scholarly journals The Feasibility of an Interactive Health Coaching Mobile Application to Prevent Malnutrition and Muscle Loss in Esophageal Cancer Patients Receiving Neoadjuvant Concurrent Chemoradiotherapy: A Prospective Pilot study (Preprint)

10.2196/28695 ◽  
2021 ◽  
Author(s):  
Kyungmi Yang ◽  
Dongryul Oh ◽  
Jae Myoung Noh ◽  
Han Gyul Yoon ◽  
Jong-Mu Sun ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Pilot Study ◽  
Cancer Patients ◽  
Mobile Application ◽  
Concurrent Chemoradiotherapy ◽  
Health Coaching ◽  
Muscle Loss ◽  
Prospective Pilot Study ◽  
Interactive Health

scholarly journals The Effects of an Interactive Health Coaching Application to Prevent Malnutrition and Muscle Loss in Esophageal Cancer Patients Receiving Neoadjuvant Concurrent Chemoradiotherapy: A Prospective Pilot study (Preprint)

2021 ◽  
Author(s):  
Kyungmi Yang ◽  
Dongryul Oh ◽  
Jae Myoung Noh ◽  
Han Gyul Yoon ◽  
Jong-Mu Sun ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Usual Care ◽  
Cancer Patients ◽  
Usual Care Group ◽  
Mobile Application ◽  
Health Coaching ◽  
Care Group ◽  
Muscle Loss ◽  
Individualized Care ◽  
Interactive Health

BACKGROUND Excessive muscle loss is an important prognostic factor in esophageal cancer patients undergoing neoadjuvant chemoradiotherapy (NACRT) as reported in our previous research. OBJECTIVE We prospectively tested the effectiveness of a health coaching mobile application in preventing malnutrition and muscle loss in this patient population. METHODS Between July 2019 and May 2020, we enrolled 38 male patients with esophageal cancer scheduled for NACRT. For 8 weeks from the start of radiotherapy (RT), the patients used a health coaching mobile application, the Noom®, that interactively provided online advice about food intake, exercise, and weight changes. The skeletal muscle index (SMI) measured on computed tomography, and nutrition-related laboratory markers were assessed before and after RT. We evaluated the changes of SMI, nutritional and inflammatory factors between the patients who used a mobile application (Noom group) and our previous study cohort (usual care group). Additionally, we analyzed the factors associated with walk steps recorded in the application. RESULTS Two patients dropped out of the study (no application use [n=1]; treatment changed to a definitive aim [n=1]). The use (or activation) of the application was noted in approximately 70% of patients (36 patients) until the end of the trial. Compared to the 1:2 matched usual care group by propensity scores balanced with age, primary tumor location, tumor stage, pre-RT body mass index, and pre-RT SMI level, 30 operable patients showed less aggravation of the prognostic nutritional index (PNI) (-6.7 vs. -9.8, P=.04). However, there was no significant difference in the SMI change or the number of patients with excessive muscle loss (∆SMI/50 days > 10%). In patients with excessive muscle loss, walk steps significantly decreased in the last four weeks compared to those in the first four weeks. Age affected the absolute number of walk steps (P=.01), while pre-RT sarcopenia was related to the recovery of reduced walk steps (P=.03). CONCLUSIONS For esophageal cancer patients receiving NACRT, an interactive health coaching mobile application helped nutritional self-care with less decrease in PNI, although it did not prevent excessive muscle loss. Low physical activity estimated by the number of walking steps did not recover even a few weeks after the end of NACRT in patients with old age or pretreatment sarcopenia. An individualized care model with proper exercise as well as nutritional support may be required to reduce muscle loss and malnutrition.

scholarly journals 18F-FDG PET/CT Parameters for Predicting Prognosis in Esophageal Cancer Patients Treated With Concurrent Chemoradiotherapy

2021 ◽  
Vol 20 ◽  
pp. 153303382110246
Author(s):  
Seokmo Lee ◽  
Yunseon Choi ◽  
Geumju Park ◽  
Sunmi Jo ◽  
Sun Seong Lee ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Cancer Patients ◽  
Fdg Pet ◽  
Concurrent Chemoradiotherapy ◽  
Curative Intent ◽  
Squamous Cell Esophageal Cancer ◽  
Pet Ct ◽  
Significant Difference ◽  
Fdg Pet Ct

Background and Aims: This study evaluated the prognostic value of 18F-fluorodeoxyglucose positron emission tomography with integrated computed tomography (18F-FDG PET/CT) performed before and after concurrent chemoradiotherapy (CCRT) in esophageal cancer. Methods: We analyzed the prognosis of 50 non-metastatic squamous cell esophageal cancer (T1-4N0-2) patients who underwent CCRT with curative intent at Inje University Busan Paik Hospital and Haeundae Paik Hospital from 2009 to 2019. Median total radiation dose was 54 Gy (range 34-66 Gy). Our aim was to investigate the relationship between PET/CT values and prognosis. The primary end point was progression-free survival (PFS). Results: The median follow-up period was 9.9 months (range 1.7-85.7). Median baseline maximum standard uptake value (SUVmax) was 14.2 (range 3.2-27.7). After treatment, 29 patients (58%) showed disease progression. The 3-year PFS and overall survival (OS) were 24.2% and 54.5%, respectively. PFS was significantly lower ( P = 0.015) when SUVmax of initial PET/CT exceeded 10 (n = 22). However, OS did not reach a significant difference based on maximum SUV ( P = 0.282). Small metabolic tumor volume (≤14.1) was related with good PFS ( P = 0.002) and OS ( P = 0.001). Small total lesion of glycolysis (≤107.3) also had a significant good prognostic effect on PFS ( P = 0.009) and OS ( P = 0.025). In a subgroup analysis of 18 patients with follow-up PET/CT, the patients with SUV max ≤3.5 in follow-up PET/CT showed longer PFS ( P = 0.028) than those with a maximum SUV >3.5. Conclusion: Maximum SUV of PET/CT is useful in predicting prognosis of esophageal cancer patients treated with CCRT. Efforts to find more effective treatments for patients at high risk of progression are still warranted.

Esophagectomy after concurrent chemoradiotherapy improves locoregional control in clinical stage II or III esophageal cancer patients

2004 ◽  
Vol 60 (5) ◽  
pp. 1484-1493 ◽  
Author(s):  
Zhongxing Liao ◽  
Zhen Zhang ◽  
Jing Jin ◽  
Jaffer A. Ajani ◽  
Stephen G. Swisher ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Cancer Patients ◽  
Concurrent Chemoradiotherapy ◽  
Clinical Stage ◽  
Stage Ii ◽  
Locoregional Control

The Effect of Oral Methadone on the QTc Interval in Advanced Cancer Patients: A Prospective Pilot Study

2010 ◽  
Vol 13 (6) ◽  
pp. 638-639 ◽  
Author(s):  
Daniel Bruce Heppe ◽  
Mark C.P. Haigney ◽  
Mori J. Krantz
Keyword(s):  
Pilot Study ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Qtc Interval ◽  
Advanced Cancer Patients ◽  
Prospective Pilot Study ◽  
Oral Methadone

scholarly journals Resilience at the End of Life as a Predictor for Postloss Growth in Bereaved Caregivers of Cancer Patients: A Prospective Pilot Study

2016 ◽  
Vol 51 (3) ◽  
pp. e3-e5 ◽  
Author(s):  
Yong Joo Lee ◽  
Youn Seon Choi ◽  
In Cheol Hwang ◽  
Hyo Min Kim ◽  
Sun Wook Hwang
Keyword(s):  
Pilot Study ◽  
End Of Life ◽  
Cancer Patients ◽  
Prospective Pilot Study

Home management of acute medical complications in cancer patients: a prospective pilot study

2015 ◽  
Vol 24 (5) ◽  
pp. 2129-2137 ◽  
Author(s):  
C. Font ◽  
F. Fernández-Avilés ◽  
C. Calderon ◽  
T. García-Fernández ◽  
N. Arab ◽  
...  
Keyword(s):  
Pilot Study ◽  
Cancer Patients ◽  
Medical Complications ◽  
Home Management ◽  
Prospective Pilot Study

scholarly journals Long-Term Survival in Nonsurgical Esophageal Cancer Patients Who Received Consolidation Chemotherapy Compared With Patients Who Received Concurrent Chemoradiotherapy Alone: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 ◽  
Author(s):  
Xiaojie Xia ◽  
Zeyuan Liu ◽  
Qin Qin ◽  
Xiaoke Di ◽  
Zhaoyue Zhang ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Cancer Patients ◽  
Concurrent Chemoradiotherapy ◽  
Meta Analysis ◽  
Objective Response ◽  
Progression Free Survival ◽  
Cochrane Library ◽  
Consolidation Chemotherapy ◽  
Term Survival ◽  
Treatment Toxicity

BackgroundConcurrent chemoradiotherapy (CCRT) is the standard treatment for nonsurgical esophageal cancer (EC). However, esophageal cancer patients receiving CCRT alone are still unsatisfactory in terms of local control and overall survival (OS) benefit. Clinicians generally add consolidation chemotherapy (CCT) after CCRT. It remains controversial whether CCT following CCRT is beneficial for esophageal cancer. We, therefore, undertook a meta-analysis to assess the need for CCT in inoperable esophageal cancer.Materials and MethodsWe combed PubMed, Embase, Cochrane Library, Web of Science, and CNKI for relevant published articles up to July 2020 that compared CCRT plus CCT to CCRT alone for patients with nonsurgical EC. Our primary endpoint was OS and progression-free survival (PFS), and the secondary endpoint was treatment toxicity. We analyzed the hazard ratio (HR) to estimate the time-to-event data and the odds ratio (OR) to compare the treatment-related effect. To assess heterogeneity, we performed the I2 test and examined publication bias using funnel plots analysis.ResultsThe 11 retrospective studies involved 2008 patients. Of these 2008 patients, 1018 received CCRT plus CCT, and 990 received CCRT. Compared to CCRT alone, CCT after CCRT did not improve disease control rate (DCR) (OR 1.66; 95% CI 0.53–5.15, p=0.384) and objective response rate (ORR) (OR 1.44; 95% CI 0.62–3.35, p=0.393). However, OS (HR 0.72; 95% CI 0.59–0.86, p < 0.001) and PFS (HR 0.61; 95% CI 0.44–0.84, p=0.003) did increase. Our results show that CCT plus CCRT had a clear survival advantage over CCRT alone. The risk of treatment toxicity did not increase for EC patients who received CCT.ConclusionCCT after CCRT significantly increases OS and PFS in patients with nonsurgical EC and could provide them remarkable survival benefits. The results provide an evidence-based framework for the use of CCT after CCRT.

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