients. Six of the 8 multi-item scales of QLQ-C30 had a high reliability (Cronbach’s α>0.7); where physical functioning and pain scores were less reliable (Cronbach’s α of 0.66 and 0.68 respectively).In the QLQ-BR23, 3 of 5 multi-item scales were reliable; less reliable were breast and arm symptoms scale(Cronbach’s α of 0.65 and 0.61 respectively). In our analysis the most determinative subscales of QLQ-C30on global health was emotional functioning followed by fatigue, role functioning and appetite loss (respectivelyp=0.002, p=0.01; p=0.03 and p=0.08). Among QLQ-BR23 scales systemic therapy side effects, future perspectiveand upset by hair loss subscales had high impact on global health status (respectively p=0.006; p=0.01 and p=0.03).Conclusions: The Turkish version of EORTC QLQ-C30 and QLQ-BR23 modules are reliable and valid tools toassess quality of life of Turkish breast cancer patients.     

A Randomized,Open-Labeled,Prospective Controlled Study to Assess the Efficacy of Frontline Empirical Intravenous Piperacillin/Tazobactam Monotherapy in Comparison with Ceftazidime Plus Amikacin for Febrile Neutropenia in Pediatric Oncology Patients

Background: Febrile neutropenia (FN) is the most common complication in pediatric oncology patients. Appropriate empirical antibiotics treatment is essential for treatment outcome. Methods: This study was a randomized prospective controlled study to demonstrate the efficacy of piperacillin/tazobactam (PIP/TZO) monotherapy compared with ceftazidime/amikacin in children with FN. Pediatric oncology patients at Chiang Mai University Hospital, diagnosed with FN, were randomized to receive either PIP/TZO 320 mg/kg/day divided every 8 hours or ceftazidime 100 mg/kg/day divided every 8 hours plus amikacin 15 mg/kg/day once daily. Treatment responses were compared between the two groups. Results: One-hundred and eighteen febrile neutropenic episodes in 70 patients (42 males and 28 females) were enrolled. The median age was 7 (3-10) years. The early response and complete response to initial treatment were achieved in 48/59 (81.4%) episodes and 41/59 (69.5%) episodes in PIP/TZO group compared with 40/59 (67.8%) episodes and 33/59 (55.9%) episodes in ceftazidime/amikacin group (p-value 0.091 and 0.128, respectively). Treatment modification in PIP/TZO group was required in 18/59 (30.5%) compared with 26/59 (44.1%) patients in ceftazidime/amikacin group (p-value 0.128). Similarly, the duration of fever, duration of neutropenia and duration of antibiotics treatment were not significantly different between two groups. No serious adverse events were observed. Conclusion: The treatment responses of PIP/TZO monotherapy and ceftazidime/amikacin therapy were not significantly different. Both therapies were effective for FN in pediatric oncology patients.     

Use of Comprehensive Geriatric Assessment and Geriatric Screening for Older Adults in the Radiation Oncology Setting: A Systematic Review

Aims

Comprehensive geriatric assessment (CGA) is a multidisciplinary diagnostic process that evaluates medical, psychological, social and functional capacity. No systematic review of the use of CGA in radiation oncology has been conducted. This paper reviews the use of CGA in radiation oncology, examines whether such assessments are feasible and evaluates the effectiveness of these assessments in predicting and modifying outcomes.