Symptom burden and survival outcome: 3 cycles versus 6 cycles of chemotherapy in advanced NSCLC

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 17054-17054
Author(s):  
X. S. Wang ◽  
C. Lu ◽  
Q. Shi ◽  
D. Fariclough ◽  
G. Mobley ◽  
...  
Keyword(s):  
Symptom Severity ◽  
Advanced Nsclc ◽  
Piecewise Linear ◽  
Symptom Burden ◽  
Primary Treatment ◽  
Mixed Effect ◽  
Affective Symptoms ◽  
Effect Regression ◽  
Md Anderson ◽  
Nsclc Patients

17054 Background: Improving survival and quality of life is the primary treatment goal for patient with advanced NSCLC receiving palliative chemotherapy. The optimal treatment duration remains to be determined, and there are few studies that examine longitudinal symptom burden in this population. Methods: We prospectively collected self-reported symptom data from advanced stage NSCLC patients receiving chemotherapy. Symptom data was collected weekly utilizing the MD Anderson Symptom Inventory (15 symptoms) pre chemotherapy until therapy discontinuation or up to 26 weeks. Principal components analysis of symptoms measures with a Varimax rotation were used to identify symptom clusters. A piecewise linear mixed-effect regression model was used to estimate the changes over time in symptom severity, and Cox modeling was used for data analysis. Results: Data from 102 subjects were available for analysis. Chemotherapy was primarily discontinued because of tumor progression or a decline in the patient's functional status. Seventy patients received only 2 cycles of chemotherapy, while 46 and 29 patients received 4 and 6 cycles of chemotherapy, respectively. Four clusters of symptoms were identified prior to therapy, including: general symptoms (such as pain, fatigue, sleeping disturbance), GI distress (nausea, vomiting, lack of appetite & constipation), affective symptoms (sadness & distress) and specific disease related symptoms (coughing & shortness of breath). In patients who received = 3 cycles of chemotherapy, a rapid increased in symptom severity was observed, compared to those who received > 3 cycles (P<.05). Patients who received =3 cycles of chemotherapy demonstrated shorter survival compared to those who received > 3 of chemotherapy (HR=9.9, CI=4–22.7, P<.001). Conclusion: Patients with advanced NSCLC who received more than 3 cycles of chemotherapy demonstrated more stable symptom burden and longer survival compared to those who received = 3 cycles of chemotherapy. No significant financial relationships to disclose.

Patient-reported symptom burdens in NSCLC patients undergoing proton, 3DCRT, or IMRT.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 7574-7574
Author(s):  
Xin Shelley Wang ◽  
Zhongxing X. Liao ◽  
Ritsuko Komaki ◽  
James D. Cox ◽  
Daniel Richard Gomez ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Longitudinal Study ◽  
Radiation Dose ◽  
Sore Throat ◽  
Symptom Burden ◽  
Mixed Effect ◽  
Poor Appetite ◽  
Patient Reported ◽  
Nsclc Patients ◽  
Over Time

7574 Background: Concurrent chemoradiation (CXRT) for stage III non-small-cell lung cancer (NSCLC) patients is associated with the development of systemic self-reported symptom burden as well as radiation esophagitis (RE). This longitudinal study aims to provide a profile of the symptom burden among 3 radiation techniques concurrently used with chemotherapy: 3-dimensional conformal radiation therapy (3DCRT), intensity- modulated radiation therapy (IMRT) and proton beam therapy (PBT). Methods: NSCLC patients (N=164) treated at MD Anderson Cancer Center rated symptoms via the M. D. Anderson Symptom Inventory (MDASI) weekly from pre-therapy up to 20 weeks post-therapy. Descriptive analysis identified major symptom burden, and mixed effect modeling examined change over time in symptom outcomes among the 3 types of CXRT. Results: Average total radiation dose was higher (p=.0003) for PBT (N=30, 71.6 Gy) and IMRT (N=67, 66.3 Gy) than for 3DCRT (N=24, 62.1 Gy). Over time, all patients reported a cluster of symptoms that increased as the dose accumulated, including fatigue, drowsiness, pain, difficulty swallowing, poor appetite and sore throat; symptoms generally peaked at week 7-9 and returned to pre-therapy levels at week 13. The IMRT group had significant less-severe sore throat (p=.03), while there were no significant differences in symptom severity among the 3 types of CXRT for the other major symptoms before, during and after CXRT. However, there was a trend of more patients reporting moderate to severe sickness symptoms as a component score (fatigue, pain, sore throat, poor appetite and drowsiness) in the 3DCRT group than in the IMRT or PBT groups at end of CXRT (50% vs. 44%, 31%) and at 13 weeks (53% vs. 23%, 25%). Also, there was a trend of more patients under 3DCRT than IMRT or PBT had moderate to severe sore throat (RE symptom) by end of CXRT (60% vs. 44%, 46%) and no different by 13 weeks (27% vs. 25%, 31%). Conclusions: Although clinical studies have reported the toxicities of CXRT, this is the first longitudinal study that compared symptom profiles for NSCLC patients receiving PBT, IMRT and 3DCRT. There is an impression of more severe treatment-related symptoms for 3DCRT (although in lower radiation dose) than IMRT or PBT.

scholarly journals Translation and validation of the Chinese version of the MD Anderson Symptom Inventory for measuring perioperative symptom burden in patients with gynecologic cancer

2021 ◽  
Author(s):  
Ting Zhang ◽  
Ying-ying Zheng ◽  
Zhi-rong Yang ◽  
Qiuling Shi ◽  
Xin Shelley Wang ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Symptom Severity ◽  
Assessment Tool ◽  
Gynecologic Cancer ◽  
Symptom Burden ◽  
Chinese Version ◽  
Chinese Patients ◽  
Gynecologic Cancers ◽  
Symptom Inventory ◽  
Md Anderson

Abstract Background: Gynecologic cancers are among the most prevalent malignancies in China, and millions of gynecologic cancer patients are expected to undergo open abdominal surgery as initial treatment. The tumor- and surgery-related symptom burden are not well studied owing to a lack of a standardized and validated assessment tool in Chinese. The study was to translate and validate the MD Anderson Symptom Inventory for measuring perioperative symptom burden in gynecologic cancer patients (MDASI-PeriOp-GYN) and examine the utility of the Chinese version.Methods: The MDASI-PeriOp-GYN was translated in a stepwise manner. First, two native speakers independently translated the 9 PeriOp-GYN symptom items. Then the 9 items were translated back into English by another two bilingual translators. After discussion and revision, the four translators reached an agreement. The finalized Chinese version was administered to women with three common gynecologic cancer types (cervical, ovarian, and endometrial cancers) recruited from the gynecological oncology department of Sichuan Cancer Hospital & Institute between July and October 2019. Reliability and validity of the translated version were assessed. Results: Overall, 324 women with gynecologic cancers were enrolled. Cronbach’s α values were 0.826 and 0.735 for the symptom severity and interference scales, respectively. Test-retest reliability values were 0.885, 0.873, and 0.914 for the symptom severity, PeriOp-GYN, and interference scales, respectively. Significant correlations were found between the MDASI-PeriOp-GYN-C and EORTC QLQ-C30 along with the QLQ-OV28 module (-0.608–0.871, P<0.001). Known-group validity was supported by significant differences in the scores of the four scales grouped by time intervals, surgery type, and functional status (all P<0.01). Conclusions: The MDASI-PeriOp-GYN-C is a valid and reliable tool for measuring symptoms in Chinese patients undergoing surgery for gynecologic cancers. The tool could be used in clinical practice and clinical trials to instantly gather patients’ health and quality of life data.

scholarly journals Translation and validation of the Chinese version of the MD Anderson symptom inventory for measuring perioperative symptom burden in patients with gynecologic cancer

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ting Zhang ◽  
Ying-ying Zheng ◽  
Zhi-rong Yang ◽  
Qiuling Shi ◽  
Xin Shelley Wang ◽  
...  
Keyword(s):  
Symptom Severity ◽  
Assessment Tool ◽  
Uterine Cancer ◽  
Gynecologic Cancer ◽  
Symptom Burden ◽  
Chinese Version ◽  
Chinese Patients ◽  
Gynecologic Cancers ◽  
Symptom Inventory ◽  
Md Anderson

Abstract Background Gynecologic cancers are among the most prevalent malignancies in China. Cervical and uterine cancer respectively account for the sixth and eighth highest incidence of cancer among Chinese women. Abdominal surgery is one of the important treatment methods for gynecological tumors. However, the tumor- and surgery-related symptom burden are not well studied owing to a lack of a standardized and validated assessment tool in the Chinese population. The study aimed to translate and validate the MD Anderson Symptom Inventory for measuring perioperative symptom burden in gynecologic cancer patients (MDASI-PeriOp-GYN) and examine the utility of the Chinese version of MDASI-PeriOp-GYN. Methods The MDASI-PeriOp-GYN was translated in a stepwise manner. First, two native speakers independently translated the 9 PeriOp-GYN symptom items. Then the nine items were translated back into English by two different bilingual translators. After discussion and revision, the four translators reached an agreement. Finally, the finalized Chinese version was administered to women with three common gynecologic cancer types (cervical, ovarian, and endometrial cancers) recruited from the gynecological oncology department of Sichuan Cancer Hospital & Institute between July and October 2019. The reliability and validity of the translated version were assessed. Results Overall, 324 women with gynecologic cancers were enrolled. Cronbach’s α values were 0.826 and 0.735 for the symptom severity and interference scales, respectively. Test–retest reliability values were 0.885, 0.873, and 0.914 for symptom severity, PeriOp-GYN, and interference scales. Significant correlations were found between the MDASI-PeriOp-GYN-C and EORTC QLQ-C30 along with the QLQ-OV28 module (− 0.608–0.871, P < 0.001). Known-group validity was supported by significant differences in the scores of the four scales grouped by time intervals, surgery type, and functional status (all P < 0.01). Conclusions The MDASI-PeriOp-GYN-C is a valid and reliable tool for measuring symptoms in Chinese patients undergoing surgery for gynecologic cancers. The tool could be used in clinical practice and clinical trials to instantly gather patients’ health and quality of life data.

scholarly journals P2.04-15 Association Between Opioids and Outcome of 1st Line Immunotherapy in Advanced NSCLC Patients: A Retrospective Evaluation

2019 ◽  
Vol 14 (10) ◽  
pp. S713
Author(s):  
P. Bironzo ◽  
D. Pignataro ◽  
M. Audisio ◽  
M. Tagliamento ◽  
C. Paratore ◽  
...  
Keyword(s):  
Advanced Nsclc ◽  
Retrospective Evaluation ◽  
Nsclc Patients

scholarly journals A clinical variable‐based nomogram could predict the survival for advanced NSCLC patients receiving second‐line atezolizumab

2021 ◽  
Author(s):  
Xiaoling Shang ◽  
Jianxiang Shi ◽  
Xiaohui Wang ◽  
Chenglong Zhao ◽  
Haining Yu ◽  
...  
Keyword(s):  
Advanced Nsclc ◽  
Clinical Variable ◽  
Second Line ◽  
Nsclc Patients

scholarly journals P33.10 Identification of Long-Responders and Fast-Progressors under Immunotherapy Based on Early Monitoring of dNLR in Advanced NSCLC Patients

2021 ◽  
Vol 16 (3) ◽  
pp. S409
Author(s):  
M. Riudavets ◽  
E. Auclin ◽  
F. Blanc-Durand ◽  
A. De Giglio ◽  
J.C. Benitez ◽  
...  
Keyword(s):  
Advanced Nsclc ◽  
Nsclc Patients

scholarly journals Potential of community-based risk estimates for improving hospital performance measures and discharge planning

2021 ◽  
Vol 10 (2) ◽  
pp. e001230
Author(s):  
Michael Reid ◽  
George Kephart ◽  
Pantelis Andreou ◽  
Alysia Robinson
Keyword(s):  
Discharge Planning ◽  
Care Transitions ◽  
Hospital Setting ◽  
Hospital Performance ◽  
Case Mix ◽  
Readmission Rates ◽  
Mixed Effect ◽  
Adjusted Risk ◽  
Community Risk ◽  
Effect Regression

BackgroundRisk-adjusted rates of hospital readmission are a common indicator of hospital performance. There are concerns that current risk-adjustment methods do not account for the many factors outside the hospital setting that can affect readmission rates. Not accounting for these external factors could result in hospitals being unfairly penalized when they discharge patients to communities that are less able to support care transitions and disease management. While incorporating adjustments for the myriad of social and economic factors outside of the hospital setting could improve the accuracy of readmission rates as a performance measure, doing so has limited feasibility due to the number of potential variables and the paucity of data to measure them. This paper assesses a practical approach to addressing this problem: using mixed-effect regression models to estimate case-mix adjusted risk of readmission by community of patients’ residence (community risk of readmission) as a complementary performance indicator to hospital readmission rates.MethodsUsing hospital discharge data and mixed-effect regression models with a random intercept for community, we assess if case-mix adjusted community risk of readmission can be useful as a quality indicator for community-based care. Our outcome of interest was an unplanned repeat hospitalisation. Our primary exposure was community of residence.ResultsCommunity of residence is associated with case-mix adjusted risk of unplanned repeat hospitalisation. Community risk of readmission can be estimated and mapped as indicators of the ability of communities to support both care transitions and long-term disease management.ConclusionContextualising readmission rates through a community lens has the potential to help hospitals and policymakers improve discharge planning, reduce penalties to hospitals, and most importantly, provide higher quality care to the people that they serve.

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