Evaluating survival likelihoods in palliative patients using multiple criteria of survival rates and quality of life

2010 ◽  
pp. 221-238
Author(s):  
Virginia M. Miori ◽  
Daniel J. Miori
Keyword(s):  
Quality Of Life ◽  
Survival Rates ◽  
Multiple Criteria ◽  
Palliative Patients

scholarly journals Challenges and Perspectives on Breast Cancer Survivorship: The Journey Continues

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 96-96
Author(s):  
Victoria Raveis ◽  
Simona Kwon
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Survivor ◽  
Breast Cancer Survivors ◽  
Cancer Survival ◽  
Survival Rates ◽  
Extended Period ◽  
Health Issues ◽  
Age Related

Abstract Women have a 1-in-8 lifetime risk of breast cancer. Earlier diagnosis and treatment advances have improved 15- and 20-year survival rates. Increased survival can mean coping with the effects of cancer and its treatment over an extended period of time, while experiencing age-related changes in functioning and the emergence of other health issues. To explore breast cancer survivors’ perspectives on their issues and concerns across the life-course, focus groups were conducted with a culturally diverse sample (N=18) of survivors (72% white, 28% Black, 11% Hispanic). Participants were 44-82 years old. Most, 83% were 50 and older, 56% were 60 and older. The majority (83%) were diagnosed in their 40’s and 50’s. Two were diagnosed in their early 30’s and one at age 68. Participants reaffirmed the necessity, as a breast cancer survivor, of being a life-long health advocate on their own behalf, and the importance of being self-informed. As one woman commented: “Knowledge is power”. Survivors shared that their emergent health issues were complicated by their cancer history, and, that, as a cancer survivor, “I never stop worrying”. A widespread concern was not knowing if the health issues and co-morbidities they experienced (such as joint pain, neuropathy, tendinitis, heart disease), were age-related, a consequence of their cancer, or a late treatment effect. An overriding sentiment expressed was that clinicians have not recognized the importance of quality of life in cancer survival. As a survivor succinctly stated: “We are living longer, but we need to live long with quality of life.”

scholarly journals A Dutch phase III randomized multicenter trial: whole brain radiotherapy vs. stereotactic radiotherapy for 4-10 brain metastases

2021 ◽  
Author(s):  
Dianne Hartgerink ◽  
Anna Bruynzeel ◽  
Danielle Eekers ◽  
Ans Swinnen ◽  
Coen Hurkmans ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Brain Metastases ◽  
Survival Rates ◽  
Whole Brain Radiotherapy ◽  
Phase Iii ◽  
Whole Brain ◽  
Brain Radiotherapy ◽  
One Year

Abstract Background The clinical value of whole brain radiotherapy (WBRT) for brain metastases (BM) is a matter of debate due to the significant side effects involved. Stereotactic radiosurgery (SRS) is an attractive alternative treatment option that may avoid these side effects and improve local tumor control. We initiated a randomized trial (NCT02353000) to investigate whether quality of life is better preserved after SRS compared with WBRT in patients with multiple brain metastases. Methods Patients with 4 to 10 BM were randomized between the standard arm WBRT (total dose 20 Gy in 5 fractions) or SRS (single fraction or 3 fractions). The primary endpoint was the difference in quality of life (QOL) at three months post-treatment. Results The study was prematurely closed due to poor accrual. A total of 29 patients (13%) were randomized, of which 15 patients have been treated with SRS and 14 patients with WBRT. The median number of lesions were 6 (range, 4-9) and the median total treatment volume was 13.0 cc 3 (range, 1.8-25.9 cc 3). QOL at three months decreased in the SRS group by 0.1 (SD=0.2), compared to 0.2 (SD=0.2) in the WBRT group (p=0.23). The actuarial one-year survival rates were 57% (SRS) and 31% (WBRT) (p=0.52). The actuarial one-year brain salvage-free survival rates were 50% (SRS) and 78% (WBRT) (p=0.22). Conclusion In patients with 4 to 10 BM, SRS alone resulted in one-year survival for 57% of patients while maintaining quality of life. Due to the premature closure of the trial, no statistically significant differences could be determined.

Clinical and Quality of Life Differences in Patients with COPD With and Without a Background of Hospitalization in the Last Year

2021 ◽  
Vol 16 (4) ◽  
pp. 228-233
Author(s):  
Jhonatan Betancourt-Peña ◽  
Juan Carlos Ávila-Valencia ◽  
Jorge Karim Assis ◽  
David Alejandro Escobar-Vidal
Keyword(s):  
Quality Of Life ◽  
Survival Rates ◽  
Cross Sectional Study ◽  
Chronic Obstructive ◽  
Upward Trend ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Lower Socioeconomic ◽  
Causes Of Mortality

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of death worldwide. An upward trend is estimated by 2030. One of the causes of mortality is the exacerbations of symptoms that result in hospitalizations. These hospitalizations reduce the quality of life, limit performance in daily life, and increase the costs for the health system and the patient. Objective: This study aimed to determine the differences between hospitalized and non-hospitalized patients with a medical diagnosis of COPD, considering some sociodemographic and clinical variables, and survival rates. Methods: A cross-sectional study was conducted, which included patients diagnosed with COPD who initiated pulmonary rehabilitation (PR) from January to September 2018. The patients were divided into two groups: patients with one or more exacerbations that led to the hospitalization (COPD-H) and patients without hospitalizations in the last year (COPD-NH). Results: There were 128 participants (78 males and 50 females), with a mean age of 71.10±(9.34) in the COPD-H group and 71.30±(8.91) in the COPD-NH group. When comparing both groups, COPD-NH had a higher socioeconomic status (p=0.041), reporting a higher FEV1 44.71± (14.97), p=0.047, and comorbidities according to the COTE index (p<0.001). Conclusion: The patients with the highest number of hospitalizations belonged to a lower socioeconomic stratum and had a higher number of comorbidities. Therefore, it is necessary to identify these factors at the beginning of PR.

Mini-review: Childhood-onset Craniopharyngioma

2021 ◽  
Author(s):  
Anna Otte ◽  
Hermann L Müller
Keyword(s):  
Quality Of Life ◽  
Survival Rates ◽  
Residual Tumor ◽  
Tumor Location ◽  
Multidisciplinary Teams ◽  
Low Grade ◽  
Childhood Onset ◽  
Severe Impairment ◽  
Grade Malignancy

Abstract Craniopharyngiomas are rare embryonic malformational tumors of the sellar/parasellar region, classified by the WHO as tumors with low-grade malignancy (WHO I°). The childhood adamantinomatous subtype of craniopharyngioma is usually cystic with calcified areas. At the time of diagnosis, hypothalamic/pituitary deficits, visual disturbances and increased intracranial pressure are major symptoms. The treatment of choice in case of favorable tumor location (without hypothalamic involvement) is complete resection. It is important to ensure that optical and hypothalamic functionality are preserved. In case of unfavorable tumor location, i.e. with hypothalamic involvement, a hypothalamus-sparing surgical strategy with subsequent local irradiation of residual tumor is recommended. In the further course of the disease, recurrences and progression often occur. Nevertheless, overall survival rates are high at 92%. Severe impairment of quality of life and comorbidities such as metabolic syndrome, hypothalamic obesity and neurological consequences can be observed in patients with disease- and/or treatment-related lesions of hypothalamic structures. Childhood-onset craniopharyngioma frequently manifests as a chronic disease so that patients require lifelong, continuous care by experienced multidisciplinary teams to manage clinical and quality of life consequences.For this review, a search for original articles and reviews published between 1986 and 2020 was performed in Pubmed, Science Citation Index Expanded, EMBASE and Scopus. The search terms used were “craniopharyngioma, hypothalamus, pituitary obesity, irradiation, neurosurgery”.

scholarly journals The Current Status of Integrative Oncology in Korea

2021 ◽  
Vol 20 ◽  
pp. 153473542110638
Author(s):  
Eun-Bin Kwag ◽  
Soo-Dam Kim ◽  
Ji Hye Park ◽  
So-Jung Park ◽  
Mi-Kyung Jeong ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Causes Of Death ◽  
Survival Rates ◽  
Current Status ◽  
Integrative Oncology ◽  
Recurrence Rates ◽  
Current State ◽  
Look Ahead

Cancer is one of the leading causes of death worldwide, and Korea is no exception. Humanity has been fighting cancer for many years, and as a result, we now have effective treatments such as chemotherapy, radiation, and surgery. However, there are other issues that we are only now beginning to address, such as cancer patients’ quality of life. Moreover, numerous studies show that addressing these issues holistically is critical for overall cancer treatment and survival rates. This paper describes how Korea is attempting to reduce cancer incidence and recurrence rates while also managing the quality of life of cancer patients. Integrative Oncology is the field that addresses these broad issues, and understanding the current state of integrative oncology in Korea is critical. The goal of this paper is to provide an overview of the current state of integrative oncology in Korea as well as to look ahead to future developments.

Quality of Life in Childhood Cancer: Meaning, Methods, and Missing Pieces

2006 ◽  
Author(s):  
Rachel B. Levi
Keyword(s):  
Quality Of Life ◽  
Pediatric Oncology ◽  
Survival Rates ◽  
Well Being ◽  
Related Quality ◽  
Health Related ◽  
Domains Of Life ◽  
Definition Of ◽  
Health Organization

It is only in the last three decades that the quality of the lives of children and adolescents treated for cancer and their families has become a major focus in the field of pediatric oncology. This shift from helping families to tolerate arduous treatments and prepare for early death is a result of advances in treatment and survival rates for most pediatric disease categories. One result of this paradigm shift is that quality of life (QOL) has become a critical construct within the field of pediatric oncology. The construct of QOL was initially developed for use with adult populations and was based on the definition of health generated in 1948 by the World Health Organization (WHO): “a state of complete physical, mental, and social well being, and not merely the absence of disease or infirmity.” Although there remains no universally adopted definition of QOL, the WHO’s definition of QOL as an “individual’s perceptions of their position in life in the context of the culture and value system in which they live and in relation to their goals, standards, and concerns” is frequently employed (WHO, 1993). This definition includes several domains that are considered central to the QOL construct: physical, mental/emotional, and social. This initial construct has been expanded with adult populations to include physical symptoms and functioning, functional status (i.e., ability to participate in daily and life activities), psychological functioning, and social functioning (e.g., Ware, 1984). This more expansive definition is referred to as health-related quality of life (HRQOL). HRQOL emphasizes the impact of health on one’s QOL but looks further to include other domains of life functioning that are also potentially affected by health/illness states (Jenney, 1998). The HRQOL construct was initially developed for populations of adults living with chronic illness to assess the impacts of illness/injury/disability, medical treatment, or health care policy on an individual’s life quality (for reviews, see Aaronson et al., 1991; Patrick&Erikson, 1993; Speith&Harris, 1996). Over time, there have been modifications and developments in the construct, approaches to measurement, and the measures themselves (Wilson & Cleary, 1994).

scholarly journals Impact of enucleation on adult retinoblastoma survivors’ quality of life: A qualitative study of survivors' perspectives

2019 ◽  
Vol 18 (3) ◽  
pp. 322-331
Author(s):  
Smita C. Banerjee ◽  
Elaine Pottenger ◽  
Mary Petriccione ◽  
Joanne F. Chou ◽  
Jennifer S. Ford ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Survival Rates ◽  
Psychosocial Problems ◽  
Active Coping ◽  
Narrative Form ◽  
Free Text ◽  
Physical Problems ◽  
The Us ◽  
Compensatory Skills

AbstractObjectivesRetinoblastoma is the most common primary intraocular tumor of childhood with >95% survival rates in the US. Traditional therapy for retinoblastoma often included enucleation (removal of the eye). While much is known about the visual, physical, and cognitive ramifications of enucleation, data are lacking about survivors' perception of how this treatment impacts overall quality of life.MethodsQualitative analysis of an open-ended response describing how much the removal of an eye had affected retinoblastoma survivors' lives and in what ways in free text, narrative form.ResultsFour hundred and four retinoblastoma survivors who had undergone enucleation (bilateral disease = 214; 52% female; mean age = 44, SD = 11) completed the survey. Survivors reported physical problems (n = 205, 50.7%), intrapersonal problems (n = 77, 19.1%), social and relational problems (n = 98, 24.3%), and affective problems (n = 34, 8.4%) at a mean of 42 years after diagnosis. Three key themes emerged from survivors' responses; specifically, they (1) continue to report physical and intrapersonal struggles with appearance and related self-consciousness due to appearance; (2) have multiple social and relational problems, with teasing and bullying being prominent problems; and (3) reported utilization of active coping strategies, including developing more acceptance and learning compensatory skills around activities of daily living.Significance of resultsThis study suggests that adult retinoblastoma survivors treated with enucleation continue to struggle with a unique set of psychosocial problems. Future interventions can be designed to teach survivors more active coping skills (e.g., for appearance-related issues, vision-related issues, and teasing/bullying) to optimize survivors' long-term quality of life.

A literature review of the role of brachytherapy in the management of early-stage breast cancer

2019 ◽  
Vol 19 (3) ◽  
pp. 281-290
Author(s):  
Rebecca Thorpe ◽  
Heather Drury-Smith
Keyword(s):  
Quality Of Life ◽  
Overall Survival ◽  
Local Recurrence ◽  
Literature Review ◽  
Survival Rates ◽  
External Beam Radiation ◽  
Recurrence Rates ◽  
Overall Survival Rates

AbstractBackground:This review evaluates whether brachytherapy can be considered as an alternative to whole breast irradiation (WBI) using criteria such as local recurrence rates, overall survival rates and quality of life (QoL) factors. This is an important issue because of a decline in local recurrence rates, suggesting that some women at very low risk of recurrence may be incurring the negative long-term side effects of WBI without benefitting from a reduction in local recurrence and greater overall survival. As such, the purpose of this literature review is to evaluate whether brachytherapy is a credible alternative to external beam radiation with a particular focus on the impact it has on patient QoL.Methods:The search terms used were devised by using the Population Intervention Comparison Outcome framework, and a literature search was carried out using Boolean connectors and Medical Subject Headings in the PubMed database. The resultant articles were manually assessed for relevance and appraised using the Scottish Intercollegiate Guidelines Network tool. Additional papers were sourced from the citations of articles found using the search strategy. Government guidelines and regulations were also used following a manual search on the National Institute for Health and Care Excellence website. This process resulted in a total of 30 sources being included as part of the review.Results:Three types of brachytherapy were the foundation for the majority of the papers found: interstitial multi-catheter brachytherapy, intra-cavity brachytherapy and permanent seed implantation. The key themes that arose from the literature were that brachytherapy is equivalent to WBI both in terms of 5-year local recurrence rates and overall survival rates at 10–12 years. The findings showed that brachytherapy was superior to WBI for some QoL factors such as being less time-consuming and equal in terms of others such as breast cosmesis. The results did also show that brachytherapy does come with its own local toxicities that could impact upon QoL such as the poor breast cosmesis associated with some brachytherapy techniques.Conclusion:In conclusion, brachytherapy was deemed a safe or acceptable alternative to WBI, but there is a need for further research on the long-term local recurrence rates, survival rates and quality of life issues as the volume of evidence is still significantly smaller for brachytherapy than for WBI. Specifically, there needs to be further investigation as to which patients will benefit from being offered brachytherapy and the influence that factors such as co-morbidities, performance status and patient choice play in these decisions.

scholarly journals MANAGEMENT OF ENDOCRINE DISEASE: Neuroendocrine surveillance and management of neurosurgical patients

2017 ◽  
Vol 176 (5) ◽  
pp. R217-R233 ◽  
Author(s):  
Aoife Garrahy ◽  
Mark Sherlock ◽  
Christopher J Thompson
Keyword(s):  
Quality Of Life ◽  
Time Course ◽  
Dynamic Testing ◽  
Hormone Replacement ◽  
Survival Rates ◽  
Cranial Irradiation ◽  
Pituitary Dysfunction ◽  
Neurosurgical Patients ◽  
Life Threatening

Advances in the management of traumatic brain injury, subarachnoid haemorrhage and intracranial tumours have led to improved survival rates and an increased focus on quality of life of survivors. Endocrine sequelae of the acute brain insult and subsequent neurosurgery, peri-operative fluid administration and/or cranial irradiation are now well described. Unrecognised acute hypopituitarism, particularly ACTH/cortisol deficiency and diabetes insipidus, can be life threatening. Although hypopituitarism may be transient, up to 30% of survivors of TBI have chronic hypopituitarism, which can diminish quality of life and hamper rehabilitation. Patients who survive SAH may also develop hypopituitarism, though it is less common than after TBI. The growth hormone axis is most frequently affected. There is also accumulating evidence that survivors of intracranial malignancy, who have required cranial irradiation, may develop hypopituitarism. The time course of the development of hormone deficits is varied, and predictors of pituitary dysfunction are unreliable. Furthermore, diagnosis of GH and ACTH deficiency require dynamic testing that can be resource intensive. Thus the surveillance and management of neuroendocrine dysfunction in neurosurgical patients poses significant logistic challenges to endocrine services. However, diagnosis and management of pituitary dysfunction can be rewarding. Appropriate hormone replacement can improve quality of life, prevent complications such as muscle atrophy, infection and osteoporosis and improve engagement with physiotherapy and rehabilitation.

scholarly journals Instruments to assess quality of life in patients with heart failure

2015 ◽  
Vol 28 (4) ◽  
pp. 851-858 ◽  
Author(s):  
Amanda Braga de Louredo ◽  
Ana Luiza Coelho Leite ◽  
Gisela Rosa Franco Salerno ◽  
Marcelo Fernandes ◽  
Silvana Blascovi-Assis
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Heart Diseases ◽  
Survival Rates ◽  
Clinical Syndrome ◽  
Metric Properties ◽  
Patients With Heart Failure ◽  
Assess Quality ◽  
Source Of Information

Abstract Introduction : Heart failure (HF) is a complex clinical syndrome representing the common final pathway of various heart diseases. It is characterized by low exercise tolerance, low survival rates and deteriorated quality of life. Several studies mention Quality of Life (QoL) as an important source of information on how disease truly affects patient's lives. In this context, the assessment of QoL is extremely important to provide data that support the choice of a therapeutic strategy and the assessment of the effectiveness of a treatment. Objectives : This study aimed to investigate and identify the most appropriate and widely used instrument for the assessment of quality of life in patients with HF. Methods : We searched the databases of Lilacs, Medline, Pubmed, Scielo and CAPES to identify relevant articles published in English and Portuguese between 2000 and 2010. Results : We found 25 papers that described, quoted or used instruments for the assessment of QoL in patients with HF. Conclusion : The MLHFQ is the most widely used instrument to assess QoL in patients with HF. Its good metric properties have been confirmed in a large number of studies. In addition, it has a simple structure and is easy to administer, which makes it the most recommended instrument for this purpose.

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