P14.30 Treatment outcomes of newly-diagnosed glioblastoma multiforme (GBM) by O6-methylguanine DNA methyltransferase promoter (MGMT) status: a multi-country study

Abstract INTRODUCTION This study evaluated the relationship of MGMT status with first-line (1L) treatment outcomes of patients with newly-diagnosed GBM in France, Germany, Italy, Spain, the UK (EU5), and Canada. MATERIALS AND METHODS Medical oncologists and neuro-oncologists across EU5 and Canada completed a point in time, cross-sectional survey for the next 8 GBM patients seen between May and July 2016 within EU5 and Canada. All results apart from time to progression (TTP) were presented for patients receiving 1L active drug treatment. TTP was calculated from initiation of 1L treatment to initiation of second-line treatment. Results presented are statistically significant (p<0.05) unless otherwise specified. Bases vary depending on data availability. RESULTS A total of 241 physicians reported on 1747 patients with GBM. 875 were receiving 1L active drug treatment at time of survey. Mean age was 59.7 years (median=61) and 34.6% were women. Mean life expectancy was 14.9 months (median=12) at diagnosis and mean TTP was 8.5 months (median=7.3). Surgery was performed in 62% of patients (n=546) prior to 1L drug treatment; 38% of patients (n=329) had no surgery. Patients with surgery had a higher life expectancy at diagnosis vs patients with no surgery prior to 1L (mean=16.4 vs 12.2 months; median=15.0 vs 12.0). Patients who received corticosteroids (n=524) vs no corticosteroids during radiotherapy (n=64) had a shorter life expectancy at diagnosis (mean=15.0 vs 16.8 months, p=0.07; median=12.5 vs 13.9) and were more likely to have 8 or more inpatient days due to GBM (21% vs 8%, p=0.07) in the last 3 months prior to the survey. 62% of patients (n=541) had an MGMT-status recorded (tested: methylated or unmethylated), and 38% (n=334) were untested/ awaiting results (untested) at 1L. MGMT-tested patients had better life expectancy at diagnosis (mean=16.1 vs 12.9 months; median=15.0 vs 12.0) and longer TTP (mean=8.9 vs 7.8 months; median=7.8 vs 6.4) than untested patients. Among MGMT-tested patients, 58% were methylated and 42% were unmethylated. Methylated patients had similar life expectancy at diagnosis (mean=15.9 vs 16.3 months, p=0.85; median=15.0 vs 15.0) and TTP (mean=9.0 vs 8.8 months, p=0.42; median=8.0 vs 7.5) as unmethylated patients. CONCLUSIONS This analysis provides valuable insights into the 1L treatment outcomes of GBM patients in EU5 and Canada. Patients who did not undergo surgery had worse treatment outcomes. Steroid use appears to be associated with worse outcomes and higher healthcare resource utilization. Patient treatment outcomes varied depending on whether they are MGMT tested.

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P14.36 Treatment patterns by O6-methylguanine DNA methyltransferase promoter (MGMT) status in newly-diagnosed glioblastoma multiforme (GBM): a multi-country chart review study

Neuro-Oncology ◽

10.1093/neuonc/noz126.271 ◽

2019 ◽

Vol 21 (Supplement_3) ◽

pp. iii75-iii75

Author(s):

A Z Fu ◽

G J Thompson ◽

J P Hall ◽

A Bailey ◽

J Kemp ◽

...

Keyword(s):

Drug Therapy ◽

Side Effects ◽

Dna Methyltransferase ◽

Treatment Patterns ◽

Newly Diagnosed ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Methylguanine Dna Methyltransferase ◽

The Uk ◽

To Receive

Abstract INTRODUCTION This study explored the relationship between MGMT testing and treatment patterns of patients with newly-diagnosed GBM from France, Germany, Italy, Spain, the UK (EU5), and Canada. MATERIALS AND METHODS Medical oncologists and neuro-oncologists across EU5 and Canada completed a point in time, cross-sectional survey for the next eight GBM patients seen between May and July 2016 (GBM Disease-specific ProgrammeTM). Statistically significant differences (p<0.05) between groups are presented. RESULTS A total of 241 physicians reported on 1,747 GBM patients. 1L patients had mean age 59.7 years (SD=12.3) and 36% were female. Of 1,113 (64%) patients who had an MGMT test performed with results recorded (tested), 58% (n=651) were methylated and 42% (n=462) were unmethylated. The remaining 634 patients (36%) were MGMT untested or awaiting MGMT results at time of survey (untested). Overall, 63% of patients received surgery prior to their 1L drug therapy, 78% received radiotherapy (RT; mean 4.3 sessions) in conjunction with 1L drug therapy, 90% received corticosteroids during RT, and 89% received temozolomide (TMZ). Patients who received corticosteroids during RT received similar drug treatments to those that did not, but were less likely to receive surgery prior to 1L treatment (65% vs 83%). MGMT-tested patients were more likely to receive surgery (66% vs 57%) and RT (81% vs 71%) than untested patients. Tested patients were also more likely to receive TMZ (92% vs 83%), and less likely to receive procarbazine+/lomustine+/vincristine (PCV; 3% vs 7%) or other chemotherapies (5% vs 11%). For 1L patients that experienced side effects, the most common effects included fatigue (74%), nausea (60%), and appetite loss (59%). Untested patients were more likely to stop their 1L drug treatment due to progression/recurrence of GBM (44% vs 36%). Patients who received surgery prior to 1L treatment were more likely to receive TMZ than those who did not (93% vs 82%). Among MGMT tested patients at 1L, methylated patients were more likely to receive RT (84% vs 78%) and TMZ (95% vs 89%) than unmethylated patients, and less likely to receive PCV (2% vs 5%) or other chemotherapy (4% vs 7%). Methylated patients with reported treatment-related side effects were less likely to experience dehydration (0% vs 10%), loss of strength/unusual weakness (5% vs 25%), memory problems (16% vs 35%), and nausea (51% vs 75%). CONCLUSIONS More than one-third of GBM patients in EU5 and Canada are not tested for MGMT-methylation. Untested patients are less likely to receive standard treatments than tested patients. Generally, TMZ is used in most patients regardless of MGMT testing and status. MGMT-methylated patients are more likely to receive standard treatments and experience fewer side effects than MGMT-unmethylated patients.

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Patient-reported experience and outcomes from orthodontic treatment

Journal of Orthodontics ◽

10.1177/1465312520904377 ◽

2020 ◽

Vol 47 (2) ◽

pp. 107-115

Author(s):

Elizabeth Bradley ◽

Andrew Shelton ◽

Trevor Hodge ◽

David Morris ◽

Hilary Bekker ◽

...

Keyword(s):

Secondary Care ◽

Orthodontic Treatment ◽

Clinical Care ◽

Patient Treatment ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Fixed Appliance ◽

Treatment Experience ◽

Patient Reported ◽

Pre Treatment

Objective: To measure patient-reported impact of orthodontic treatment in terms of pre-treatment concerns, treatment experience and treatment outcome. Setting: Four sites in Yorkshire, including two secondary care settings (Leeds Dental Institute and St Luke’s Hospital, Bradford) and two specialist orthodontic practices. Design: Cross-sectional survey. Participants: NHS orthodontic patients (aged 12+ years) who have completed comprehensive orthodontic treatment, excluding orthognathic surgery and craniofacial anomalies. Methods: Participants were opportunistically identified by the direct clinical care team during scheduled appointments and those eligible were invited to participate. Data were collected using the Orthodontic Patient Treatment Impact Questionnaire (OPTIQ), a validated 12-item measure with questions relating to pre-treatment experience, impact of treatment and outcome from treatment. Results: Completed questionnaires for analysis included 120 from primary care and 83 from secondary care. The most common pre-treatment concerns were alignment (89%) and being embarrassed to smile (63%). The most common expectations from orthodontic treatment were improved confidence to eat (87%) and smile (72%) in front of others, improved appearance of teeth (85%) and reduced teasing/bullying (63%). Only 67% respondents recalled receiving written information and the lowest recall related to retainer type and length of retention. The most commonly reported complications were sore mouth (68%), fixed appliance breakage (61%) and gingivitis (39%). Treatment caused greatest impact in relation to pain, limitations in eating and effect on speech. Overall satisfaction with orthodontic treatment was reported by 96% of respondents, 87% would have orthodontic treatment again (if needed) and 91% would recommend treatment to a friend. Conclusions: The OPTIQ is a useful patient-reported tool to identify pre-treatment concerns and expectations, treatment experience and outcome. Orthodontic treatment leads to high levels of satisfaction.

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Smoking cessation care provision in Australian alcohol and other drug treatment services: A cross-sectional survey of staff self-reported practices

Journal of Substance Abuse Treatment ◽

10.1016/j.jsat.2017.04.003 ◽

2017 ◽

Vol 77 ◽

pp. 101-106 ◽

Cited By ~ 6

Author(s):

Eliza Skelton ◽

Flora Tzelepis ◽

Anthony Shakeshaft ◽

Ashleigh Guillaumier ◽

Adrian Dunlop ◽

...

Keyword(s):

Smoking Cessation ◽

Drug Treatment ◽

Care Provision ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Treatment Services

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Contraceptive Practice of Married Women: Experience from a Rural Community of Bangladesh

Anwer Khan Modern Medical College Journal ◽

10.3329/akmmcj.v5i1.18767 ◽

2014 ◽

Vol 5 (1) ◽

pp. 14-18

Author(s):

Md Atiqur Rahman ◽

Md Mahfuzar Rahman ◽

Sazia Huq ◽

Sardar Mahmud Hossain

Keyword(s):

Side Effects ◽

Life Expectancy ◽

Contraceptive Use ◽

Oral Contraceptive Pill ◽

Married Women ◽

Fertility Rate ◽

Reproductive Age ◽

Cross Sectional Survey ◽

Cross Sectional ◽

High Level

Bangladesh is a country having high density of population in the world. Its fertility rate ranges from 4.1 to 5.49 and life expectancy is 66years while the total fertility rate of Asia is 2.2 and life expectancy 70 years. This descriptive type of cross sectional survey was carried out among 240 married women of reproductive age from July to December, 2012 in some villages of Keranigonj, Upazila, Dhaka. 73(31%) were practicing some methods of contraception, while 167 (69%) were not using it. OCP (Oral Contraceptive Pill) was the commonest method of contraception followed by Condoms 12(5%), Injectable 12(5%), Implant 12(5%) & Tubectomy 6(3%). None was found using IUCD and Traditional method ( withdrawal, rhythm method ) and emergency contraceptive method. The use of contraceptive was more common in grand multipara (p<0.01), >35 years old ladies (p<0.05). Non users of contraceptives in this study were 167 (69%) and the major reason for the non use was intention to have more children 53(31.46%) followed by pressure from the husband 21(12.35%), prohibition by the religion 18 (10.9%) and desire for son 17 (10.11%). Among the 73 contraceptive users 38 (52%) experienced side effects with the use of contraceptives. The commonest side effects were menstrual irregularities 17(23.8%) followed by change in body weight 8(11.19%). Frequency of contraceptive use was found comparatively low among rural married women despite high level of awareness. Desire for larger family, religious concerns and fear of side effects were the main factors responsible for non users. Religious scholars must play their role in clarifying many aspects regarding contraceptives. DOI: http://dx.doi.org/10.3329/akmmcj.v5i1.18767 Anwer Khan Modern Medical College Journal Vol. 5, No. 1: January 2014, Pages 14-18

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Fertility preservation in children newly diagnosed with cancer: Existing standards of practice in Australia and New Zealand

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.9047 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 9047-9047

Author(s):

J. A. Heath ◽

C. J. Stern

Keyword(s):

New Zealand ◽

Fertility Preservation ◽

Pediatric Oncology ◽

North American ◽

Ethical Issues ◽

Ovarian Tissue ◽

Newly Diagnosed ◽

Cross Sectional Survey ◽

Cross Sectional ◽

And Storage

9047 Background: Over the past two decades, rapid advances have occurred in both the successful treatment of childhood cancers and reproductive medicine. We sought to establish the current level of clinical practice for sperm, oocyte and gonadal tissue collection and storage in children newly diagnosed with cancer in Australia and New Zealand (ANZ). Methods: A cross-sectional survey of all pediatric oncology services in ANZ was performed. Comparisons to recently published North American practices and to current recommendations for best practice were also made. Results: Of the 13 centers invited to participate, 12 (92%) completed the survey. All centers had offered sperm conservation, but only ten (83%) had offered oocyte/ovarian tissue conservation. Available methods of gamete collection and storage were not consistent. Two centers were using GnRH agonists as fertility protection in post-pubertal females. Forty-two per cent had offered fertility conservation to males and females prior to completion of sexual development. All centers were more likely to offer sperm conservation than oocyte conservation for any given disease. The most common diseases for which conservation was offered were lymphomas and sarcomas. The anticipated cumulative dose at which centers elected to offer fertility preservation varied widely, both for the alkylator cyclophosphamide (1g/m2 to 10g/m2) and for abdominal/pelvic irradiation (any to 12 Gy) and spinal irradiation (any to 18Gy). Fertility counseling was offered in a variety of settings by 82% of centers. Despite 92% of centers agreeing that fertility preservation guidelines would be helpful, only two (17%) had any in place. Overall, there was greater uptake and consistency of utilization of fertility services in ANZ when compared with published North American data. Conclusions: There are inconsistencies regarding the indications for and methods of gamete conservation in pediatric oncology centers throughout ANZ. Unresolved medical, legal and ethical issues suggest the development of guidelines and a voluntary code of practice would be helpful. No significant financial relationships to disclose.

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Usefulness and acceptability of an animation to raise awareness to grief experienced by carers of individuals with dementia

Dementia ◽

10.1177/14713012211041259 ◽

2021 ◽

pp. 147130122110412

Author(s):

Clara Scher ◽

Sophie Crawley ◽

Claudia Cooper ◽

Elizabeth L Sampson ◽

Kirsten J Moore

Keyword(s):

Qualitative Data ◽

Healthcare Professionals ◽

Survey Design ◽

Newly Diagnosed ◽

Cross Sectional Survey ◽

Cross Sectional ◽

People With Dementia ◽

Before And After ◽

Qualitative Responses ◽

Person With Dementia

Aim Many carers of individuals with dementia experience high levels of grief before and after the death of the person with dementia. This study aimed to determine the usefulness, acceptability, and relevance of an animation developed to raise awareness to grief experienced by carers of people with dementia. Methods This research had a cross-sectional survey design. We contacted carers of people with dementia over the phone or email. Participants evaluated the animation through an online or paper-based survey. We used descriptive statistics and analysed qualitative data using thematic analysis. We required a sample of 40 carers to adequately power the study with a target of 75% of carers finding the animation useful, acceptable, and relevant. Results 31/78 carers approached evaluated the animation. Ninety-four percent of participants found the animation relevant to their situation, meeting our target. However, we fell short of this target for usefulness (68%) and acceptability (73%). The qualitative responses suggested that participants felt the animation could help improve the understanding of grief among carers, family, friends, and healthcare professionals. Carers also shared that the animation would be most useful for carers of newly diagnosed people with dementia. Conclusion Most carers of people with dementia in this study reported that the animation was useful, acceptable, and relevant. Dissemination of the resource may be useful for the majority of carers, with the caveat that a few carers may find it distressing and need to be referred for further support.

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Spatial Patterns of Pulmonary Tuberculosis Analysing Rainfall Patterns in Visual Formation

International Journal of Public Health Science (IJPHS) ◽

10.11591/ijphs.v7i1.11376 ◽

2018 ◽

Vol 7 (1) ◽

pp. 13

Author(s):

Hendra Rohman

Keyword(s):

Rainy Season ◽

Rainfall Intensity ◽

Monitoring Program ◽

Tuberculosis Patient ◽

Geographical Information ◽

Patient Treatment ◽

Cross Sectional Survey ◽

Cross Sectional ◽

High Rainfall ◽

Pattern Distribution

Management sustainability related tuberculosis patient treatment was limited. Tuberculosis analysis was still in the form of data aggregation. This is cross sectional survey using geographical information system, analyzed by descriptive methods, the sample included 162 pulmonary tuberrculosis patient in 2014. The variables were pulmonary tuberrculosis patients and isohyet data. Mycrobacterium tuberculosis will be survive and multiply during rainy season. Rainfall data was an increasing pattern from first quarter to fourth quarter in 2014, however data in 2011, 2012 and 2013, which each quarter was largely experiencing sustained increase and decline. Pulmonary tuberrculosis patients were most prevalent in 2014. It was increase in the rainy season. The most high rainfall intensity (> 2400 mm) in east of Lendah and western of Kokap areas, while the lowest intensity (< 1500 mm) in east of Nanggulan, in the south of Panjatan and Galur areas. It was mostly located in areas with high rainfall intensity (2200 - 2400 mm) which spreads and stretches in Sentolo, Wates, and Panjatan areas. Pulmonary tuberrculosis occurred over the rainy season. Spatial pattern distribution of pulmonary tuberrculosis patients in high rainfall intensity spreads and stretches from east to west areas. Active case monitoring program should be performed by tuberculosis program that concerned in areas of high rainfall intensity.

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Trend in age-specific cancer mortality and cancer-free life expectancy in China, 2008–17: a cross-sectional survey of nationwide data

The Lancet ◽

10.1016/s0140-6736(20)32429-6 ◽

2020 ◽

Vol 396 ◽

pp. S9

Author(s):

Xinlei Miao ◽

Xiuhua Guo ◽

Yue Cai ◽

Rongshou Zheng ◽

Haochen Li ◽

...

Keyword(s):

Life Expectancy ◽

Cancer Mortality ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Specific Cancer

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Regional disparities in access to assisted reproductive technology: assessment of patient satisfaction when employing modern technology to close the gap

Journal of Assisted Reproduction and Genetics ◽

10.1007/s10815-020-02027-7 ◽

2021 ◽

Author(s):

Sasha Mikhael ◽

Anna Gaidis ◽

Larisa Gavrilova-Jordan

Keyword(s):

Patient Satisfaction ◽

Treatment Outcomes ◽

Assisted Reproductive Technology ◽

Reproductive Technology ◽

Control Group ◽

Health Providers ◽

Office Visits ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Geographic Disparities

Abstract Purpose Geographic disparities for assisted reproductive technology (ART) continue to exist. Travel cost and time off work may create additional barriers for patients living remotely. Implementing telehealth can alleviate these barriers by reducing office visits. The aim of this study was to evaluate patient satisfaction with telehealth during ART. Methods This was a cross-sectional survey and retrospective cohort study. Patients living remotely who underwent ART utilizing telehealth between 2015 and 2018 at a single institution were selected for the telehealth group. The non-telehealth control group included randomly selected patients who underwent IVF at the same institution between 2015 and 2018. Demographic variables and treatment outcomes were obtained for both groups. A patient satisfaction questionnaire was distributed to telehealth patients. Statistical analysis using χ2 test was performed to compare ART outcomes between both groups. Results Ninety-seven control and 97 telehealth patients were included. For telehealth patients, the mean number of office visits and distance traveled was 2.9 (± 0.8 SD) and 143.1 miles (± 49.2 SD) respectively. 58.8% of patients completed the survey. 44/57 participants had an oocyte retrieval and 42/44 underwent embryo transfer. For those who completed the survey, the clinical pregnancy rate was 31/44 and the live birth rate was 25/44. There was no difference in treatment outcomes between telehealth compared to controls. 73% of patients were highly satisfied with telehealth. Conclusions Telehealth can improve access to ART in underserved areas and results in high patient satisfaction. Reproductive health providers could consider telehealth as a safe and efficacious tool to ameliorate geographic disparities.

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