Cingulotomy for medically refractory cancer pain

Object Cingulotomy has been reported in the literature as a potential treatment option for refractory cancer-related pain. However, the optimal candidates for this intervention and the outcomes are not well characterized. The goal of this study was to review the available literature on cingulotomy, specifically for cancer-related pain. Methods A search of PubMed, PubMed Central, the Cochrane Library, and MEDLINE was performed to identify all articles discussing cingulotomy for cancer pain. The text strings “cingul*” and “pain” were separated by the Boolean AND operator, and used to perform the query on PubMed. Only studies in which a stereotactic technique was used, as opposed to an open technique, and specifically detailing outcomes for cancer pain were included. For centers with multiple publications, care was taken not to double-count individual patients. Results The literature review revealed only 8 unique studies describing outcomes of stereotactic cingulotomy for cancer pain. Between 32% and 83% of patients had meaningful pain relief. The location of the lesion was variable, ranging between 1 cm and 4 cm posterior to the tip of the anterior horn. Although serious adverse events are rare, a decline in focused attention can been seen in the early postoperative period, along with apathy and decreased activity. Conclusions For patients with cancer pain with diffuse pain syndromes, head and neck malignancies, and significant emotional distress, cingulotomy may be a safe treatment option with minimal cognitive changes.

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The use of non-pharmacological adjuvant therapies for cancer pain: a narrative review in the context of dance

Research Society and Development ◽

10.33448/rsd-v11i1.24771 ◽

2022 ◽

Vol 11 (1) ◽

pp. e30411124771

Author(s):

Elaine Izabel da Silva Cruz ◽

Aline Helena da Silva Cruz ◽

Rômulo Alberto Silva Marques ◽

Rodrigo da Silva Santos ◽

Angela Adamski da Silva Reis

Keyword(s):

Cancer Pain ◽

Cancer Treatment ◽

Life Quality ◽

Pharmacological Therapy ◽

Cochrane Library ◽

Patients With Cancer ◽

Number Of Publications ◽

The Cochrane Library ◽

The Relationship

Cancer is one of the leading causes of morbidity in the globe, with more than half of patients reporting pain as a result of the disease. By reducing cancer-related pain, dance has the potential to redefine the life of patients independently of their cure prognosis. This review investigated the benefits of dance as adjuvant, non-pharmacological therapy for cancer treatment. To identify studies related to this topic, we searched the Cochrane Library, PUBMED, Scielo, BVS, Embase, CINAHL, and PsycINFO databases. However, we found few published systematic reports investigating the effects of dance in cancer treatment. The numbers are even smaller when we considered the relationship between dance and cancer pain. Although there is a small number of publications on this theme, we reviewed studies that indicate that there is a positive relationship between dance practice and cancer pain management. Moreover, we found that the decline of pain contributed to the better life quality of patients with cancer. We concluded that dance is a physical practice that may improve patients’ quality of life. Regarding the estimations of cancer diagnosis and pain during disease development and therapy, it is fundamental new studies and clinical trials that integrate dance as adjuvant therapy for improving cancer pain and patient’s life quality.

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Therapeutic Ultrasound for Chronic Pain Management in Joints: A Systematic Review

Pain Medicine ◽

10.1093/pm/pnz102 ◽

2019 ◽

Vol 21 (7) ◽

pp. 1437-1448 ◽

Cited By ~ 2

Author(s):

Rohit Aiyer ◽

Selaiman A Noori ◽

Ke-Vin Chang ◽

Boyoun Jung ◽

Abdullah Rasheed ◽

...

Keyword(s):

Systematic Review ◽

Statistical Significance ◽

Therapeutic Ultrasound ◽

Hip Pain ◽

Functional Improvement ◽

Cochrane Library ◽

Pubmed Central ◽

Pain Syndromes ◽

Low Intensity Ultrasound ◽

The Cochrane Library

Abstract Background Treatments for joint pain and dysfunction focus on restoration of joint motion, improvement in pain and a return to the previous level of the patient's daily activity. Therapeutic ultrasound is a noninvasive modality widely utilized in the management of musculoskeletal disorders. The objective of this systematic review was to evaluate the effectiveness of therapeutic ultrasound in the management of patients with knee, shoulder and hip pain. Methods Using PRISMA guidelines, a search of the PubMed, CENTRAL (The Cochrane Library), Web of Science and Scopus databases was performed to retrieve randomized controlled trials (RCTs) that evaluated therapeutic ultrasound (continuous and pulsed) in patients with chronic knee, shoulder and hip pain. Results The search strategy identified 8 trials for knee, 7 trials for shoulder and 0 trials for hip that met the criteria for inclusion. All 8 trials showed improvement in knee pain, and of these studies 3 showed statistical significance improvement for therapeutic ultrasound versus the comparator. For shoulder pain, all 7 trials showed reduction in pain, but should be noted that 4 of studies demonstrated that therapeutic ultrasound is inferior to the comparator modality, Conclusion Therapeutic ultrasound is frequently used in the treatment of knee, shoulder and hip pain and is often combined with other physiotherapeutic modalities. The literature on knee arthritis is most robust, with some evidence supporting therapeutic ultrasound, though the delivery method of ultrasound (pulsed vs continuous) is controversial. As a monotherapy, ultrasound treatment may not have a significant impact on functional improvement but can be a reasonable adjunct to consider with other common modalities. In all three pain syndromes, especially for hip pain, further trials are needed to define the true effect of low-intensity ultrasound therapy knee, shoulder and hip pain. No conclusive recommendations may be made for optimal settings or session duration.

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Survival of Patients Treated with Antibiotics and Immunotherapy for Cancer: A Systematic Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm9051458 ◽

2020 ◽

Vol 9 (5) ◽

pp. 1458 ◽

Cited By ~ 1

Author(s):

Fausto Petrelli ◽

Alessandro Iaculli ◽

Diego Signorelli ◽

Antonio Ghidini ◽

Lorenzo Dottorini ◽

...

Keyword(s):

Cancer Patients ◽

Checkpoint Inhibitors ◽

Meta Analysis ◽

Progression Free Survival ◽

Cochrane Library ◽

Free Survival ◽

Patients With Cancer ◽

Hazard Ratios ◽

The Cochrane Library ◽

Reporting Data

Antibiotics (ABs) are common medications used for treating infections. In cancer patients treated with immune checkpoint inhibitors (ICIs), concomitant exposure to ABs may impair the efficacy of ICIs and lead to a poorer outcome compared to AB non-users. We report here the results of a meta-analysis evaluating the effects of ABs on the outcome of patients with solid tumours treated with ICIs. PubMed, the Cochrane Library and Embase were searched from inception until September 2019 for observational or prospective studies reporting the prognoses of adult patients with cancer treated with ICIs and with or without ABs. Overall survival (OS) was the primary endpoint, and progression-free survival (PFS) was the secondary endpoint. The effect size was reported as hazard ratios (HRs) with a 95% confidence interval (CI) and an HR > 1 associated with a worse outcome in ABs users compared to AB non-users. Fifteen publications were retrieved for a total of 2363 patients. In the main analysis (n = 15 studies reporting data), OS was reduced in patients exposed to ABs before or during treatment with ICIs (HR = 2.07, 95%CI 1.51–2.84; p < 0.01). Similarly, PFS was inferior in AB users in n = 13 studies with data available (HR = 1.53, 95%CI 1.22–1.93; p < 0.01). In cancer patients treated with ICIs, AB use significantly reduced OS and PFS. Short duration/course of ABs may be considered in clinical situations in which they are strictly needed.

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Comparative Effectiveness and Harms of Intraoperative Transesophageal Echocardiography in Noncardiac Surgery: A Systematic Review

Seminars in Cardiothoracic and Vascular Anesthesia ◽

10.1177/1089253218756756 ◽

2018 ◽

Vol 22 (2) ◽

pp. 122-136 ◽

Cited By ~ 4

Author(s):

Ashraf Fayad ◽

Sasha Shillcutt ◽

Massimiliano Meineri ◽

Terrence D. Ruddy ◽

Mohammed Toseef Ansari

Keyword(s):

Systematic Review ◽

Transesophageal Echocardiography ◽

Comparative Effectiveness ◽

Noncardiac Surgery ◽

Cochrane Library ◽

Serious Adverse Events ◽

Ovid Medline ◽

Quantitative Synthesis ◽

The Cochrane Library ◽

Important Design

Intraoperative use of transesophageal echocardiography (TEE) has become commonplace in high-risk noncardiac surgeries but the balance of benefits and harms remains unclear. This systematic review investigated the comparative effectiveness and harms of intraoperative TEE in noncardiac surgery. We searched Ovid MEDLINE, PubMed, EMBASE, and the Cochrane Library from 1946 to March 2017. Two reviewers independently screened the literature for eligibility. Studies were assessed for the risk of selection bias, confounding, measurement bias, and reporting bias. Three comparative and 13 noncomparative studies were included. Intraoperative TEE was employed in a total of 1912 of 3837 patients. Studies had important design limitations. Data were not amenable to quantitative synthesis due to clinical and methodological diversity. Reported incidence of TEE complications ranged from 0% to 1.7% in patients undergoing various procedures (5 studies, 540 patients). No serious adverse events were observed for mixed surgeries (2 studies, 197 patients). Changes in surgical or medical management attributable to the use of TEE were noted in 17% to 81% of patients (7 studies, 558 patients). The only randomized trial of intraoperative TEE was grossly underpowered to detect meaningful differences in 30-day postoperative outcomes. There is lack of high-quality evidence of effectiveness and harms of intraoperative TEE in the management of non-cardiac surgeries. Evidence, however, indicates timely evaluation of cardiac function and structure, and hemodynamics. Future studies should be comparative evaluating confounder-adjusted impact on both intraoperative and 30-day postoperative clinical outcomes.

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Survival of Patients Treated with Antibiotics and Immunotherapy for Cancer: A Systematic Review and Meta-Analysis

10.20944/preprints202003.0425.v1 ◽

2020 ◽

Author(s):

Fausto Petrelli ◽

Alessandro Iaculli ◽

Diego Signorelli ◽

Antonio Ghidini ◽

Lorenzo Dottorini ◽

...

Keyword(s):

Cancer Patients ◽

Checkpoint Inhibitors ◽

Meta Analysis ◽

Progression Free Survival ◽

Cochrane Library ◽

Free Survival ◽

Patients With Cancer ◽

Hazard Ratios ◽

The Cochrane Library ◽

Reporting Data

Antibiotics (ABs) are common medications used for treating infections. In cancer patients treated with immune checkpoint inhibitors (ICIs), concomitant exposure to ABs may impair the efficacy of ICIs and lead to a poorer outcome compared to AB non-users. We report here the results of a meta-analysis evaluating the effects of ABs on the outcome of patients with solid tumors treated with ICIs. PubMed, the Cochrane Library, and Embase were searched from inception until September 2019 for observational or prospective studies reporting prognosis of adult patients with cancer treated with ICIs and with or without ABs. Overall survival (OS) was the primary endpoint, and progression-free survival (PFS) was the secondary endpoint. The effect size was reported as hazard ratios (HRs) with a 95% confidence interval (CI), and an HR > 1 associated with a worse outcome in ABs users compared to no-ABs users. Fifteen publications were retrieved for a total of 2363 patients. In the main analysis (n = 15 studies reporting data), OS was reduced in patients exposed to ABs before or during treatment with ICIs (HR = 2.07, 95%CI 1.51–2.84; P<.01). Similarly, PFS was inferior in ABs users in n = 13 studies with data available (HR = 1.53, 95%CI 1.22–1.93; p<.01). In cancer patients treated with ICIs, AB use significantly reduces OS and PFS. Short duration/course of ABs may be considered in clinical situations in which they are strictly needed.

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Risk of Suicide Mortality Among Cancer Patients: A Meta-Analysis of Observational Studies

European Psychiatry ◽

10.1016/j.eurpsy.2017.02.157 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S290-S291 ◽

Cited By ~ 3

Author(s):

R. Calati ◽

V. Di Mattei ◽

P. Courtet

Keyword(s):

Suicide Risk ◽

Meta Analysis ◽

Suicide Mortality ◽

Cochrane Library ◽

Case Control Studies ◽

Patients With Cancer ◽

Competing Interest ◽

Trim And Fill ◽

Meta Analyses ◽

The Cochrane Library

IntroductionSuicide rates among patients with cancer are higher than ones in the general population.ObjectiveThis meta-analysis aims to estimate the suicide risk in patients with cancer.MethodsWe searched Medline, PsycINFO, and the Cochrane library to identify articles published before July 1, 2016, examining the association between suicide [death (SD), attempt (SA), ideation (SI)] and any form of diagnosed cancer.ResultsWe initially identified 4880 records and after unsuitable studies were removed, our search yielded 102 publications of which 14 were used in the meta-analyses. Patients with cancer had higher risk of SD (seven studies, 247.869 participants; odds ratio [OR] = 1.52, 95% CI = 1.22–1.89, P = 0.0002) compared with those without cancer (among case-control studies focused on SD versus living controls). Among studies focused on SD versus other deaths, patients with cancer had higher risk of SD (two studies, 23.839 participants; OR = 1.53, 95% CI = 1.03–2.27, P = 0.03). No difference has been detected for risk of SA (four studies, 8.147.762 participants) and for SI (two studies, 37.879 participants).Since publication bias was detected, the “trim and fill” method was applied. The majority of the included studies have a high quality at the STROBE statement.ConclusionThe assessment of suicide risk in this population is crucial.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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American Society of Hematology/American Society of Clinical Oncology clinical practice guideline update on the use of epoetin and darbepoetin in adult patients with cancer

Blood ◽

10.1182/blood-2010-08-300541 ◽

2010 ◽

Vol 116 (20) ◽

pp. 4045-4059 ◽

Cited By ~ 139

Author(s):

J. Douglas Rizzo ◽

Melissa Brouwers ◽

Patricia Hurley ◽

Jerome Seidenfeld ◽

Murat O. Arcasoy ◽

...

Keyword(s):

Clinical Oncology ◽

Chemotherapeutic Agents ◽

Concurrent Chemotherapy ◽

Cochrane Library ◽

Patients With Cancer ◽

Increased Risk ◽

American Society ◽

Meta Analyses ◽

Dose Modifications ◽

The Cochrane Library

Abstract Purpose: To update American Society of Hematology/American Society of Clinical Oncology recommendations for use of erythropoiesis-stimulating agents (ESAs) in patients with cancer. Methods: An Update Committee reviewed data published between January 2007 and January 2010. MEDLINE and the Cochrane Library were searched. Results: The literature search yielded one new individual patient data analysis and four literature-based meta-analyses, two systematic reviews, and 13 publications reporting new results from randomized controlled trials not included in prior or new reviews. Recommendations: For patients undergoing myelosuppressive chemotherapy who have a hemoglobin (Hb) level less than 10 g/dL, the Update Committee recommends that clinicians discuss potential harms (eg, thromboembolism, shorter survival) and benefits (eg, decreased transfusions) of ESAs and compare these with potential harms (eg, serious infections, immune-mediated adverse reactions) and benefits (eg, rapid Hb improvement) of RBC transfusions. Individual preferences for assumed risk should contribute to shared decisions on managing chemotherapy-induced anemia. The Committee cautions against ESA use under other circumstances. If used, ESAs should be administered at the lowest dose possible and should increase Hb to the lowest concentration possible to avoid transfusions. Available evidence does not identify Hb levels ≥ 10 g/dL either as thresholds for initiating treatment or as targets for ESA therapy. Starting doses and dose modifications after response or nonresponse should follow US Food and Drug Administration–approved labeling. ESAs should be discontinued after 6 to 8 weeks in nonresponders. ESAs should be avoided in patients with cancer not receiving concurrent chemotherapy, except for those with lower risk myelodysplastic syndromes. Caution should be exercised when using ESAs with chemotherapeutic agents in diseases associated with increased risk of thromboembolic complications. Table 1 lists detailed recommendations.

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Prognostic Role of MicroRNA-126 for Survival in Malignant Tumors: A Systematic Review and Meta-Analysis

Disease Markers ◽

10.1155/2015/739469 ◽

2015 ◽

Vol 2015 ◽

pp. 1-11 ◽

Cited By ~ 6

Author(s):

Jie Bu ◽

Hui Li ◽

Xiao-yang Li ◽

Li-hong Liu ◽

Wei Sun ◽

...

Keyword(s):

Systematic Review ◽

Malignant Tumors ◽

Meta Analysis ◽

Cochrane Library ◽

Prognostic Role ◽

Patients With Cancer ◽

Hazard Ratios ◽

High Level ◽

The Cochrane Library

Background.Increasing studies found that miR-126 expression may be associated with the prognosis of cancers. Here, we performed a meta-analysis to assess the prognostic role of miR-126 in different cancers.Methods.Eligible studies were identified by searching in PubMed, Embase, the Cochrane Library, CNKI, and Wan Fang databases up to March 2015. Pooled hazard ratios (HRs) and their corresponding 95% confidence intervals (CIs) were calculated to investigate the correlation between miR-126 and survival of cancers.Results.Thirty studies including a total of 4497 participants were enrolled in this meta-analysis. The pooled results showed that high level of miR-126 was a predictor for favorable survival of carcinomas, with pooled HR of 0.77 (95% CI 0.64–0.93) for OS, 0.64 (95%CI 0.48–0.85) for DFS, and 0.70 (95% CI 0.50–0.98) for PFS/RFS/DSS. However, high level of circulating miR-126 predicted a significantly worse OS in patients with cancer (HR = 1.65, 95% CI 1.09–2.51).Conclusions.Our results indicated that miR-126 could act as a significant biomarker in the prognosis of various cancers.

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Management of cancer-associated anemia with erythropoiesis-stimulating agents: ASCO/ASH clinical practice guideline update

Blood Advances ◽

10.1182/bloodadvances.2018030387 ◽

2019 ◽

Vol 3 (8) ◽

pp. 1197-1210 ◽

Cited By ~ 14

Author(s):

Julia Bohlius ◽

Kari Bohlke ◽

Roberto Castelli ◽

Benjamin Djulbegovic ◽

Maryam B. Lustberg ◽

...

Keyword(s):

Literature Review ◽

Similar Efficacy ◽

Cochrane Library ◽

Erythropoiesis Stimulating Agents ◽

Additional Information ◽

Patients With Cancer ◽

American Society ◽

Meta Analyses ◽

The Cochrane Library ◽

Rbc Transfusion

Abstract Purpose: To update the American Society of Clinical Oncology (ASCO)/American Society of Hematology (ASH) recommendations for use of erythropoiesis-stimulating agents (ESAs) in patients with cancer. Methods: PubMed and the Cochrane Library were searched for randomized controlled trials (RCTs) and meta-analyses of RCTs in patients with cancer published from January 31, 2010, through May 14, 2018. For biosimilar ESAs, the literature search was expanded to include meta-analyses and RCTs in patients with cancer or chronic kidney disease and cohort studies in patients with cancer due to limited RCT evidence in the cancer setting. ASCO and ASH convened an Expert Panel to review the evidence and revise previous recommendations as needed. Results: The primary literature review included 15 meta-analyses of RCTs and two RCTs. A growing body of evidence suggests that adding iron to treatment with an ESA may improve hematopoietic response and reduce the likelihood of RBC transfusion. The biosimilar literature review suggested that biosimilars of epoetin alfa have similar efficacy and safety to reference products, although evidence in cancer remains limited. Recommendations: ESAs (including biosimilars) may be offered to patients with chemotherapy-associated anemia whose cancer treatment is not curative in intent and whose hemoglobin has declined to < 10 g/dL. RBC transfusion is also an option. With the exception of selected patients with myelodysplastic syndromes, ESAs should not be offered to most patients with nonchemotherapy-associated anemia. During ESA treatment, hemoglobin may be increased to the lowest concentration needed to avoid transfusions. Iron replacement may be used to improve hemoglobin response and reduce RBC transfusions for patients receiving ESA with or without iron deficiency. Additional information is available at www.asco.org/supportive-care-guidelines and www.hematology.org/guidelines.

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Better survival of patients with oligo- compared with polymetastatic cancers: a systematic review and meta-analysis of 173 studies

F1000Research ◽

10.12688/f1000research.52546.1 ◽

2021 ◽

Vol 10 ◽

pp. 423

Author(s):

Fausto Petrelli ◽

Antonio Ghidini ◽

Michele Ghidini ◽

Roberta Bukovec ◽

Francesca Trevisan ◽

...

Keyword(s):

Meta Analysis ◽

Stage Iv ◽

Progression Free Survival ◽

Hazard Ratio ◽

Modern Concept ◽

Cochrane Library ◽

Published Data ◽

Patients With Cancer ◽

Risk Of Death ◽

The Cochrane Library

Background: The modern concept of oligometastatic (OM) state has been initially developed to describe patients with a low burden of disease and with a potential for cure with local ablative treatments. We systematically assessed the risk of death and relapse of oligometastatic (OM) cancers compared to cancers with more diffuse metastatic spread, through a meta-analysis of published data. Methods: PubMed, the Cochrane Library, and EMBASE were searched for studies reporting prognosis of patients with OM solid tumors. Risk of death and relapse were extracted and pooled to provide an adjusted hazard ratio with a 95% confidence interval (HR 95%CI). The primary outcome of the study refers to overall mortality in OM vs. polymetastatic (PM) patients. Results. Mortality and relapse associated with OM state in patients with cancer were evaluated among 104,234 participants (n=173 studies). Progression-free survival was better in patients with OM disease (hazard ratio [HR] = 0.62, 95% CI 0.57–0.68; P <.001; n=69 studies). Also, OM cancers were associated with a better OS (HR = 0.65, 95% CI 0.62-0.68; P<.01; n=161 studies). In colorectal (CRC), breast, non-small cell lung cancer (NSCLC) and renal cell carcinoma (RCC) the reduction in the risk of death for OM patients were 35, 38, 30 and 42%, respectively. Conclusions. Patients with oligometastases have a significantly better prognosis than those with more widespread stage IV tumors. We suggest that a treatment strategy that involves bot the primary and the metastases should be identified at the time of diagnosis.

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