scholarly journals Analysis of the Clinical Management and Quality of Life of Frail Patients with Cancer and Breakthrough Pain in Clinical Practice.

2021 ◽  
Author(s):  
Gemma Soler González ◽  
Juan Pérez Cajaraville ◽  
Silvia Forcano Sanjuan ◽  
José Luis Firvida Pérez ◽  
César Margarit Ferri ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Clinical Management ◽  
Breakthrough Pain ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Patients With Cancer ◽  
Frail Patients ◽  
Gradual Onset

Abstract BackgroundThe purpose of this study was to analyse the clinical management and quality of life of frail patients with cancer, chronic pain and breakthrough pain (BTP) and to assess whether treatment was conditioned by their frailty status.Methods This was an observational study in adult frail patients with cancer, chronic background pain and BTP. Outcomes of interest collected include clinical and sociodemographic data, Karnofsky Performance Status, quality of life (EuroQoL-5D-5L), chronic pain and BTP characteristics, as well as treatments administered for their control.ResultsA total of 222 patients were included with a mean age of 68 years (range 24-91), 60.5% men, with a mean Karnofsky of 63.2%. The number of daily episodes of BTP was 3.8 (95% CI 3.3-4.3), with a duration of 34.6 minutes (95% CI 28.8-40.3), and 56.8% had a gradual onset. Opioids were administered to 88.3% of patients for the chronic pain, and to 83.8% for BTP. The treatment's daily doses administered for chronic pain and BTP did not differ from those usually recommended. Quality of life was significantly worst in frail patients with cancer than no frail patients and was related to performance status (p<0.001) and to the social-familial status (p=0.045). ConclusionsBTP in frail patients with cancer presents with more episodes, of a shorter duration and more gradual onset compared to other patients with BTP, and Quality of life was seriously affected. No relevant differences were seen in the doses or method of administration of treatments for chronic pain and BTP in frail patients with cancer as compared to the standard recommendations for non-frail patients. Trial registration: Not applicable to the study.

scholarly journals Efficacy of naloxegol on symptoms and quality of life related to opioid-induced constipation in patients with cancer: a 3-month follow-up analysis

2020 ◽  
pp. bmjspcare-2020-002249
Author(s):  
Manuel Cobo Dols ◽  
Carmen Beato Zambrano ◽  
Luis Cabezón Gutiérrez ◽  
Rodolfo Chicas Sett ◽  
María Isabel Blancas López-Barajas ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Karnofsky Performance Status ◽  
Moderate Intensity ◽  
Life Questionnaire ◽  
Inadequate Response ◽  
Patient Assessment ◽  
Patients With Cancer ◽  
Bowel Movements

ObjectivesOpioid-induced constipation (OIC) can affect up to 63% of all patients with cancer. The objectives of this study were to assess quality of life as well as efficacy and safety of naloxegol, in patients with cancer with OIC.MethodsAn observational study was made of a cohort of patients with cancer and with OIC exhibiting an inadequate response to laxatives and treated with naloxegol. The sample consisted of adult outpatients with a Karnofsky performance status score ≥50. The Patient Assessment of Constipation Quality of Life Questionnaire (PAC-QOL) and the Patient Assessment of Constipation Symptoms (PAC-SYM) were applied for 3 months.ResultsA total of 126 patients (58.2% males) with a mean age of 61.3 years (range 34–89) were included. Clinically relevant improvements (>0.5 points) were recorded in the PAC-QOL and PAC-SYM questionnaires (p<0.0001) from 15 days of treatment. The number of days a week with complete spontaneous bowel movements increased significantly (p<0.0001) from 2.4 to 4.6 on day 15, 4.7 after 1 month and 5 after 3 months. Pain control significantly improved (p<0.0001) during follow-up. A total of 13.5% of the patients (17/126) presented some gastrointestinal adverse reaction, mostly of mild (62.5%) or moderate intensity (25%).ConclusionsClinically relevant improvements in OIC-related quality of life, number of bowel movements and constipation-related symptoms were recorded as early as after 15 days of treatment with naloxegol in patients with cancer and OIC, with a good safety profile.

Quality of life in patients with advanced gastroesophageal (GE) adenocarcinoma treated with modified docetaxel, cisplatin, and fluorouracil (mDCF).

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 92-92
Author(s):  
E. C. Smyth ◽  
Y. Y. Janjigian ◽  
E. Robinson ◽  
E. C. Sheehy ◽  
I. Karpenko ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Functioning ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Wilcoxon Test ◽  
Score Change ◽  
Two Phase ◽  
Phase Ii Studies ◽  
Significant Toxicity

92 Background: Although DCF is a standard first line chemotherapy option for advanced GE adenocarcinoma, the regimen is associated with significant toxicity. Even so, time to detriment in quality of life (QoL) was significantly better with parent DCF than CF (Ajani, JCO 2007). Modified DCF (mDCF) has demonstrated less toxicity than parent DCF without compromising efficacy in two phase II studies (Shah, GI ASCO 2010; Kelsen, ASCO 2009). We report the quality of life (QoL) over time of patients receiving mDCF on these two clinical trials. Methods: Patients (pts) treated on two protocols utilizing the mDCF regimen, either alone or in combination with bevacizumab, were administered standard EORTC QoL questionnaires (QLC –C30 version 3), at baseline, 6 weeks, 3, 6, 9 and 12 months (m). Chemotherapy and QoL assessment continued until disease progression. Mean score change from baseline was assessed using Wilcoxon test. Results: 94 eligible pts have been enrolled on both studies; QoL questionnaires are available on 87 pts. 74% are male, median age 58 years (range 28-78), with baseline Karnofsky performance status of 80% (range 70-100). Patient compliance with QoL assessment was high at baseline but diminished with time; 89% of pts completed the questionnaire at baseline and 41% at 12m. There was no significant detriment in EORTC QOL scores (including global health, physical and social functioning and fatigue) during treatment with mDCF (Table). Conclusions: In patients with advanced GE cancer, we observed no detriment in QoL scores in patients receiving mDCF therapy. Specifically, physical and social functioning, fatigue, appetite, and global heath QoL scores were maintained at baseline levels during the first 6 months of therapy, and appear to improve in patients who remained on protocol therapy during the next 6 months of treatment. [Table: see text] No significant financial relationships to disclose.

scholarly journals Long Survival in a Patient with Brain Metastases from Breast Cancer

2008 ◽  
Vol 2 ◽  
pp. CMO.S317
Author(s):  
G Sanna ◽  
G Petralia ◽  
M Cossu Rocca ◽  
C Marenghi ◽  
F Nolè
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Brain Metastases ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Good Control ◽  
Short Report ◽  
Whole Brain Irradiation ◽  
Her Family

The incidence of brain metastases (BMs) is apparently rising in patients with advanced breast cancer, possibly due to better therapeutic approaches for control of metastatic growth in other organs. Occurrence of BMs severely affects quality of life and is associated with dire prognosis. In this short report we describe the clinical case of a 47 year old woman, with BMs from breast cancer diagnosed in May 2001. The patient was treated with whole brain irradiation and radiosurgery, with initial control of BMs. Due to previous radiotherapy fields and doses, further local treatments are not feasible anymore. Since September 2006, the patient has been receiving systemic therapy with Lapatinib at the dose of 1500 mg/die continuously, with a good control of cerebral, liver and nodal metastasis after one year of treatment (September 2007). Her quality of life is acceptable, her Karnofsky Performance Status (KPS) is more than 70%, and she takes care of her family, and has not experienced neuro-cognitive dysfunction.

Breakthrough pain in community-dwelling patients with cancer pain and noncancer pain, Part 2: Impact on function, mood, and quality of life

2010 ◽  
Vol 6 (2) ◽  
pp. 109-116 ◽  
Author(s):  
Russell K. Portenoy, MD ◽  
Daniel Bruns, PsyD ◽  
Bonnie Shoemaker, BSN ◽  
Steven A. Shoemaker, MD
Keyword(s):  
Quality Of Life ◽  
Cancer Pain ◽  
Breakthrough Pain ◽  
Community Dwelling ◽  
Patients With Cancer ◽  
Noncancer Pain

Three or More Courses of Stereotactic Radiosurgery for Patients with Multiply Recurrent Brain Metastases

Neurosurgery ◽  
2017 ◽  
Vol 80 (6) ◽  
pp. 871-879 ◽  
Author(s):  
Rupesh Kotecha ◽  
Nicholas Damico ◽  
Jacob A. Miller ◽  
John H. Suh ◽  
Erin S. Murphy ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Overall Survival ◽  
Confidence Interval ◽  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Cox Regression ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Intracranial Recurrence

Abstract BACKGROUND: Although patients with brain metastasis are treated with primary stereotactic radiosurgery (SRS), the use of salvage therapies and their consequence remains understudied. OBJECTIVE: To study the intracranial recurrence patterns and salvage therapies for patients who underwent multiple SRS courses. METHODS: A retrospective review was performed of 59 patients with brain metastases who underwent ≥3 SRS courses for new lesions. Cox regression analyzed factors predictive for overall survival. RESULTS: The median age at diagnosis was 52 years. Over time, patients underwent a median of 3 courses of SRS (range: 3-8) to a total of 765 different brain metastases. The 6-month risk of distant intracranial recurrence after the first SRS treatment was 64% (95% confidence interval: 52%-77%). Overall survival was 40% (95% confidence interval: 28%-53%) at 24 months. Only 24 patients (41%) had a decline in their Karnofsky Performance Status ≤70 at last office visit. Quality of life was preserved among 77% of patients at 12 months, with 45% experiencing clinically significant improvement during clinical follow-up. Radiation necrosis developed in 10 patients (17%). On multivariate analysis, gender (males, Hazard Ratio [HR]: 2.0, P &lt; .05), Karnofsky Performance Status ≤80 (HR 3.2, P &lt; .001), extracranial metastases (HR: 3.6, P &lt; .001), and a distant intracranial recurrence ≤3 months from initial to repeat SRS (HR: 3.8, P &lt; .001) were associated with a poorer survival. CONCLUSION: In selected patients, performing ≥3 SRS courses controls intracranial disease. Patients may need salvage SRS for distant intracranial relapse, but focal retreatments are associated with modest toxicity, do not appear to negatively affect a patient's performance status, and help preserve quality of life.

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