Analysis of pretreatment nonpharmacologic, pharmacologic factors, and yoga intervention on CINV outcomes in breast cancer patients undergoing adjuvant chemotherapy.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 1093-1093
Author(s):  
Malur R. Usharani ◽  
Rao M. Raghavendra ◽  
Kodaganur Srinivasachar Gopinath ◽  
Ramesh Bilimagga S ◽  
Ravi B Diwakar ◽  
...  

1093 Background: Chemotherapy induced nausea and vomiting (CINV) is affected by both pretreatment patient factors, chemotherapy and antiemetic regimen and psychological interventions. In this study we evaluated the effects of mind body intervention such as yoga in modulating CINV outcomes controlled for the above factors. Methods: Chemotherapy naïve breast cancer patients with stage II and III disease participating in a randomized controlled trial comparing yoga (n=45) vs. supportive therapy (n=53) were assessed for CINV outcomes during adjuvant chemotherapy. Morrows Assessment of nausea and emesis was used to asses CINV symptoms including their frequency, severity and anticipatory nature. We developed a multiple regression analyses to test the role of intervention on CINV beyond that explained by the independent prognostic factors [age (<50/≥50 years), stage of disease (II vs III), menopausal status (pre vs post), antiemetic regimen (5HT3 antagonists vs. antidopaminergics), administration of anxiolytics (yes/ no) and type of chemotherapy regimen (FAC vs. CMF)] that were included in model A. Model B includes these six variables plus intervention (yoga vs. supportive therapy) in predicting nausea and vomiting outcomes. Results: Intervention emerged as a primary predictor for nausea frequency (β= -0.38, p=0.002), intensity (β= -0.44, p=0.001 ), anticipatory nausea frequency (β=-0.26 , p= 0.04) and intensity (β=-0.38 , p=0.004 ). Age group emerged as a primary predictor for anticipatory vomiting frequency (β=-0.39 , p=0.01 ) and secondary predictor for nausea frequency (β=-0.41, p= 0.006). Administration of anxiolytics emerged as a primary predictor for vomiting intensity (β=-0.40, p= 0.001) and secondary predictor for anticipatory nausea frequency (β=-0.26 , p= 0.05). Conclusions: Yoga intervention influences CINV outcomes when controlled for pretreatment and pharmacological factors during chemotherapy in breast cancer patients poorly controlled for nausea and vomiting.

1992 ◽  
Vol 9 (1) ◽  
pp. 25-31
Author(s):  
Peter W. Dunne ◽  
Matthew R. Sanders ◽  
John H. Kearsley

Cancer patients undergoing chemotherapy frequently experience anticipatory distress before treatment sessions. Eighty-six cancer patients (ovarian, lymphoma and breast) were assessed to determine the prevalence of anticipatory nausea and vomiting (ANV). Approximately one patient in three reported anticipatory nausea (AN), and of these 6 also experienced anticipatory vomiting (AV). Several patients reported anticipatory anxiety without any sensation of nausea. Clinically the notion of anticipatory distress may be more fruitful so that the problem of pretreatment anxiety is also addressed. Generally, AN was rated as moderate or worse in severity, occurred fairly consistently, and often began well before arrival at hospital on treatment day. It is suggested that future research should endeavour to link more closely the topography of the problem and the intervention techniques employed, as well as evaluating a broader range of possible interventions.


2020 ◽  
Vol 12 ◽  
pp. 175883592095835
Author(s):  
Wei-Ping Li ◽  
Hong-Fei Gao ◽  
Fei Ji ◽  
Teng Zhu ◽  
Min-Yi Cheng ◽  
...  

Background and aims: Male breast cancer is an uncommon disease. The benefit of adjuvant chemotherapy in the treatment of male breast cancer patients has not been determined. The aim of this study was to explore the value of adjuvant chemotherapy in men with stage I–III breast cancer, and we hypothesized that some male patients may safely skip adjuvant chemotherapy. Methods: Male breast cancer patients between 2010 and 2015 from the Surveillance Epidemiology and End Results database were included. Univariate and multivariate Cox analyses were used to analyse the factors associated with survival. The propensity score matching method was adopted to balance baseline characteristics. Kaplan–Meier curves were used to evaluate the impacts of adjuvant chemotherapy on survival. The primary endpoint was survival. Results: We enrolled 514 patients for this study, including 257 patients treated with chemotherapy and 257 patients without. There was a significant difference in overall survival (OS) but not in breast cancer-specific survival (BCSS) between the two groups ( p < 0.001 for OS and p = 0.128 for BCSS, respectively). Compared with the non-chemotherapy group, the chemotherapy group had a higher 4-year OS rate (97.5% versus 95.2%, p < 0.001), while 4-year BCSS was similar (98% versus 98.8%, p = 0.128). The chemotherapy group had longer OS than the non-chemotherapy group among HR+, HER2–, tumour size >2 cm, lymph node-positive male breast cancer patients ( p < 0.05). Regardless of tumour size, there were no differences in OS or BCSS between the chemotherapy and non-chemotherapy cohorts for lymph node-negative patients (OS: p > 0.05, BCSS: p > 0.05). Adjuvant chemotherapy showed no significant effects on both OS and BCSS in patients with stage I (OS: p = 0.100, BCSS: p = 0.858) and stage IIA breast cancer (OS: p > 0.05, BCSS: p > 0.05). Conclusion: For stage I and stage IIA patients, adjuvant chemotherapy could not improve OS and BCSS. Therefore, adjuvant chemotherapy might be skipped for stage I and stage IIA male breast cancer patients.


Author(s):  
Shozo Ohsumi ◽  
Sachiko Kiyoto ◽  
Mina Takahashi ◽  
Seiki Takashima ◽  
Kenjiro Aogi ◽  
...  

Abstract Purpose Scalp cooling during chemotherapy infusion to mitigate alopecia for breast cancer patients is becoming widespread; however, studies regarding hair recovery after chemotherapy with scalp cooling are limited. We conducted a prospective study of hair recovery after chemotherapy with scalp cooling. Patients and methods One hundred and seventeen Japanese female breast cancer patients who completed planned (neo)adjuvant chemotherapy using the Paxman Scalp Cooling System for alopecia prevention were evaluated for alopecia prevention in our prospective study. We evaluated their hair recovery 1, 4, 7, 10, and 13 months after chemotherapy. Primary outcomes were grades of alopecia judged by two investigators (objective grades) and patients’ answers to the questionnaire regarding the use of a wig or hat (subjective grades). Results Of 117 patients, 75 completed scalp cooling during the planned chemotherapy cycles (Group A), but 42 discontinued it mostly after the first cycle (Group B). Objective and subjective grades were significantly better in Group A than in Group B throughout 1 year, and at 4 and 7 months after chemotherapy. When we restricted patients to those with objective Grade 3 (hair loss of > 50%) at 1 month, Group A exhibited slightly faster hair recovery based on the objective grades than Group B. There was less persistent alopecia in Group A than in Group B. Conclusions Scalp cooling during chemotherapy infusion for Japanese breast cancer patients increased the rate of hair recovery and had preventive effects against persistent alopecia.


2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Teri L. Malo ◽  
Isaac Lipkus ◽  
Tobi Wilson ◽  
Hyo S. Han ◽  
Geza Acs ◽  
...  

Introduction. This study aimed to evaluate whether OncotypeDx test results predict receipt of adjuvant chemotherapy in breast cancer patients who received an OncotypeDx recurrence score (RS).Materials and Methods. Pathology records were used to identify breast cancer patients who had OncotypeDx testing between December 2004 and January 2009 (n=118). Patient sociodemographic information, tumor characteristics, RS, and treatment-specific data were collected via chart review. RS was classified as follows: low (RS≤17), intermediate (RS = 18–30), or high (RS≥31). Bivariate analyses were conducted to investigate the relationship between adjuvant chemotherapy receipt and each sociodemographic and clinical characteristic; significant sociodemographic and clinical variables were included in a multivariable logistic regression model.Results. In multivariable analysis controlling for tumor size, histologic grade, and nuclear grade, only RS remained significantly associated with chemotherapy uptake. Relative to low RS, an intermediate (adjusted odds ratio [AOR], 21.24; 95% confidence interval [CI], 3.62–237.52) or high (AOR, 15.07; 95% CI, 1.28–288.21) RS was associated with a greater odds of chemotherapy uptake.Discussion. Results indicate that RS was significantly associated with adjuvant chemotherapy uptake, suggesting that OncotypeDx results were used to inform treatment decision making, although it is unclear if and how the information was conveyed to patients.


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