| 61. |
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| 62. |
- Goldwasser, Francois, et al.
(författare)
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Timing of palliative care needs reporting and aggressiveness of care near the end of life in metastatic lung cancer : A national registry-based study
- 2018
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Ingår i: Cancer. - : Wiley. - 0008-543X .- 1097-0142. ; 124:14, s. 3044-3051
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND Early integration of palliative care for patients with metastatic lung cancer improves their quality of life and survival and reduces the aggressiveness of care near the end of life. This study examined the association between the timing of palliative care needs reporting and the aggressiveness of end-of-life care.METHODS This retrospective cohort study used the French National Hospital Registry to identify all hospitalized adults (20 years old) who died of metastatic lung cancer in France between 2010 and 2013. It compared the use of care and treatments near the end of life as a function of the timing of the first reporting of palliative care needs. The use of chemotherapy and the use of invasive ventilation were defined as primary outcomes. Propensity score weighting was used to control for potential confounders.RESULTS Among a total of 64,950 deceased patients with metastatic lung cancer, the reporting of palliative care needs was characterized as timely (from 91 to 31 days before death) for 26.3%, late (from 30 to 8 days before death) for 31.5%, and very late (from 7 to 0 days before death) for 12.8%. Palliative care needs were not reported for 19,106 patients (29.4%). Patients with timely reporting of palliative care needs had the earliest and most progressive decrease in the use of anticancer therapy. The use of invasive ventilation also increased with a delay in palliative care needs reporting.CONCLUSIONS There is a clear association between the timing of palliative care needs reporting and the aggressiveness of care near the end of life.
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| 63. |
- Greimel, Elfriede R, et al.
(författare)
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The European Organization for Research and Treatment of Cancer (EORTC) Quality-of-Life questionnaire cervical cancer module: EORTC QLQ-CX24.
- 2006
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Ingår i: Cancer. - : Wiley. - 0008-543X .- 1097-0142. ; 107:8, s. 1812-22
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The authors report on the development and validation of a cervical cancer module for the European Organization for Research and Treatment of Cancer (EORTC) Quality-of-Life (QoL) questionnaire (QLQ), which was designed to assess disease-specific and treatment-specific aspects of QoL in patients with cervical cancer. METHODS: The cervical cancer module (EORTC QLQ-CX24) was developed in a multicultural, multidisciplinary setting to supplement the EORTC QLQ-C30 core questionnaire. The QLQ-C30 and the cervical cancer module were administered to 346 patients with cervical cancer who underwent radical hysterectomy and received radiotherapy and chemotherapy. Psychometric analyses were performed by using data from 2 independent samples. RESULTS: The QLQ-CX24 consists of 3 multiitem scales and 5 single-item scales. Multitrait scaling analyses revealed high internal consistencies for the subscales with Cronbach alpha coefficients ranging from .72 to .87 (Symptom Experience, .72; Body Image, .86; Sexual/Vaginal Functioning, .87). Convergent and discriminant validity were fulfilled with scaling errors below 3%. The QLQ-CX24 was capable of discriminating between clinical subgroups. All items exhibited good compliance with <3% missing values. Most patients completed the EORTC QLQ-C30 and the QLQ-CX24 in <15 minutes (86%), and many did not require any assistance to complete the questionnaires (65%). CONCLUSIONS: The current psychometric analyses supported the content and construct validity and the reliability of the EORTC QLQ-CX24 module. This newly developed module is a useful instrument for assessing the QoL of patients who are treated for cervical cancer both in clinical trials and in clinical practice.
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| 64. |
- Grenabo Bergdahl, Anna, et al.
(författare)
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Risk of Dying From Prostate Cancer in Men Randomized to Screening Differences Between Attendees and Nonattendees
- 2009
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Ingår i: Cancer. - : Wiley. - 1097-0142 .- 0008-543X. ; 115:24, s. 5672-5679
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Although the true benefits and disadvantages of prostate cancer screening are still not known, the analysis of fatal cases is important for increasing knowledge of the effects of prostate cancer screening on mortality. Who dies from prostate cancer despite participation in a population-based prostate-specific antigen (PSA) screening program? METHODS: From the Goteborg branch of the European Randomized study of Screening for Prostate Cancer, 10,000 men randomly assigned to active PSA-screening every second year formed the basis of the present study. Prostate cancer mortality was attributed to whether the men were attendees in the screening program (attending at least once) or nonattendees. RESULTS: Thirty-nine men died from prostate cancer during the first 13 years. Both overall (34% vs 13 %; P <.0001) and cancer-specific mortality (0.8% vs 0.3 %; P < .005) were found to be significantly higher among nonattendees compared with attendees. Furthermore, the majority of deaths (12 of 18) among screening attendees were in men diagnosed at first screening (prevalent cases). Only 6 deaths (including 3 interval cases) were noted among men complying with the biennial screening program. CONCLUSIONS: Nonattendees in prostate cancer screening constitute a high-risk group for both death from prostate cancer and death from other causes comparable to that described in other cancer screening programs. Cancer 2009;115:5672-9. (C) 2009 American Cancer Society.
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| 65. |
- Gronlund, B, et al.
(författare)
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Sequential topotecan and oral etoposide in recurrent ovarian carcinoma pretreated with platinum-taxane - Results from a multicenter phase I/II study
- 2005
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Ingår i: Cancer. - : Wiley. - 1097-0142 .- 0008-543X. ; 103:7, s. 1388-1396
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND. The objectives of this study were to determine the maximum tolerable dose (MTD), toxicity, efficacy, and feasibility of a sequential regimen of fixed-dose topotecan (1.00 mg/m(2) on Days 1-5) and increasing doses of oral etoposide (50 mg, 75 mg, and 100 mg on Days 6-12 or Days 6-19) in patients with recurrent ovarian carcinoma. METHODS. This multicenter, open-label study was planned as a Phase I-II study that included patients with epithelial ovarian carcinoma who failed or who developed recurrent disease < 12 months after the end of platinum and taxane-containing chemotherapy. Dose-limiting toxicity (DLT) was defined as follows: Grade 4 neutropenia for > 1 week, or neutropenic fever 38.5 degrees C for > 24 hours/sepsis, or Grade 4 thrombocytopenia for > 1 week, or thrombocytopenia with bleeding, or Grade 3-4 nonhematologic toxicity. RESULTS. The MTD, as defined in the protocol, could not be settled because of unpredictable toxicity, because DLT was found at all dose levels except the starting dose level. In 28 patients (Phase I), 155 cycles were evaluable for toxicity. The main DLT was neutropenia Grade 4 for > 1 week or neutropenic fever/sepsis. Overall, neutropenia Grade 4 that lasted > 1 week and sepsis were noticed in 3% and 2% of cycles, respectively. Because no MTD was reached, the planned Phase II trial was not initiated. However, the patients from Phase I were followed until they developed progressive disease and, among them, 9 patients (32%) obtained an objective response (according to Response Evaluation Criteria in Solid Tumors (RECIST) or CA125 response criteria). CONCLUSIONS. Combined topotecan and oral etoposide was inappropriate in patients with recurrent ovarian carcinoma because of unpredictable hematologic toxicity. However, the high objective response rate highlighted the potential additive effect of topoisomerase I and II inhibitors.
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| 66. |
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| 67. |
- Hallböök, Helene, et al.
(författare)
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Treatment outcome in young adults and children > 10 years of age with acute lymphoblastic leukemia in Sweden : A comparison between a pediatric protocol and an adult protocol
- 2006
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Ingår i: Cancer. - : Wiley. - 0008-543X .- 1097-0142. ; 107:7, s. 1551-1561
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND. Several studies have reported a more favorable outcome for teenagers and young adults with acute lymphoblastic leukemia (ALL) when they were treated in pediatric oncology departments compared with adult hematology departments. However, biased risk grouping and high treatment-related mortality have hampered some of those comparisons. METHODS. In Sweden during the 1990s, adolescents with ALL were treated in a pediatric oncology unit or in an adult hematologic unit, depending on the initial referral. In the current national, comparative, retrospective study, patients with ALL aged 10 years to 40 years who were treated either according to the Nordic Society of Pediatric Hematology and Oncology (NOPHO) ALL protocol (1992-2000) (NOPHO-92 protocol) or according to the Swedish Adult ALL Group protocol (1994-2000) (Adult protocol) were included. None of the protocols had age as a high-risk criterion. RESULTS. In total, 243 patients with B-precursor and T-cell ALL were treated according to the protocols. There was a significant difference in the remission rate between the NOPHO-92 protocol (99%; n = 144 patients) and the Adult protocol (90%; n = 99 patients; P <.01), and the event-free survival (EFS) was also superior for the NOPHO-92 protocol compared with the Adult protocol (P <.01). However, EFS was higher for patients aged 15 years to 25 years compared with patients aged 26 years to 40 years within the Adult protocol group (P =.01). The treatment protocol itself was identified as an independent risk factor. CONCLUSIONS. The NOPHO-92 protocol resulted in a better outcome than the Adult protocol; therefore, adolescents may benefit from the pediatric protocol treatment strategy. Prospective trials are warranted to determine whether young adults would benefit from similar treatment.
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