scholarly journals Implementação de um Protocolo Fisioterapêutico em Pacientes Hemato-Oncológicos

2021 ◽  
Vol 67 (1) ◽  
Author(s):  
Stephanie Roberta Monteiro Longaray ◽  
Dionéia Oliveira ◽  
Soraia Genebra Ibrahim Forgiarini ◽  
Vanessa Giendruczak da Silva
Keyword(s):  
Medical Research ◽  
Research Council ◽  
Medical Research Council ◽  
Group Performance ◽  
Performance Status ◽  
Eastern Cooperative Oncology Group ◽  
Multidimensional Fatigue Inventory ◽  
Oncology Group ◽  
Porto Alegre

Introdução: Os cânceres hematológicos afetam o organismo com diversas disfunções, e a fisioterapia tem o intuito de auxiliar na prevenção e no tratamento, proporcionando uma melhor qualidade de vida. Objetivo: Verificar os efeitos de um protocolo fisioterapêutico em indivíduos com câncer hematológico. Método: Trata-se de um estudo quase-experimental, com participantes de 18 a 50 anos de idade, de ambos os sexos, realizado no Complexo Hospitalar da Santa Casa de Misericórdia de Porto Alegre. Aplicou-se um protocolo fisioterapêutico por quatro semanas, conforme o estágio hematológico individual, no qual foram avaliados força, bem-estar geral e performance, além de fadiga, respectivamente, com as escalas: Medical Research Council (MRC), Karnofsky, Eastern Cooperative Oncology Group Performance Status (ECOG) e Multidimensional Fatigue Inventory (MFI) 20 - versão brasileira. Resultados: Foram incluídos 11 indivíduos. Verificou-se um aumento significativo da força muscular (p=0,024). Na avaliação do bem-estar geral e performance, não houve diferença significativa (p=0,192) e (p=0,368), assim como nos exames sanguíneos (p>0,05). Na análise dos sinais vitais, apenas a frequência respiratória apresentou aumento significativo no pré e pós-protocolo (p=0,04). Houve correlações significativas entre as escalas de Karnofsky e ECOG (r=-0,81;), MFI e ECOG (r=0,64) e MFI e de Borg (r=0,67), com p<0,05. Conclusão: Os resultados mostraram que é possível utilizar um protocolo fisioterapêutico que se adapte ao perfil hematológico e às condições clínicas do paciente nessa área, existindo correlações entre diversas variáveis funcionais avaliadas, contudo mais estudos são necessários.

Comprehensive Geriatric Assessment Adds Information to Eastern Cooperative Oncology Group Performance Status in Elderly Cancer Patients: An Italian Group for Geriatric Oncology Study

2002 ◽  
Vol 20 (2) ◽  
pp. 494-502 ◽  
Author(s):  
Lazzaro Repetto ◽  
Lucia Fratino ◽  
Riccardo A. Audisio ◽  
Antonella Venturino ◽  
Walter Gianni ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Daily Living ◽  
Group Performance ◽  
Performance Status ◽  
Eastern Cooperative Oncology Group ◽  
Geriatric Oncology ◽  
Oncology Group ◽  
Elderly Cancer Patients

PURPOSE: To appraise the performance of Comprehensive Geriatric Assessment (CGA) in elderly cancer patients (≥ 65 years) and to evaluate whether it could add further information with respect to the Eastern Cooperative Oncology Group performance status (PS). PATIENTS AND METHODS: We studied 363 elderly cancer patients (195 males, 168 females; median age, 72 years) with solid (n = 271) or hematologic (n = 92) tumors. In addition to PS, their physical function was assessed by means of the activity of daily living (ADL) and instrumental activities of daily living (IADL) scales. Comorbidities were categorized according to Satariano’s index. The association between PS, comorbidity, and the items of the CGA was assessed by means of logistic regression analysis. RESULTS: These 363 elderly cancer patients had a good functional and mental status: 74% had a good PS (ie, lower than 2), 86% were ADL-independent, and 52% were IADL-independent. Forty-one percent of patients had one or more comorbid conditions. Of the patients with a good PS, 13.0% had two or more comorbidities; 9.3% and 37.7% had ADL or IADL limitations, respectively. By multivariate analysis, elderly cancer patients who were ADL-dependent or IADL-dependent had a nearly two-fold higher probability of having an elevated Satariano’s index than independent patients. A strong association emerged between PS and CGA, with a nearly five-fold increased probability of having a poor PS (ie, ≥ 2) recorded in patients dependent for ADL or IADL. CONCLUSION: The CGA adds substantial information on the functional assessment of elderly cancer patients, including patients with a good PS. The role of PS as unique marker of functional status needs to be reappraised among elderly cancer patients.

Prognostic factors of ado-trastuzumab emtansine treatment in patients with metastatic HER-2 positive breast cancer

2020 ◽  
pp. 107815522092408 ◽  
Author(s):  
Deniz Tataroglu Ozyukseler ◽  
Mustafa Basak ◽  
Seval Ay ◽  
Aygül Koseoglu ◽  
Serdar Arıcı ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Group Performance ◽  
Performance Status ◽  
Eastern Cooperative Oncology Group ◽  
Progression Free Survival ◽  
Trastuzumab Emtansine ◽  
Oncology Group ◽  
Cancer Antigen ◽  
Free Survival

Background Ado-trastuzumab emtansine is an antibody-drug conjugate that combines the cytotoxic activity of emtansine with human epidermal growth factor receptor 2-targeted antitumor features of trastuzumab. Objective We conducted a study of metastatic breast cancer patients treated with trastuzumab emtansine. By evaluating progression-free survival, overall survival, and response rates, we aimed to find prognostic factors of trastuzumab emtansine treatment. Methods Our study is a single-center, retrospective, observational study. We have clinical data from 78 patients treated with trastuzumab emtansine for metastatic breast cancer, from May 2016 through May 2019, at Kartal Dr Lutfi Kirdar Education and Research Hospital, Medical Oncology Department. Our objective is to assess the survival and response rates in trastuzumab emtansine-treated individuals and the factors associated with survival. The factors we analyzed were cancer antigen 15-3 sensitivity, Eastern Cooperative Oncology Group-Performance Status, presence or absence of visceral metastases, presence or absence of cranial metastases, and treatment-associated thrombocytopenia. Results Among 78 patients, median progression-free survival was 7.8 months, and overall survival was 21.1 months. Twenty of the patients had an objective tumor response. The results showed that trastuzumab emtansine was tolerable with a manageable safety profile and consistent with the results of the previous literature. Mostly seen adverse events were anemia, thrombocytopenia, fatigue, and increased levels of alkaline phosphatase. Patients with Eastern Cooperative Oncology Group-Performance Status = 2 had worse progression-free survival and overall survival compared to ones with Eastern Cooperative Oncology Group-Performance Status < 2; progression-free survival and overall survival are worse in cancer antigen 15-3-sensitive breast cancer patients. According to our findings, treatment-associated thrombocytopenia was a significant prognostic factor for survival. Patients with thrombocytopenia had 12 months progression-free survival, whereas patients without thrombocytopenia had only 4.1 months progression-free survival. In like manner, overall survival was much better in the thrombocytopenia-experienced patients as 29.5 versus 11.8 months. Conclusions Trastuzumab emtansine prolongs progression-free survival and overall survival with a manageable safety profile. Thrombocytopenia, Eastern Cooperative Oncology Group-Performance Status, and cancer antigen 15-3 are correlated with progression-free survival and/or overall survival.

Long-Term Survival in Patients Receiving Conventional Therapy for Newly Diagnosed Multiple Myeloma; Results from United Kingdom Medical Research Council Trials 1980–1997.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 4921-4921
Author(s):  
Bradley M. Augustson ◽  
Gulnaz Begum ◽  
Gareth J. Morgan ◽  
J. Anthony Child ◽  
Nicola J. Barth ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Medical Research ◽  
Conventional Therapy ◽  
Research Council ◽  
Medical Research Council ◽  
Performance Status ◽  
Serological Response ◽  
Long Term Survivors

Abstract Introduction: With conventional therapy, the median survival for patients following diagnosis of multiple myeloma (MM) is 31 months. Prior to 1985 2–4% of patients survived up to 10 years, subsequently this figure has improved to around 10%. We have analysed the United Kingdom Medical Research Council (MRC) trial records to identify the proportion, presentation features and outcome of patients who have survived greater than 7.5 years. Methods: Patients selected were those randomised to conventional (melphalan and ABCM based) therapy who survived greater than 7.5 years; all of these patients had achieved a plateau phase. Their presenting clinical and laboratory features were compared to a group of patients (matched by trial and treatment) who also reached plateau but were the first of the cohort to die directly from MM. Time to response and absolute response was calculated. Clinical course and performance status were assessed from 3 month follow-up clinical data forms and central laboratory paraprotein analysis. Results: 239/2781 (8.5%) of eligible patients survived greater than 7.5 years. 170 patients had died (median and interquartile range (IQR) 9.5 years and 8.3–11.7 years) and 69 patients were still alive at the time of the analysis, median follow-up of 11.4 years (IQR 9.2–14.1 years). Compared to the matched short-lived control group, these long term survivors had lower β2-microglobulin, preserved albumin, lower marrow plasmacytosis, less renal impairment, better performance status, fewer fractures, less bone pain and fewer lytic lesions at presentation. There were no differences in age, lymphocytes, or depth of serological response, however, median time to reach plateau was delayed for the long term survivors {0.77 years (IQR 0.41–1.05) versus 0.42 years (0.26–0.73 for controls)}. 35 patients remain in first plateau with no progression, 28 patients died in first plateau most commonly of vascular disease (25%) or cancer (21%). 176 patients relapsed and 11 (6%) died of myeloma in first relapse, however the majority (140/176, 80%) achieved a second plateau and having relapsed a second time 53/114 (46%) achieved a third plateau. 43 of these 140 patients died in second plateau or beyond of a cause other than myeloma - (vascular 7/43 (16%), cancer 5/43 (12%), renal 5/43 (12%), infection 6/43 (14%), other 4/43 (9%). 30/239 patients (13%) died with no information on disease status or cause of death. Following second relapse 73/114 (64%) patients died directly as a result of myeloma. Time spent in performance status 1 and 2 was 96% for plateau 1, 83% for relapse 1 and 63% beyond relapse 2. Conclusions: 8.5% of MRC trial patients receiving conventional non-intensive therapy survive greater than 7.5 years. Factors associated with long survival include low disease burden, better performance status and less end organ damage. Absolute serological response had no bearing on overall outcome; however rapid response is associated with poorer survival. The existence of second and subsequent plateau phases of MM, have rarely been documented in the literature. A large proportion of time following relapse is spent with good performance status, suggesting that patients experience a good quality of life during much of this period.

Octreotide Alone or With Prednisone in Patients With Advanced Thymoma and Thymic Carcinoma: An Eastern Cooperative Oncology Group Phase II Trial

2004 ◽  
Vol 22 (2) ◽  
pp. 293-299 ◽  
Author(s):  
Patrick J. Loehrer ◽  
Wei Wang ◽  
David H. Johnson ◽  
David S. Ettinger
Keyword(s):  
Thymic Carcinoma ◽  
Response Rate ◽  
Group Performance ◽  
Performance Status ◽  
Objective Response ◽  
Survival Rates ◽  
Eastern Cooperative Oncology Group ◽  
Oncology Group ◽  
Octreotide Scan ◽  
To Receive

Purpose To determine the objective response rate, duration of remission and toxicity of octreotide alone or with the later addition of prednisone in patients with unresectable, advanced thymic malignancies in whom the pretreatment octreotide scan was positive. Patients and Methods Forty-two patients with advanced thymoma or thymic carcinoma were entered onto the trial, of whom 38 were fully assessable (one patient had inconclusive histology; three patients had negative octreotide scan). Patients received octreotide 0.5 mg subcutaneously tid. At 2 months, patients were evaluated. Responding patients continued to receive octreotide alone; patients with progressive disease were removed from the study. All others received prednisone 0.6 mg/kg orally qid for a maximum of 1 year. Results Two complete (5.3%) and 10 partial responses (25%) were observed (four partial responses with octreotide alone; the remainder with octreotide plus prednisone). None of the six patients without pure thymoma responded. The 1- and 2-year survival rates were 86.6% and 75.7%, respectively. Patients with an Eastern Cooperative Oncology Group performance status of 0 lived significantly longer than did those with a performance status of 1 (P = .031). Conclusion Octreotide alone has modest activity in patients with octreotide scan–positive thymoma. Prednisone improves the overall response rate but is associated with increased toxicity. Additional studies with the agent are warranted.

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