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chemotherapy versus palliative care

Sushilkumar Satish Gupta, Abhinav Binod Chandra
205 Background: Indwelling pleural catheter (IPC) placement is an alternative to chemical pleurodesis for malignant pleural effusion (MPE), a complication of advanced cancer. In 1997 an IPC was approved which uses vacuum bottles (VB) for drainage (PleurX, Becton, Dickinson and Company, Franklin Lakes, NJ), and later another IPC system, which employs a manually operated vacuum pump (VP) for drainage (Aspira, Bard Access Systems, Salt Lake City, UT). Most studies comparing IPC versus chemical pleurodesis used the VB IPC...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Raymond Mailhot Vega, Lisa Zullig, Alissa Wassung, Dorella Walters, Noah Berland, Kevin Lee Du, Jiyoung Ahn, Cynthia G Leichman, Deirdre Jill Cohen, Ping Gu, Abraham Chachoua, Lawrence P Leichman, Karen Pearl, Peter B Schiff
155 Background: Malnutrition incidence in cancer approaches 85%, disproportionately burdening those with lung, GI, and advanced stage cancers. Malnourished patients have impaired chemotherapy response, shorter survival, longer hospital stays, and decreased QoL. Home delivered meals are nutritional interventions that improve patient well-being, nutrition, and lower healthcare costs in the elderly but have not been studied as an intervention in cancer patients. HDMTM are nutritionist prescribed home delivered meals tailored to patient's symptoms, co-morbidities, and health needs...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Marco Maltoni, Emanuela Scarpi, Monia Dall'Agata, Stefania Schiavon, Claudia Biasini, Carla Codecà, Chiara Maria Broglia, Elisabetta Sansoni, Roberto Bortolussi, Ferdinando Garetto, Luisa Fioretto, Maria Teresa Cattaneo, Alice Giacobino, Massimo Luzzani, Giovanna Luchena, Sara Alquati, Silvia Quadrini, Vittorina Zagonel, Luigi Cavanna, Daris Ferrari, Paolo Pedrazzoli, Giovanni Luca Frassineti, Antonella Galiano, Andrea Casadei Gardini, Manlio Monti, Oriana Nanni
AIM: Early palliative care (EPC) in oncology has shown sparse evidence of a positive impact on patient outcomes, quality of care outcomes and costs. PATIENTS AND METHODS: Data for this secondary analysis were taken from a trial of 207 outpatients with metastatic pancreatic cancer randomly assigned to receive standard cancer care plus on-demand EPC (standard arm) or standard cancer care plus systematic EPC (interventional arm). After 20 months' follow-up, 149 (80%) had died...
December 2016: European Journal of Cancer
Ikuto Tsukiyama, Masayuki Ejiri, Yoshihiro Yamamoto, Haruhisa Nakao, Masashi Yoneda, Katsuhiko Matsuura, Ichiro Arakawa, Hiroko Saito, Tadao Inoue
OBJECTIVES: This study assessed the cost-effectiveness of combination treatment with gemcitabine and cisplatin compared to treatment with gemcitabine alone for advanced biliary tract cancer (BTC) in Japan. METHODS: A monthly transmitted Markov model of three states was constructed based on the Japan BT-22 trial. Transition probabilities among the health states were derived from a trial conducted in Japan and converted to appropriate parameters for our model. The associated cost components, obtained from a receipt-based survey undertaken at the Aichi Medical University Hospital, were those related to inpatient care, outpatient care, and treatment for BTC...
October 26, 2016: Journal of Gastrointestinal Cancer
Tomohiro Enokida, Shinya Suzuki, Tetsuro Wakasugi, Tomoko Yamazaki, Susumu Okano, Makoto Tahara
BACKGROUND: Hypomagnesemia is a common adverse event during cetuximab (Cmab) treatment. However, few reports have investigated the incidence and risk factors of hypomagnesemia in head and neck cancer patients treated with Cmab. METHODS: We retrospectively reviewed 131 head and neck cancer patients who received Cmab-containing therapy. Main eligibility criteria were ≥3 Cmab administrations, no prior EGFR-directed therapy, and no prophylactic Mg supplementation...
2016: Frontiers in Oncology
Matthew Chan, Kiara Hugh-Yeun, Gillian Gresham, Caroline H Speers, Hagen F Kennecke, Winson Y Cheung
BACKGROUND: We compared the patterns and factors associated with chemotherapy and bevacizumab use in elderly versus young patients with metastatic colon cancer (mCC) and determined the effect of systemic therapy on overall survival (OS) according to age. MATERIALS AND METHODS: Patients diagnosed with mCC from 2009 to 2010 in British Columbia, Canada were reviewed and categorized as elderly patients (age ≥ 70 years) and young patients (age < 70 years). Cox regression models adjusted for age and confounders were used to determine the effect of systemic therapy on OS...
August 30, 2016: Clinical Colorectal Cancer
E J Denton, D Hart, Z Wainer, G Wright, P A Russell, M Conron
BACKGROUND: Lung cancer accounts for significant morbidity and mortality worldwide. The effect of recent changes in demographics and management on outcomes in Australia has not been clearly defined. AIMS: To compare three consecutive lung cancer cohorts to evaluate emergent differences in diagnosis, management and mortality. METHODS: For comparative analysis, 2119 lung cancer patients were divided into three successive cohorts. Current death data were sought from the Victorian Cancer Registry...
August 2016: Internal Medicine Journal
Ulla Näppä, Olav Lindqvist, Birgit H Rasmussen, Bertil Axelsson
PURPOSE: Palliative chemotherapy treatment (PCT) offered late in the cancer disease trajectory may be problematic. It is not easy to accurately calculate whether the potential benefits will outweigh the side-effects. This study investigates whether routine use of the Performance Status in Palliative Chemotherapy questionnaire (PSPC) affects the proportions of patients receiving PCT during the last month of life, care utilization, and documentation routines. A secondary aim was to gather registered nurses' experiences of the PSPC in routine use...
April 2016: European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society
Krista L Noonan, Cheryl Ho, Janessa Laskin, Nevin Murray
Over the past three decades, survival in advanced non-small-cell lung cancer (NSCLC) clinical trials has doubled with an increase in 1-year survival from 25% to 50 to 55%. This has been mainly attributed to improvements in systemic therapy. Although modern first-line chemotherapy regimens have more favorable toxicity profiles, a statistically significant improvement in overall survival has not been demonstrated in existing meta-analyses of second-generation versus third-generation combinations. Moreover, pivotal trials demonstrating statistically significant survival superiority of third-generation regimens are consistently not reproducible even for nonsquamous populations using pemetrexed-platinum combinations...
November 2015: Journal of Thoracic Oncology
Hari Shankar Shukla, Bhawna Sirohi, Anu Behari, Atul Sharma, Jahar Majumdar, Manomoy Ganguly, Mallika Tewari, Sandeep Kumar, Sunil Saini, Peush Sahni, Tomcha Singh, Vinay Kumar Kapoor, V Sucharita, Tanvir Kaur, Deepak Kumar Shukla, Goura Kishor Rath
The document is based on consensus among the experts and best available evidence pertaining to Indian population and is meant for practice in India.All postcholecystectomy gallbladder specimens should be opened and examined carefully by the operating surgeon and be sent for histopathological examination.All "incidental" gall bladder cancers (GBCs) picked up on histopathological examination should have an expert opinion.Evaluation of a patient with early GBC should include essential tests: A computed tomography (CT) scan (multi-detector or helical) of the abdomen and pelvis for staging with a CT chest or chest X-ray, and complete blood counts, renal and liver function tests...
April 2015: Indian Journal of Medical and Paediatric Oncology
Areej R El-Jawahri, Gregory A Abel, David P Steensma, Thomas W LeBlanc, Amir T Fathi, Timothy A Graubert, Daniel J DeAngelo, Martha Wadleigh, Karen K Ballen, Julia E Foster, Eyal C Attar, Philip C Amrein, Andrew M Brunner, Richard M Stone, Jennifer S Temel
BACKGROUND: Health care utilization in older adults (age ≥60 years) with acute myeloid leukemia (AML) has not been well studied. METHODS: We conducted a retrospective analysis of 330 consecutive older patients who were diagnosed with AML between May 1, 2005 and December 23, 2011, at 2 hospitals in Boston to examine their health care utilization and end-of-life care. Using multivariable logistic and linear regression models adjusting for covariates, we also compared health care utilization between patients who received intensive induction chemotherapy (n = 197; cytarabine/ anthracycline combination) versus nonintensive chemotherapy (n = 133; single-agent therapy)...
August 15, 2015: Cancer
Marie A Bakitas, Tor D Tosteson, Zhigang Li, Kathleen D Lyons, Jay G Hull, Zhongze Li, J Nicholas Dionne-Odom, Jennifer Frost, Konstantin H Dragnev, Mark T Hegel, Andres Azuero, Tim A Ahles
PURPOSE: Randomized controlled trials have supported integrated oncology and palliative care (PC); however, optimal timing has not been evaluated. We investigated the effect of early versus delayed PC on quality of life (QOL), symptom impact, mood, 1-year survival, and resource use. PATIENTS AND METHODS: Between October 2010 and March 2013, 207 patients with advanced cancer at a National Cancer Institute cancer center, a Veterans Affairs Medical Center, and community outreach clinics were randomly assigned to receive an in-person PC consultation, structured PC telehealth nurse coaching sessions (once per week for six sessions), and monthly follow-up either early after enrollment or 3 months later...
May 1, 2015: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Manuel Segura-González, Miguel Quintana-Quintana
Metastatic breast cancer as initial onset represents between 20 and 30 % of cases and is considered an incurable disease. The goal of its treatment is palliative, looking for increasing the survival while reducing the symptoms. Maintenance chemotherapy studies for metastatic breast cancer have demonstrated to prolong the progression-free survival, with unclear results in terms of overall survival. The main objectives of our study were the progression-free survival and overall survival in patients with recurring or metastatic breast cancer treated with capecitabine in the maintenance chemotherapy setting compared with patients not receiving maintenance chemotherapy...
April 2015: Medical Oncology
K J Roberts, A J Sutton, K R Prasad, G J Toogood, J P A Lodge
BACKGROUND: Surgical resection of colorectal liver metastases (CRLMs) is the standard of care when possible, although this strategy has not been compared with non-operative interventions in controlled trials. Although survival outcomes are clear, the cost-effectiveness of surgery is not. This study aimed to estimate the cost-effectiveness of resection for CRLMs compared with non-operative treatment (palliative care including chemotherapy). METHODS: Operative and non-operative cohorts were identified from a prospectively maintained database...
March 2015: British Journal of Surgery
Clémence Guenne, Jérôme Fayette, Alain Cosmidis, Carine Fuchsmann, Sophie Tartas, Véronique Favrel, Philippe Céruse
BACKGROUND: No specific study has focused on patients with metastatic squamous cell carcinoma of the head and neck (SCCHN) at diagnosis. Due to high response rates of induction chemotherapy in chemo-naïve patients with localized disease, their prognosis should be better than patients with recurrent disease. METHODS: From January 1, 2008 to July 1, 2012, we retrospectively collected all patients' records with SCCHN diagnosed as metastatic. Patients, disease, treatment and its results were analyzed...
2014: Drug Design, Development and Therapy
Pierre Bories, Sarah Bertoli, Emilie Bérard, Julie Laurent, Eliane Duchayne, Audrey Sarry, Eric Delabesse, Odile Beyne-Rauzy, Françoise Huguet, Christian Récher
We assessed in a French regional healthcare network the distribution of treatments, prognostic factors, and outcome of 334 newly diagnosed acute myeloid leukemia patients aged 60 years or older over a 4-year period of time (2007-2010). Patients were selected in daily practice for intensive chemotherapy (n = 115), azacitidine (n = 95), or best supportive care (n = 124). In these three groups, median overall survival was 18.9, 11.3, and 1.8 months, respectively. In the azacitidine group, multivariate analysis showed that overall survival was negatively impacted by higher age (P = 0...
December 2014: American Journal of Hematology
J S Abramson, T Feldman, A R Kroll-Desrosiers, L S Muffly, E Winer, C R Flowers, F Lansigan, C Nabhan, L J Nastoupil, R Nath, A Goy, J J Castillo, D Jagadeesh, B Woda, S T Rosen, S M Smith, A M Evens
BACKGROUND: Optimal frontline therapy for peripheral T-cell lymphoma (PTCL) in the modern era remains unclear. PATIENTS AND METHODS: We examined patient characteristics, treatment, and outcomes among 341 newly diagnosed PTCL patients from 2000 to 2011. Outcome was compared with a matched cohort of diffuse large B-cell lymphoma (DLBCL) patients, and prognostic factors were assessed using univariate and multivariate analyses. RESULTS: PTCL subtypes included PTCL, not otherwise specified (PTCL-NOS) (31%), anaplastic large T-cell lymphoma (ALCL) (26%), angioimmunoblastic T-cell lymphoma (23%), NK/T-cell lymphoma (7%), acute T-cell leukemia/lymphoma (6%), and other (7%)...
November 2014: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Fernanda Capella Rugno, Bianca Sakamoto Ribeiro Paiva, Carlos Eduardo Paiva
OBJECTIVES: To evaluate some health indicators in women with advanced breast or gynecological cancers (ABGCs) after discontinuation of active cancer treatment in function of the model of care received. METHODS: This prospective study included patients who were discontinuing anticancer treatment to be followed up only with palliative care (PC). Patients who had been evaluated at least once in PC were categorized as the integrated care model (ICM); those who had not been consulted by the PC team before, as the traditional care model (TCM)...
November 2014: Gynecologic Oncology
Ahmed A Zeeneldin, Hanan Ramadan, Mosaad M El Gammal, Magdy M Saber, Dina Elgamal, Mohamed A Sherisher
BACKGROUND AND AIMS: To study the clinico-pathological features, treatments and outcomes of gastric carcinoma (GC) in the elderly (⩾65 years) and the non-elderly Egyptian patients. METHODS: This retrospective cohort study included 168 patients with histologically confirmed GC treated at Tanta Cancer Center between 2003 and 2007. RESULTS: Compared to the non-elderly, elderly patients had significantly higher proportion of tumors involving the cardia (p=0...
September 2014: Journal of the Egyptian National Cancer Institute
Anandi H W Schiphorst, Norbert M Verweij, Apollo Pronk, Marije E Hamaker
BACKGROUND: Care for elderly patients with low rectal cancer can pose dilemmas, because radical total mesorectal excision surgery comes with high morbidity and mortality rates. OBJECTIVE: The purpose of this study was to analyze the treatment of patients with low rectal cancer, comparing treatment choices, guideline adherence, and outcomes for elderly patients (≥75 years) with younger patients (<75 years). DESIGN: Patient data were retrieved from the hospital pathology database and from the hospital prospective colorectal surgery database for surgically treated patients...
August 2014: Diseases of the Colon and Rectum
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