Quality of Life in Patients with Good Prognosis Metastatic Germ Cell Tumours: Comparison of Four Chemotherapy Schedules (EORTC 30941/MRC TE20)

2002 ◽  
pp. 183-195 ◽  
Author(s):  
S. D. Fosså ◽  
◽  
L. Collette ◽  
N. Aaronson ◽  
R. de Wit ◽  
...  
2009 ◽  
Vol 7 (2) ◽  
pp. 467
Author(s):  
R. Rajendranath ◽  
C.N. Patil ◽  
S. Veluswami ◽  
S. Tenali ◽  
S. Vishwanathan

2021 ◽  
pp. 1-11
Author(s):  
Sabine Kliesch ◽  
Stefanie Schmidt ◽  
Doris Wilborn ◽  
Clemens Aigner ◽  
Walter Albrecht ◽  
...  

<b><i>Objectives:</i></b> We developed the first German evidence- and consensus-based clinical guideline on diagnosis, treatment, and follow-up of germ cell tumours (GCT) of the testes in adult patients. We present the guideline content in 2 separate publications. The present second part summarizes the<b><i></i></b>recommendations for the treatment of advanced disease stages and for the management of follow-up and late effects. <b><i>Materials and Methods:</i></b> An interdisciplinary panel of 42 experts including 1 patient representative developed the guideline content. Clinical recommendations and statements were based on scientific evidence and expert consensus. For this purpose, evidence tables for several review questions, which were based on systematic literature searches (last search in March 2018), were provided. Thirty-one experts, who were entitled to vote, rated the final clinical recommendations and statements. <b><i>Results:</i></b> Here we present the treatment recommendations separately for patients with metastatic seminoma and non-seminomatous GCT (stages IIA/B and IIC/III), for restaging and treatment of residual masses, and for relapsed and refractory disease stages. The recommendations also cover extragonadal and sex cord/stromal tumours, the management of follow-up and toxicity, quality-of-life aspects, palliative care, and supportive therapy. <b><i>Conclusion:</i></b> Physicians and other medical service providers who are involved in the diagnostics, treatment, and follow-up of GCT (all stages, outpatient and inpatient care as well as rehabilitation) are the users of the present guideline. The guideline also comprises quality indicators for measuring the implementation of the guideline recommendations in routine clinical care; these data will be presented in a future publication.


2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii329-iii329
Author(s):  
Bo Li

Abstract BACKGROUND The optimal radiation field in patients with bifocal germ cell tumours(GCTs) is controversial, especially in non-metastatic cases. Accordingly, we analysed the survival, growth, and health-related quality of life (HRQOL) data of patients with bifocal GCTs. METHODS The data of 87 patients diagnosed with bifocal GCTs at our hospital during the last 10 years were collected. The WHO AnthroPlus software—used to monitor the growth of persons aged 5–19 years—was employed to calculate the Z-score of height (ZSOH) at diagnosis and the last follow-up. The absolute change in the ZSOH was defined as |ZSOH last follow-up - ZSOH diagnosis|. The Pediatric Quality of Life Inventory 4.0 was used to evaluate HRQOL. RESULTS The median follow-up was 49 months (range,6–134 months). Among 49 patients with non-metastatic germinoma, those receiving cranial spinal irradiation(CSI; n=12) or whole-brain radiotherapy (WBRT; n=34) had comparable disease-free survival (DFS;p=0.54), but better DFS than those receiving focal radiotherapy(n=3;p=0.016). Furthermore, among 17 patients with non-metastatic non-germinomatous GCTs, DFS was not significantly different between those treated with CSI(n=4) and those receiving WBRT(n=13;p=0.11). Twenty-nine patients had paired ZSOH data at both diagnosis and the last follow-up. Patients receiving CSI(p=0.026) or &gt;40Gy(p=0.048) experienced a significant decline of absolute change in the ZSOH. HRQOL analysis(n=35) did not reveal difference between patients receiving CSI and those not receiving CSI. CONCLUSIONS Given the comparable DFS and HRQOL but negative impact on growth, CSI could be spared, especially in patients with non-metastatic bifocal germinoma.


2001 ◽  
Vol 19 (6) ◽  
pp. 1629-1640 ◽  
Author(s):  
Ronald de Wit ◽  
J. Trevor Roberts ◽  
Peter M. Wilkinson ◽  
Pieter H.M. de Mulder ◽  
Graham M. Mead ◽  
...  

PURPOSE: To test the equivalence of three versus four cycles of bleomycin, etoposide, and cisplatin (BEP) and of the 5-day schedule versus 3 days per cycle in good-prognosis germ cell cancer. PATIENTS AND METHODS: The study was designed as a 2 × 2 factorial trial. The aim was to rule out a 5% decrease in the 2-year progression-free survival (PFS) rate. The study included the assessment of patient quality of life. A cycle of BEP consisted of etoposide 500 mg/m2, administered at either 100 mg/m2 days 1 through 5 or 165 mg/m2 days 1 through 3, cisplatin 100 mg/m2, administered at either 20 mg/m2 days 1 through 5 or 50 mg/m2 days 1 and 2. Bleomycin 30 mg was administered on days 1, 8, and 15 during cycles 1 through 3. The randomization procedure allowed some investigators to participate only in the comparison of three versus four cycles. RESULTS: From March 1995 until April 1998, 812 patients were randomly assigned to receive three or four cycles: of these, 681 were also randomly assigned to the 5-day or the 3-day schedule. Histology, marker values, and disease extent are well balanced in the treatment arms of the two comparisons. The projected 2-year PFS is 90.4% on three cycles and 89.4% on four cycles. The difference in PFS between three and four cycles is −1.0% (80% confidence limit [CL], −3.8%, +1.8%). Equivalence for three versus four cycles is claimed because both the upper and lower bounds of the 80% CL are less than 5%. In the 5- versus 3-day comparison, the projected 2-year PFS is 88.8% and 89.7%, respectively (difference, −0.9%, (80% CL, −4.1%, +2.2%). Hence, equivalence is claimed in this comparison also. Frequencies of hematologic and nonhematologic toxicities were essentially similar. Quality of life was maintained better in patients receiving three cycles; no differences were detected between 3 and 5 days of treatment. CONCLUSION: We conclude that three cycles of BEP, with etoposide at 500 mg/m2, is sufficient therapy in good-prognosis germ cell cancer and that the administration of the chemotherapy in 3 days has no detrimental effect on the effectiveness of the BEP regimen.


10.2196/13409 ◽  
2020 ◽  
Vol 9 (3) ◽  
pp. e13409 ◽  
Author(s):  
Evanthia Giannoula ◽  
Ioannis Iakovou ◽  
Ioannis Katsikavelas ◽  
Panagiotis Antoniou ◽  
Vasilios Raftopoulos ◽  
...  

Background Thyroid cancer (TC) is one of the fastest growing cancers all over the world. Differentiated thyroid cancer (DTC) is the most frequent subtype of TC. When appropriate treatment is given, the prognosis for the patient is generally excellent. Despite the generally good prognosis of thyroid carcinomas, the symptoms may range from emotional to physical discomfort, depending on the thyroid hormone status, which can severely affect the patient. Moreover, the diagnostic and therapeutic procedures that DTC patients have to undergo, such as thyroidectomy and radioiodine therapy, significantly affect their mental and physical well-being. Often, the physician only addresses the favorable prognosis of DTC compared with other cancer types and neglects to assess issues related to the quality of life (QoL) of the patient; this was the reason we decided to design a mobile app for DTC patients and their caregivers. Objective The aim of this study is to research the feasibility and applicability of an mHealth app tailored to DTC patients, as reflected in their QoL. The main features of the developed app offer access to useful information about thyroid cancer, diagnostic tests, and the appropriate therapy administered to DTC patients. Methods Based on the existing literature, we created an up-to-date information platform regarding TC and especially DTC. In order to develop an effective app that can be implemented in current health care, we designed a section where the patient and physician can keep a medical record in an effort to enable access to such information at any time. Finally, we designed a user-friendly notification program, including pill prescription, follow-up tests, and doctor visit reminders in order to equally facilitate the lives of the patient and physician. Results Having developed this mobile app, we aim to conduct a pilot quasiexperimental interventional trial. Our intention is to enroll at least 30 TC patients and assign them to intervention or control groups. Both groups will receive standard care for treating and monitoring TC, and the intervention group will also receive and use the DTC app. TC patients’ QoL will be assessed for both control and intervention groups in order to examine the effectiveness of the DTC app. QoL will be assessed through the QoL core questionnaire European Organisation for Research and Treatment of Cancer (EORTC) QLQ-THY34 in combination with the EORTC QLQ-C30 questionnaire through quantitative statistical analysis. Conclusions The use of mHealth apps can play a significant role in patient education, disease self-management, remote monitoring of patients, and QoL improvement. However, the main limitation of the majority of existing studies has been the lack of assessing their usefulness as well as the absence of specific instruments to carry out this assessment. In light of those considerations, we developed a mobile app tailored to the needs of DTC patients. Furthermore, we evaluated its contribution to the QoL of the patients by using the EORTC QLQ-THY34 questionnaire, an accurate and safe instrument for the evaluation of the QoL in TC patients, while supporting future planned endeavors in the field. International Registered Report Identifier (IRRID) PRR1-10.2196/13409


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