Does poor management of side effects compromise treatment outcome? An oncologists view

1997 ◽  
Vol 33 ◽  
pp. S72
Author(s):  
P. Harper
Keyword(s):  
Treatment Outcome ◽  
Side Effects ◽  
Poor Management

scholarly journals Digitalization of adverse event management in oncology to improve treatment outcome—A prospective study protocol

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252493
Author(s):  
Angelika M. R. Kestler ◽  
Silke D. Kühlwein ◽  
Johann M. Kraus ◽  
Julian D. Schwab ◽  
Robin Szekely ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Treatment Outcome ◽  
Side Effects ◽  
Adverse Events ◽  
Study Protocol ◽  
Reporting System ◽  
Smartphone Application ◽  
Patient Reporting ◽  
The Impact

The occurrence of adverse events frequently accompanies tumor treatments. Side effects should be detected and treated as soon as possible to maintain the best possible treatment outcome. Besides the standard reporting system Common Terminology Criteria for Adverse Events (CTCAE), physicians have recognized the potential of patient-reporting systems. These are based on a more subjective description of current patient reporting symptoms. Patient-reported symptoms are essential to define the impact of a given treatment on the quality of life and the patient’s wellbeing. They also act against an underreporting of side effects which are paramount to define the actual value of a treatment for the individual patient. Here, we present a study protocol for a clinical trial that assesses the potential of a smartphone application for CTCAE conform symptom reporting and tracking that is adjusted to the standard clinical reporting system rather than symptom oriented descriptive trial tools. The presented study will be implemented in two parts, both lasting over six months. The first part will assess the feasibility of the application with 30 patients non-randomly divided into three equally-sized age groups (<55years, 55-75years, >75years). In the second part 36 other patients will be randomly assigned to two groups, one reporting using the smartphone and one not. This prospective second part will compare the impact of smartphone reported adverse events regarding applied therapy doses and quality of life to those of patients receiving standard care. We aim for early detection and treatment of adverse events in oncological treatment to improve patients’ safety and outcomes. For this purpose, we will capture frequent adverse events of chemotherapies, immunotherapies, or other targeted therapies with our smartphone application. The presented trial is registered at the U.S. National Library of Medicine ClinicalTrials.gov (NCT04493450) on July 30, 2020.

Volumetric follow up of brain metastases: a useful method to evaluate treatment outcome and predict survival after Gamma Knife surgery?

2006 ◽  
Vol 105 (Supplement) ◽  
pp. 91-98 ◽  
Author(s):  
Guenther Christian Feigl ◽  
Gerhard A. Horstmann
Keyword(s):  
Treatment Outcome ◽  
Side Effects ◽  
Brain Metastases ◽  
Gamma Knife ◽  
Gamma Knife Surgery ◽  
Tumor Control ◽  
Tumor Type ◽  
The Mean

ObjectBrain metastases are diagnosed in 20 to 40% of all cancer patients and are associated with a considerable drop in life expectancy and often also in quality of life for these patients. Several treatment options are available including surgery, chemotherapy, whole-brain radiotherapy, stereotactic radiotherapy, stereotactic radiosurgery, and Gamma Knife surgery (GKS). However, management of brain metastases still presents a challenge and there is no general consensus on the best treatment strategy. The aim of the authors' study was to further evaluate the efficacy of GKS in the treatment of brain metastases and to evaluate the predictive value of volumetric tumor follow-up measurement.MethodsConsecutive patients with controlled systemic cancer and variable numbers of brain metastases were included in this prospective study. Patients with severe symptoms of brain compression underwent surgery before GKS. Each follow-up examination included a thorough neurological examination and a neuroradiological quantitative volumetric tumor analysis.A total of 300 consecutive patients (mean age 58 years) with 703 brain metastases were treated between December 1998 and October 2005. The mean total tumor volume (TTV) was 2.1 cm3. The overall local tumor control rate was 84.5%. In 79% of all treated metastases a mean TTV reduction of 84.7% was achieved using a mean prescription dose of 21.8 Gy. Only few, mostly mild, side effects were observed during the mean follow-up period of 12.7 months. The overall mean progression-free survival period was 9.4 months. There was a statistically significant difference in survival of patients with one compared with multiple metastases, regardless of the histological type and preceding treatment.Conclusions Gamma Knife surgery is a safe and effective treatment for patients with brain metastases regardless of the history of treatment and histological tumor type. It achieves excellent tumor control, significant TTV reduction without causing severe side effects, and accordingly, preserves quality of live. Volume changes after GKS did not serve as a predictor for treatment outcome and survival.

Treatments for Depression

2013 ◽  
pp. 508-514
Author(s):  
Dan V. Iosifescu ◽  
James W. Murrough ◽  
Dennis S. Charney
Keyword(s):  
Treatment Outcome ◽  
Side Effects ◽  
Mechanisms Of Action ◽  
Special Populations ◽  
Significant Morbidity ◽  
Antidepressant Treatments ◽  
Treatment Of Depression ◽  
Antidepressant Efficacy ◽  
Natural Remedies ◽  
Significant Data

Since major depression is associated with significant morbidity and functional impairment, effective treatments are very important. This chapter reviews several categories of currently available antidepressant treatments (including the major classes of pharmacotherapies, somatic treatments, psychotherapies and natural remedies), attempting to review key findings regarding mechanisms of action, antidepressant efficacy and major side effects. We will also review significant data related to biomarkers of treatment outcome and to treatment of depression in special populations (e.g., psychotic, melancholic, atypical, postpartum, bipolar). We will conclude with a review of future antidepressant treatments currently in development.

Clinical Significance of Plasma Drug and Prolactin Levels During Acute Chlorpromazine Treatment: A Replication Study

1979 ◽  
Vol 135 (4) ◽  
pp. 352-359 ◽  
Author(s):  
Tamara Kolakowska ◽  
Michael Orr ◽  
Michael Gelder ◽  
Manuela Heggie ◽  
David Wiles ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Side Effects ◽  
Mental State ◽  
Plasma Prolactin ◽  
Extrapyramidal Side Effects ◽  
Plasma Drug ◽  
Drug Plasma ◽  
Poor Treatment ◽  
Poor Treatment Outcome ◽  
Plasma Prl

SummaryNineteen patients with acute psychoses, the majority schizophrenics, were studied in the course of chlorpromazine (CPZ) treatment. Plasma levels of the drug, plasma prolactin (PRL), extrapyramidal side-effects (EPS) and changes in mental state were monitored weekly, as in our earlier study. The results confirm some of our previous findings: (a) plasma CPZ levels vary widely among patients and correlate poorly with daily doses of CPZ; (b) increased plasma PRL is associated with higher plasma CPZ levels and is more common among the patients who develop EPS; and (c) none of these three variables differ between groups of patients with good and poor treatment outcome. However we did not confirm our previous finding of a significant association between EPS and higher plasma CPZ, nor did we find that the ratio of CPZ-sulphoxide to CPZ differed between the improved patients and the rest.

scholarly journals Training and Skills-Gaining Fellowship for Cancer Radiotherapy Planning and Treatment With 3D-CRT in Ghana

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 92s-92s
Author(s):  
S.S. Meena ◽  
R. Chambuso ◽  
C. Edusa
Keyword(s):  
Treatment Outcome ◽  
Side Effects ◽  
Early Treatment ◽  
Conformal Radiotherapy ◽  
Radiotherapy Planning ◽  
Fellowship Program ◽  
Intensity Modulated ◽  
Treatment Techniques ◽  
2D And 3D ◽  
3D Crt

Background: The global incidence of cancer is rising, especially in low and middle income countries. Radiotherapy is important in cancer treatment of curative and palliative care, either alone or in combination with other treatment modalities. However radiotherapy techniques have evolved from two dimensional (2D) to three-dimensional conformal radiotherapy (3D-CRT) and intensity modulated radiotherapy (IMRT). In addition, this new image-based treatment planning reduces the volume of surrounding normal tissues to be irradiated unnecessarily and being exposed to high dose of radiation. Thus improves treatment outcome while reducing treatment related toxicities. Aim: To train and gain skills in radiotherapy planning and treatment with modern radiation 3D-CRT technology in Ghana. Methods: Hospital based cross sectional study will be conducted at the Sweden Ghana Medical Centre in Ghana and the Ocean Road Cancer Institute (ORCI), in Tanzania. We will recruit patients with a convenient sample size, from different cancer diagnosis and stages after obtaining their signed consents. The outcome from 2D and 3D planning and treatment techniques will be compared. We will use pretreatment CT scan images to assess tumor size prior to treatment and posttreatment CT scan images to assess treatment response. Furthermore, the WHO toxicity grading criteria will be used to assess early treatment related side effects between 2D and 3D treatment techniques. Results: I have not yet been on the fellowship program, I will go to Ghana on 1st May 2018 and am expecting to finish my fellowship at the end of May 2018. I will have a final report concerning my fellowship project by August 2018, hence I will present the results of my visit to the World Cancer Congress in October 2018. I will also share my skills and knowledge obtained during my fellowship program in Ghana to my home institution and other cancer care hospitals in Tanzania through regular conference meetings, Continuous Medical Education (CME) sessions and during my daily clinical practice while supervising postgraduate students pursuing masters of medicine in clinical oncology. After data analysis, I expect my results will show better treatment outcome with minimal early treatment side effects in 3D than 2D radiotherapy planning and treatment techniques. Conclusion: This training will significantly improve patient's treatment outcomes, care and quality of life due to minimum tissue damage after 3D conformal radiotherapy with intensity modulated radiation.

scholarly journals Profil and Evaluation of Resistant Tuberculosis Drug’s Side Effect in Diabetes and Non Diabetes Mellitus Patient at RSUD Arifin Achmad

2020 ◽  
Vol 40 (3) ◽  
pp. 156-162
Author(s):  
Dani Rosdiana ◽  
Dewi Anggraini ◽  
Indra Yovi ◽  
Marlina Tasril
Keyword(s):  
Diabetes Mellitus ◽  
Treatment Outcome ◽  
Side Effects ◽  
Side Effect ◽  
Diabetes Mellitus Patient ◽  
Cross Sectional ◽  
Resistant Tuberculosis ◽  
High Prevalence ◽  
Complete Treatment ◽  
Mdr Tb

Backgrounds: Diabetes mellitus (DM) increases the risk of reactivation of tuberculosis included multi-resistant drug tuberculosis (MDR-TB). This situation is threatening Riau province due to the high prevalence of DM. Since 2014 Arifin Achmad Hospital as a referral hospital of MDR-TB management. It’s treatment especially in DM patients, requires an evaluation of both outcome and side effects. This evaluation needs to be compared with non-DM MDR TB patients. The aim of this study was to evaluate and analyse patient’s characteristic, conversion of smear or culture, drugs side effect and treatment outcome. Methods: This is a cross sectional retrospective study in RSUD Arifin Achmad Pekanbaru on April-October 2018. Sample of this study were all patients from 2014 – 2017. This study was divided into 2 groups, namely the DM and non-DM groups, then analysed the differences between the two groups Results: There were 113 MDR TB patients had its treatment, which 61% of the patients were male. Baseline data show 26.5% of MDR TB patients have comorbid DM. The most common side effects were nausea and vomiting (100%) in all subjects. In the MDR TB DM group, we found included: well controlled plasma glucose level was 33.3%, severe side effects was16.7%, conversion in the second month 40% and cured or complete treatment was 30%. Conclusions: As many as 26,5% of MDR TB patients had DM comorbidity. There were no differences in the percentage of drugs side effects, smear conversion in the second month and treatment outcome between MDR TB DM and MDR TB non-DM group. (J Respir Indo. 2020; 40(3): 156-62)

scholarly journals Antidepressant side effects and their impact on treatment outcome in people with major depressive disorder: an iSPOT-D report

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Taylor A. Braund ◽  
Gabriel Tillman ◽  
Donna M. Palmer ◽  
Evian Gordon ◽  
A. John Rush ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Treatment Outcome ◽  
Side Effects ◽  
Depressive Disorder ◽  
Anxiety Symptoms ◽  
Post Treatment ◽  
Major Depressive ◽  
Treatment Type ◽  
The Impact ◽  
Frequency Intensity

AbstractSide effects to antidepressant medications are common and can impact the prognosis of successful treatment outcome in people with major depressive disorder (MDD). However, few studies have investigated the severity of side effects over the course of treatment and their association with treatment outcome. Here we assessed the severity of side effects and the impact of treatment type and anxiety symptoms over the course of treatment, as well as whether side effects were associated with treatment outcome. Participants were N = 1008 adults with a current diagnosis of single-episode or recurrent, nonpsychotic MDD. Participants were randomised to receive escitalopram, sertraline, or venlafaxine-extended release with equal probability and reassessed at 8 weeks regarding Hamilton Rating Scale Depression (HRSD17) and Quick Inventory of Depressive Symptomatology (QIDS-SR16) remission and response. Severity of side effects were assessed using the Frequency, Intensity, and Burden of Side Effects Rating (FIBSER) scale and assessed at day 4 and weeks 2, 4, 6, and 8. Frequency, intensity, and burden of side effects were greatest at week 2, then only frequency and intensity of side effects gradually decreased up to week 6. Treatment type and anxiety symptoms did not impact the severity of side effects. A greater burden—but not frequency or intensity—of side effects was associated with poorer treatment outcome and as early as 4 days post-treatment. Together, this work provides an informative mapping of the progression of side effects throughout the treatment course and their association with treatment outcome. Importantly, the burden of side effects that are present as early as 4 days post-treatment predicts poorer treatment outcome and should be monitored closely. iSPOT-D: Registry name: ClinicalTrials.gov. Registration number: NCT00693849.

Oral Methotrexate Monotherapy for Severe Alopecia Areata: A Single Center Retrospective Case Series

2021 ◽  
pp. 120347542199571
Author(s):  
Misaki Kinoshita-Ise ◽  
Muskaan Sachdeva ◽  
Sylvia A. Martinez-Cabriales ◽  
Neil H. Shear ◽  
Perla Lansang
Keyword(s):  
Treatment Outcome ◽  
Side Effects ◽  
Alopecia Areata ◽  
Case Series ◽  
Maximum Response ◽  
Retrospective Case ◽  
Oral Methotrexate ◽  
Systemic Corticosteroids ◽  
Final Treatment ◽  
Feasible Option

Background Although several therapeutic options have been suggested for alopecia areata (AA), none of them are consistently effective, thus making the management of severe or refractory cases challenging. Several studies have recently reported the usage of methotrexate (MTX) in AA; however, the pure effect of MTX monotherapy remains elusive. Objective To evaluate efficacy and safety of oral methotrexate monotherapy for AA. Methods We retrospectively reviewed the clinical course of AA patients including pediatric cases treated with MTX monotherapy. Their detailed clinical data including original severity of AA, final treatment outcome, the duration until the maximum response, and side effects, were assessed. Statistical analysis was performed to evaluate if the clinical factors including the duration of current alopecia, age, the presence of body hair loss, and sex were associated with treatment response. Results All included patients had severe AA and failed standard therapies. Thirteen out of 15 cases demonstrated improvement during the monotherapy, and all responders demonstrated the maximum response within 1 year. Female patients had significantly better outcomes than male patients. Other factors did not significantly influence on the treatment outcome. None of the patients experienced side effects that were severe enough to terminate the treatment. Conclusions Our results support MTX monotherapy as a feasible option for severe AA patients who fail other standard therapies or for whom systemic corticosteroids are contraindicated.

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