Feasibility of tele-chemotherapy administration to improve access to rural cancer patients.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 112-112
Author(s):  
Ramya Thota ◽  
David Michael Gill ◽  
Megan Mullalley ◽  
Zoya Sandhu ◽  
jamie brant ◽  
...  
Keyword(s):  
Rural Communities ◽  
Cancer Patients ◽  
Immune Therapy ◽  
Chemotherapy Drugs ◽  
Treatment Regimens ◽  
Chemotherapy Administration ◽  
Regional Center ◽  
Institutional Experience ◽  
Risk Treatment ◽  
Dose Modifications

112 Background: Telehealth improves access to cancer care for patients with cancer in rural communities. It allows qualified infusion nurses to administer chemotherapy in smaller rural towns under supervision by health professionals from larger tertiary sites. Here we would like to share our institutional experience in tele-chemotherapy administration to patients in rural Utah. Methods: We collected patient data including treatment regimens administered at our tele health sites from March 2019 to February 2021. Results: A total of 133 unique patients received 1073 cycles of low to intermediate risk treatment regimens. 42 unique regimens including intravenous and oral chemotherapy drugs, immune therapy and targeted drugs were administered at four rural facilities including Cassia Regional Center, Sanpete Valley Hospital, Severe Valley Hospital and Heber Valley Hospital in Utah. 52 physicians located at tertiary sites were involved in tele-chemotherapy administration. In addition to Medicare, Medicaid, the tele chemotherapy was covered by four commercial payers including Blue Cross Blue Shield, Select Health, Tricare and United Healthcare. Conclusions: Tele chemotherapy administration is feasible and allows improved access to cancer patients in rural communities. We aim to expand current project to capture the patient satisfaction and clinical outcomes including treatment delays, dose modifications, infusion reactions, hospitalizations or emergency visits.

scholarly journals Chemotherapy-Induced Neuropathy and Diabetes: A Scoping Review

2021 ◽  
Vol 28 (4) ◽  
pp. 3124-3138
Author(s):  
Mar Sempere-Bigorra ◽  
Iván Julián-Rochina ◽  
Omar Cauli
Keyword(s):  
Peripheral Neuropathy ◽  
Cancer Patients ◽  
Management Strategies ◽  
Sensory Neuropathy ◽  
Drug Regimen ◽  
Diabetic Patients ◽  
Chemotherapy Drugs ◽  
Cancer Management ◽  
Chemotherapy Administration ◽  
Patients With Diabetes

Although cancer and diabetes are common diseases, the relationship between diabetes, neuropathy and the risk of developing peripheral sensory neuropathy while or after receiving chemotherapy is uncertain. In this review, we highlight the effects of chemotherapy on the onset or progression of neuropathy in diabetic patients. We searched the literature in Medline and Scopus, covering all entries until 31 January 2021. The inclusion and exclusion criteria were: (1) original article (2) full text published in English or Spanish; (3) neuropathy was specifically assessed (4) the authors separately analyzed the outcomes in diabetic patients. A total of 259 papers were retrieved. Finally, eight articles fulfilled the criteria, and four more articles were retrieved from the references of the selected articles. The analysis of the studies covered the information about neuropathy recorded in 768 cancer patients with diabetes and 5247 control cases (non-diabetic patients). The drugs investigated are chemotherapy drugs with high potential to induce neuropathy, such as platinum derivatives and taxanes, which are currently the mainstay of treatment of various cancers. The predisposing effect of co-morbid diabetes on chemotherapy-induced peripheral neuropathy depends on the type of symptoms and drug used, but manifest at any drug regimen dosage, although greater neuropathic signs are also observed at higher dosages in diabetic patients. The deleterious effects of chemotherapy on diabetic patients seem to last longer, since peripheral neuropathy persisted in a higher proportion of diabetic patients than non-diabetic patients for up to two years after treatment. Future studies investigating the risk of developing peripheral neuropathy in cancer patients with comorbid diabetes need to consider the duration of diabetes, cancer-induced neuropathic effects per se (prior chemotherapy administration), and the effects of previous cancer management strategies such as radiotherapy and surgery.

scholarly journals Oxidative Stress and Cognitive Alterations Induced by Cancer Chemotherapy Drugs: A Scoping Review

Antioxidants ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 1116
Author(s):  
Omar Cauli
Keyword(s):  
Oxidative Stress ◽  
Cancer Patients ◽  
Repeated Administration ◽  
Caffeic Acid Phenethyl Ester ◽  
Scientific Basis ◽  
Clinical Settings ◽  
Chemotherapy Drugs ◽  
Scientific Attention ◽  
The Brain ◽  
Cognitive Alterations

Cognitive impairment is one of the most deleterious effects of chemotherapy treatment in cancer patients, and this problem sometimes remains even after chemotherapy ends. Common classes of chemotherapy-based regimens such as anthracyclines, taxanes, and platinum derivatives can induce both oxidative stress in the blood and in the brain, and these effects can be reproduced in neuronal and glia cell cultures. In rodent models, both the acute and repeated administration of doxorubicin or adriamycin (anthracyclines) or cisplatin impairs cognitive functions, as shown by their diminished performance in different learning and memory behavioural tasks. Administration of compounds with strong antioxidant effects such as N-acetylcysteine, gamma-glutamyl cysteine ethyl ester, polydatin, caffeic acid phenethyl ester, and 2-mercaptoethane sulfonate sodium (MESNA) counteract both oxidative stress and cognitive alterations induced by chemotherapeutic drugs. These antioxidant molecules provide the scientific basis to design clinical trials in patients with the aim of reducing the oxidative stress and cognitive alterations, among other probable central nervous system changes, elicited by chemotherapy in cancer patients. In particular, N-acetylcysteine and MESNA are currently used in clinical settings and are therefore attracting scientific attention.

scholarly journals HUBUNGAN ANTARA NAFSU MAKAN DENGAN ASUPAN ENERGI DAN PROTEIN PADA PASIEN KANKER PAYUDARA POST KEMOTERAPI[Correlation between Appetite with Energy and Protein Intake of Post Chemotherapy Breast Cancer Patients]

2019 ◽  
Vol 14 (2) ◽  
pp. 170
Author(s):  
Silviana Putri ◽  
Merryana Adriani ◽  
Yayuk Estuningsih
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Side Effect ◽  
Protein Intake ◽  
Pearson Correlation ◽  
Observational Research ◽  
Breast Cancer Patients ◽  
Cross Sectional ◽  
Chemotherapy Drugs ◽  
Pearson Correlation Test

Chemotherapy drugs used to kill or inhibit proliferation of cancer cell that are cytotoxic and causing side effect for breast cancer patients. The side effect of chemotherapy drugs is decreasing the appetite which causing decrease in energy and protein intake, and could affect nutritional status. This study aim to determine the relationship between appetite with energy and protein intake of post chemotherapy breast cancer patients. This research was an analytic observational research using cross sectional design and purposive sampling conducted at Dr. Ramelan Navy Hospital Surabaya with a sample size of 50 patients. Correlation between appetite with energy and protein intake were analyzed using Pearson correlation. The average of energy and protein intake were 976.3±304.2 kcal and 29.4±12.9 g. Pearson correlation test showed signifi cant correlation between appetite as chemoteraphy side effect with energy intake (p=0.000; r=-0.558) and protein intake (p=0.000; r=-0.504). Decreasing of appetite due to chemoterapy reduce the energy and protein intake of breast cancer patient. Patient are suggest to consume foods in small portion but often to maintain adequate energy and protein intake.

scholarly journals Transition from conformal to advanced radiotherapy techniques in treatment planning of gynecological cancer patients

2021 ◽  
pp. 77-77
Author(s):  
Borislava Petrovic ◽  
Olivera Ivanov ◽  
Milana Marjanovic ◽  
Jelena Licina ◽  
Ivan Gencel ◽  
...  
Keyword(s):  
At Risk ◽  
Cancer Patients ◽  
Maximum Dose ◽  
Organs At Risk ◽  
Gynecological Cancer ◽  
Conformal Radiation Therapy ◽  
Significant Difference ◽  
Treatment Plans ◽  
Radiation Induced ◽  
Risk Treatment

Background/ Aim. Transition from standard to highly conformal radiation therapy techniques, requires implementation of complex advanced dosimetry. The aim of the work was comparison of dosimetric parameters of 3DCRT and VMAT plan, as well as complications after treatment in relation to dosimetric parameters at gynecological cancer patients. Methods. Forty-nine gynecological cancer patients were included in the study. All patients were planned for 3D CRT, but due to unacceptable doses to organs at risk, treatment plans for IMRT or VMAT were generated for 21 patients. The patients were prescribed 50.4 Gy/28 fractions (4) and 45 Gy/25 fractions (45 patients). The coverage of PTV and doses to organs at risk were recorded. PTV margins were evaluated for both techniques according to the Van Herk formula. Results. ICRU 83 criteria were fulfilled in all 3DCRT /VMAT/IMRT plans providing optimal coverage of PTV. Doses to OARS: in average, the V45Gy in small bowel in IMRT/VMAT plans was four times smaller than the same of 3DCRT plans. The V45Gy of small bowels was in average 49.4cm3 in IMRT/VMAT plans, while in 3DCRT plans it was 211.6 cm3. In case of femoral head, significant reduction in V30Gy (10.8 % vs. 33.1%) and mean dose in case of IMRT/VMAT plans was recorded (30.4 Gy in 3DCRT vs 23.6 Gy). Rectum was planned with significantly lower dose in terms of V30Gy (79.5% vs 95.2%) in IMRT/VMAT plans. Bladder was better spared in VMAT plans in terms of V40Gy (51% vs. 91%), but maximum dose was higher in VMAT plans than in 3DCRT (50.1 Gy to 48.1 Gy in average). For all OARs there is statistically significant difference registered at p>0.05. Toxicities recorded in VMAT and 3DCRT patients include mainly radiation induced cystitis and enteritis. Patients treated with 3DCRT generally have longer recovery time. Homogeneity index was 0.11 for VMAT plans and 0.09 for 3DCRT plans. Conclusions. Analysis of dosimetric parameters revealed significant differences in normal tissue doses for same 3DCRT and VMAT patient, which confirmed necessity for implementation of advanced techniques for as many patients as possible.

scholarly journals The overview of modern approaches in treatment of triple negative breast cancer

2020 ◽  
Vol 7 (1) ◽  
pp. 55-65
Author(s):  
A. A. Kharitonova ◽  
I. A. Smirnova ◽  
M. V. Kiseleva
Keyword(s):  
Breast Cancer ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Parp Inhibitors ◽  
Morphological Response ◽  
Chemotherapy Drugs ◽  
Treatment Regimens ◽  
Dose Dense ◽  
Platinum Preparations ◽  
Aggressive Subtype

By far the most aggressive subtype of breast cancer is triple negative cancer. The purpose of this review is to analyze current ideas about the pathogenesis, clinical characteristics of different subtypes of triple negative breast cancer, the nature of its metastasis, mechanisms of chemoresistance. The review presents the results of modern regimens of drug therapy of triple negative breast cancer according to the publications of domestic and foreign oncologists. On the basis of various clinical studies, the effectiveness of the use of anthracyclines, taxanes in the dose-dense regime, platinum preparations and other chemotherapy drugs for the treatment of triple-negative cancer has been shown. The presented treatment regimens allow to achieve a complete morphological response in 85% of patients, to increase the rates of relapse-free and overall survival, comparable with other subtypes of breast cancer. The review highlights the possibilities of modern targeted drugs-PARP inhibitors, chk1 inhibitors UCN‑01, immunotherapy possibilities for the treatment of this aggressive subtype of breast cancer.

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