scholarly journals P-31 A retrospective audit of survival duration in patients with poor performance status receiving systemic anti-cancer therapy at mid yorkshire nhs trust

2017 ◽  
Vol 7 (Suppl 1) ◽  
pp. A11.2-A11
Author(s):  
Emma Hooson ◽  
Charlotte Gibb ◽  
Gireesh Kumaran
Keyword(s):  
Cancer Therapy ◽  
Performance Status ◽  
Poor Performance ◽  
Survival Duration ◽  
Poor Performance Status ◽  
Retrospective Audit ◽  
Anti Cancer

scholarly journals Efficacy of metronomic vinorelbine in elderly patients with advanced non-small-cell lung cancer and poor performance status

2017 ◽  
Vol 24 (3) ◽  
pp. 199 ◽  
Author(s):  
C. Bilir ◽  
S. Durak ◽  
B. Kızılkaya ◽  
I. Hacıbekiroglu ◽  
E. Nayır ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Survival Rate ◽  
Elderly Patients ◽  
Performance Status ◽  
Poor Performance ◽  
Small Cell ◽  
Survival Duration ◽  
Poor Performance Status ◽  
Small Cell Lung ◽  
Metronomic Vinorelbine

Background Metronomic chemotherapy—administration of low-dose chemotherapy—allows for a prolonged treatment duration and minimizes toxicity for unfit patients diagnosed with advanced non-small-cell lung cancer (nsclc).Methods Oral metronomic vinorelbine at 30 mg thrice weekly was given to 35 chemotherapy-naive patients who were elderly and vulnerable to toxicity and who had been diagnosed with advanced nsclc.Results Median age in this male-predominant cohort (29:6) was 76 years (range: 65–86 years). Histology was squamous cell carcinoma in 21 patients and adenocarcinoma in 14. There were no complete responses and 9 partial responses, for an overall response rate of 26%. Stable disease was seen in 15 patients (43%), and 11 patients (31%) had progressive disease. The 1-year survival rate was 34%, and the 2-year survival rate was 8%. The survival analysis showed a median progression-free survival duration of 4 months (range: 2–15 months) and an overall survival duration of 7 months (range: 3–24 months).Conclusions Metronomic vinorelbine had an acceptable efficacy and safety profile in elderly patients with multiple comorbidities who had been diagnosed with advanced nsclc. Metronomic vinorelbine could be a treatment option for elderly patients with poor performance status who are unfit for platinum-based chemotherapy and intravenous single-agent chemotherapy, and who are not candidates for combination modalities.

When should anti-cancer treatment be ended? Why and when to discontinue palliative chemotherapy.

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 41-41
Author(s):  
Yuurin Kondo ◽  
Maria Michiko Nakajima ◽  
Go Nakajima ◽  
Kazuhiko Hayashi
Keyword(s):  
Life Expectancy ◽  
End Of Life ◽  
Palliative Chemotherapy ◽  
Performance Status ◽  
Poor Performance ◽  
Poor Performance Status ◽  
Incurable Cancer ◽  
Clear Explanation ◽  
Anti Cancer ◽  
Practice Methods

41 Background: Currently, palliative chemotherapy (PC) near the end of life is frequently discussed. It is important to know when it is appropriate to end PC to maintain the best quality of life. The criteria for discontinuation of anti-cancer therapy are often “exacerbation of patient’s condition,” “problems with toxicity,” or “patient refusal.” However, there is no clear agreement regarding when to end PC. Ending treatment is one of the most difficult decisions for oncologists. The purpose of this study was to determine clear reasons for the discontinuation of PC and to gain an understanding of the current situation regarding explanation of prognosis in clinical practice. Methods: This retrospective study included 144 patients with incurable cancer who had received PC and died between January 2014 and November 2016. We examined the reasons for discontinuation of PC and whether patients had completed end-of-life discussions, including a discussion of life expectancy, when their PC was terminated. Results: Causes of discontinuation of PC were as follows: 8.3% patient’s desire, progressive disease (PD) in 48.5%, poor performance status (PS) in 20.1%, and toxicity in 17.4%. In patients who chose to end anticancer therapy voluntarily, all patients received a clear explanation of their prognosis, including life expectancy. Among 67 patients with PD, 45 (67.1%) received information regarding their prognosis; 17 of 29 patients (58.6%) with poor PS received similar information. Among patients who ended PC due to toxicity, only 8 of 25 patients (32%) completed end-of-life discussions, including a discussion of life expectancy. In addition, death within 1 month from the discontinuation of PC occurred in 0 cases where treatment was discontinued due to patient’s desire, 10 cases (15%) due to PD, 10 cases (34.4%) due to PS, and 7 cases (28%) due to toxicity. Conclusions: This study shows that patients who discontinued treatment due to poor PS or toxicity had a shorter interval between the final PC and death. Moreover, it indicated that the details of the end-of-life discussion might be influenced by the reason for discontinuation of PC, including or excluding a discussion of life expectancy.

Oral talactoferrin extends survival in patients with refractory NSCLC in a randomized, placebo-controlled, phase 2 trial

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 7540-7540 ◽  
Author(s):  
P. K. Parikh ◽  
Y. Wang ◽  
A. A. Ranade ◽  
A. K. Vaid ◽  
S. H. Advani ◽  
...  
Keyword(s):  
Primary Endpoint ◽  
Controlled Trial ◽  
Performance Status ◽  
Single Agent ◽  
Poor Performance ◽  
Poor Performance Status ◽  
Phase 2 ◽  
Line Therapy ◽  
Anti Cancer ◽  
Nsclc Patients

7540 Background: Talactoferrin alfa (TLF), an immunomodulatory protein with a novel anti-cancer mechanism of action, was active preclinically and in non-small cell lung cancer (NSCLC) patients in Phase 1b studies. Randomized Phase 2 studies in NSCLC were conducted with TLF as a single agent and combined with chemotherapy. The 110-patient combination therapy study, which was previously presented (ASCO 2006, #7095), met its primary endpoint with an improved BOR over chemotherapy alone. We now present results from the placebo- controlled single agent study. Methods: 100 Stage IIIB/IV NSCLC patients who had progressed after first or second line therapy were enrolled at 10 leading Indian cancer centers, and randomized to receive best supportive care plus either oral TLF (1.5 g bid) or placebo. TLF/placebo was administered until disease progression, for up to three 14-week cycles (12 weeks on, 2 weeks off), in a centrally monitored trial. The primary endpoint was overall survival (OS) with 80% power to detect an improvement in median OS with an a=0.05. Results: All patients had previously received a 1st line platinum based regimen; 26 also received 2nd line therapy. The TLF and placebo arms enrolled 47 and 53 patients, respectively. Baseline characteristics were similar in both groups, including proportion of patients receiving 1 or 2 prior regimens. All patients were included in the Intent To Treat (ITT) analysis. The trial met its primary endpoint with a 55% increase (2.1 month; p<0.05) in median OS. TLF was well tolerated. Adverse Events (AEs) were generally mild. No drug- related SAEs were reported. Incidence of AEs and Grade 3/4 AEs was similar in both arms. Conclusion: Oral talactoferrin, a promising new anti-cancer agent, significantly improved survival in patients with refractory NSCLC in this randomized, placebo-controlled trial. TLF was well tolerated in this population. Given its favorable toxicity profile, TLF may be particularly attractive in refractory patients with poor performance status. [Table: see text] [Table: see text]

scholarly journals Mortality among cancer patients within 90 days of therapy in a tertiary hospital of Tanzania: is our pre therapy screening effective?

2019 ◽  
Author(s):  
Marygoreth J Changalucha ◽  
MARTHA F. Mushi ◽  
Rodrick Kabangila ◽  
Vitus Silago ◽  
Beda Likonda ◽  
...  
Keyword(s):  
Cancer Therapy ◽  
Cancer Patients ◽  
Medical Center ◽  
Performance Status ◽  
Poor Performance ◽  
Tertiary Hospital ◽  
Poor Performance Status ◽  
Solid Cancer ◽  
Karnofsky Score ◽  
Days Of Therapy

Abstract Background A high mortality has been reported during the first ninety days of cancer therapy and is more pronounced in patients with febrile neutropenia. Bugando Medical Center, oncology department offers cancer diagnosis and treatment services to the population of lake-zone of Tanzania with limited data on the 90 days outcome. Here, we report the 90 days mortality and factors associated with it among cancer patients attending oncology department of the tertiary hospital in Tanzania. Methodology Enrolled participants underwent baseline physical examinations and functional status assessment using Karnofsky score. On each clinic visit, FBP was taken and patients were investigated for infections. Data were entered in Microsoft Excel and analyzed using STATA version 13. Results A total of 102 participants were enrolled. Their median age was 50 years [38-60]. The majority of study participants were females 76(75%) and 82(80.4%) had primary school education. The majority of patients had solid cancer 96(94.1%). A total of 12 (11.8%) patients died within 90 days of starting therapy. Having low hemoglobin level before starting cancer therapy (p=0.001), having Karnofsky score below 80% (p=0.001) and using 5-fluorouracil containing therapy (p=0.004) were found to be associated with mortality within 90 days of therapy among cancer patients. Conclusion About 10% of cancer patients die within 90 days of therapy. Anemic patients, with poor performance status and on 5-Fluorouracil regimen are more likely to die within 90 days of cancer therapy.

scholarly journals COVID-19 and cancer registries: learning from the first peak of the SARS-CoV-2 pandemic

2021 ◽  
Author(s):  
Alvin J. X. Lee ◽  
Karin Purshouse
Keyword(s):  
Risk Factors ◽  
Performance Status ◽  
Poor Performance ◽  
Cancer Registries ◽  
Adverse Outcomes ◽  
Smoking History ◽  
Poor Performance Status ◽  
International Studies ◽  
Patients With Cancer ◽  
Increased Risk

AbstractThe SARS-Cov-2 pandemic in 2020 has caused oncology teams around the world to adapt their practice in the aim of protecting patients. Early evidence from China indicated that patients with cancer, and particularly those who had recently received chemotherapy or surgery, were at increased risk of adverse outcomes following SARS-Cov-2 infection. Many registries of cancer patients infected with SARS-Cov-2 emerged during the first wave. We collate the evidence from these national and international studies and focus on the risk factors for patients with solid cancers and the contribution of systemic anti-cancer treatments (SACT—chemotherapy, immunotherapy, targeted and hormone therapy) to outcomes following SARS-Cov-2 infection. Patients with cancer infected with SARS-Cov-2 have a higher probability of death compared with patients without cancer. Common risk factors for mortality following COVID-19 include age, male sex, smoking history, number of comorbidities and poor performance status. Oncological features that may predict for worse outcomes include tumour stage, disease trajectory and lung cancer. Most studies did not identify an association between SACT and adverse outcomes. Recent data suggest that the timing of receipt of SACT may be associated with risk of mortality. Ongoing recruitment to these registries will enable us to provide evidence-based care.

scholarly journals Clinical indicators for the incidence of postoperative ileus after elective surgery for colorectal cancer

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yosuke Namba ◽  
Yuzo Hirata ◽  
Shoichiro Mukai ◽  
Sho Okimoto ◽  
Seiji Fujisaki ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Body Weight ◽  
Postoperative Ileus ◽  
Elective Surgery ◽  
Performance Status ◽  
Poor Performance ◽  
Poor Performance Status ◽  
Clinical Indicators ◽  
Patient Morbidity ◽  
Two Factors

Abstract Background The occurrence of postoperative ileus leads to increased patient morbidity, longer hospitalization, and higher healthcare costs. No clear policy on postoperative ileus prevention exists. Therefore, we aim to evaluate the clinical factors involved in the development of postoperative ileus after elective surgery for colorectal cancer. Methods We retrospectively analyzed patients who underwent elective surgery involving bowel resection with or without re-anastomosis for colon cancer between April 2015 and March 2020. The primary readout was the presence or absence of postoperative ileus. Univariate and multivariate analyses were used to identify pre- and intraoperative risk factors, and the incidence of postoperative ileus was assessed using independent factors. Results Postoperative ileus occurred in 48 out of 356 patients (13.5%). In multivariate analysis, male sex poor performance status, and intraoperative in–out balance per body weight were independently associated with postoperative ileus development. The incidence of postoperative ileus was 2.5% in the cases with no independent factors; however, it increased to 36.1% when two factors were observed and 75.0% when three factors were matched. Conclusions We discovered that male gender, poor performance status, and intraoperative in–out balance per body weight were associated with the development of postoperative ileus. Of these, intraoperative in–out balance per body weight is a controllable factor. Hence it is important to control the intraoperative in–out balance to lower the risk for postoperative ileus.

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