Cancer In Vietnam Research Articles

Evaluation of the Stronger Together Peer Mentoring Model Among Patients With Breast and Gynecologic Cancer in Viet Nam.

Stronger Together is a peer mentoring model that seeks to address the severe lack of mental health and psychosocial support for patients with cancer in many low- and middle-income countries (LMICs). This article presents the results of the Stronger Together pilot study among patients with breast and gynecologic cancer in Viet Nam (VN). Eligible participants comprised women age 25 years or older with a diagnosis of breast or gynecologic cancers and receiving treatment at four participating hospitals. Participants were asked whether they wanted to proceed with usual care or be matched with a trained and supervised peer mentor (a cancer survivor). Surveys were administered at baseline (0) and 2, 4, and 6 months and assessed depression, anxiety, stress, mental health and physical health components of quality of life (QOL), self-efficacy, and social support. We computed and compared 2-, 4-, and 6-month changes in scores from baseline and conducted difference-in-difference analyses to estimate the intervention effect at 6 months. The sample size included N = 186 participants. Mentees (n = 91) exhibited improvements in depression, anxiety, stress, and mental health QOL across all time points, whereas usual care participants (n = 95) experienced these improvements at later periods (4 and 6 months). Compared with usual care participants, mentees reported greater improvements in depression at 2 and 4 months, mental health QOL at all time points, and self-efficacy and social support at 4 and 6 months. Greater improvements in stress were also seen in the breast cancer subsample. Stronger Together is a promising model to improve mental health and psychosocial outcomes among patients with breast and gynecologic cancer in VN and can help fill gaps in cancer peer support interventions in many LMICs.

MO57-6 Definitive concurrent chemoradiotherapy in patients of synchronous esophageal and head and neck cancer in Vietnam

MO57-6 Definitive concurrent chemoradiotherapy in patients of synchronous esophageal and head and neck cancer in Vietnam

P1-8 Definitive chemoradiation with Folfox regimen in locally advanced middle-lower third esophageal cancer in Vietnam

P1-8 Definitive chemoradiation with Folfox regimen in locally advanced middle-lower third esophageal cancer in Vietnam

Cost-effectiveness of consolidation durvalumab for inoperable stage III non-small cell lung cancer in Vietnam

BackgroundThis study aimed to assess the cost-effectiveness of durvalumab as a treatment option for patients with inoperable stage III non-small cell lung cancer (NSCLC) from healthcare and partial societal perspectives...

Beyond Medical Bills: High Prevalence of Financial Toxicity and Diverse Management Strategies Among Vietnamese Patients With Cancer.

This study was conducted to measure financial toxicity (FT) among patients with cancer in Vietnam using the COmprehensive Score for financial Toxicity (COST) and to describe the cost management strategies employed by these patients. This comprehensive cross-sectional study enrolled 634 patients from 2 specialized oncology hospitals in Vietnam. Using COST cut-off scores, FT was classified as none/mild (≥26), moderate (14-25), or severe (≤13). Cost management strategies, or coping mechanisms, were classified into 4 groups: lifestyle changes, financial resource strategies, treatment modifications, and support seeking. The prevalence of FT was 91.8%, with 51.7% of participants demonstrating severe and 40.1% exhibiting moderate FT. Severe FT was significantly associated with female, low education level, unstable employment, low household economic status, and advanced cancer stage. The most common coping strategies were as follows: among lifestyle changes, reducing spending on basic items and leisure activities (78.7%) and cutting back on essential household expenses (66.4%); among financial resource strategies, borrowing money from relatives or friends (49.1%) and withdrawing funds from retirement or savings accounts (34.1%); within treatment modifications, switching treatment facilities or doctors due to cost concerns (9.3%); and within support seeking, obtaining help from welfare or community organizations (18.8%). All strategies were significantly more likely to be used by patients with severe FT. FT was highly prevalent among patients with cancer. Most patients relied on lifestyle adjustments and coping strategies, underscoring the need for improved financial support systems to alleviate the economic burden associated with cancer care.

A pre-post evaluation of a digital intervention to improve psychosocial outcomes of caregivers of people living with cancer in Vietnam

Objectives To evaluate a co-designed intervention using digital resources “Vietnam Cancer Caring Coping” (V-CCC) on the health literacy, depression, and quality of life of caregivers supporting a cancer patient in oncology hospitals in Vietnam. Methods A pre-post quantitative evaluation with adult cancer caregivers across regional Oncology hospitals in Vietnam (Ho Chi Minh City, Da Nang, Can Tho, and Hue). Participants completed baseline and follow-up measures of health literacy (HLS-SF12) depression (PHQ-9) and Health-related Quality of Life (5Q-5D-5L). Participants accessed and reviewed V-CCC for a 2-week period. Results Two hundred and thirty-four caregivers completed pre and post-tests. Most participants were female (n = 143, 61%), married (n = 165, 70%), aged 18–44 (n = 155, 66%), lived rurally (n = 157, 67%). All health literacy scores of participants in post-intervention were significantly higher than that in pre-intervention across all domain’s healthcare, disease prevention, and health promotion as well as the total score (p < 0.001). A significant reduction in the proportion of caregivers reporting PHQ-9 moderately severe/severe depression post-intervention was demonstrated (10.2 vs. 6.1%, respectively (p ≤ 0.001). No significant differences were observed pre and post-intervention across four 5Q-5D-5L health dimensions: mobility, self-care, usual activities, and pain/discomfort. Regarding anxiety/depression as measured by 5Q-5D-5L the proportion of participants who reported having moderate, severe, and extreme problems in pre- and post-intervention was statistically significant (32 vs. 24%), respectively (p = 0.0028). Conclusion Co-designed digital resources can reduce health literacy inequities and improve psychological outcomes for cancer caregivers.

A cross-sectional study of sleep disturbance among middle-aged cancer patients at Vietnam National Cancer Hospital.

Sleep disorders are common in cancer patients and have negative consequences for patient well-being and treatment outcomes. This study aimed to investigate sleep quality and related factors in Vietnamese middle-aged cancer patients. A cross-sectional study was conducted on 246 middle-aged in-patient cancer patients at Vietnam National Cancer Hospital (VNCH) from 1/2021 to 7/2021. Sleep was measured by the Pittsburgh Sleep Quality Index (PSQI), with a cutoff of 5. The results showed a male/female ratio of 0.85 with an average age of 52. The five most prevalent cancer types were breast, colorectal, lung, and esophagus-stomach cancer, primarily in the late stage and treated with chemotherapy. The prevalence of sleep disturbances was 58.5%. The mean PSQI score was 7.5, with sleep duration and latency of 5.4 h and 1 h, respectively. Approximately 44% of participants reported poor sleep quality, nearly 9% had daytime dysfunction, and 10.6% used sleep medication. The multivariate logistic regression results indicate that people with depression were 8.89 times more likely to have poor sleep than those without depression (95% CI:2.63-28.27, p < .001). Sleep problems are common among middle-aged people with cancer in Vietnam, especially individuals with depression. It is necessary to have more effective approaches to sleep management for cancer patients with limited resources.

Utilization of hospital anxiety and depression scale to measure mental disorders of patients with lung cancer in Vietnam: A cross-sectional study

ABSTRACT This study aimed to measure the anxiety, and depression among lung cancer patients, and identify factors associated with these conditions. A cross-sectional study was carried out at a hospital in Vietnam. A standardized medical record was used as a data collection tool. Sociodemographic, clinical and mental health characteristics were collected. Hospital Anxiety and Depression Scale (HADS) was used to measure anxiety and depression. Results showed that among 256 patients, the rate of anxiety and depression was 15.6% and 20.0%, respectively. Better quality of life was negatively associated with the likelihood of having anxiety and depression. Patients having 4-6 months from diagnosis were more likely to have anxiety (OR = 6.98) than those having less than 1 month of diagnosis. Patients having moderate pain were more likely to be depressed (OR = 6.49) compared to those without pain. Being restricted in physically strenuous activity and better perceived general quality of life were negatively associated with anxiety score. Having a better perceived general quality of life (Coef. = -1.28) was also negatively associated with depression score while having NSCLC (Coef. = 2.07) were positively correlated with depression score. To conclude, this study suggested high rates of anxiety and depression in lung cancer patient.

A real-world cohort study of first-line afatinib in patients with EGFR-mutant advanced non-small cell lung cancer in Vietnam

BackgroundThis study aimed to evaluate the efficacy and side effects of first-line afatinib treatment in a real-world setting in Vietnam.MethodsThis retrospective study was conducted across nine hospitals in Vietnam. Advanced epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC) patients who received afatinib as first-line therapy between April 2018 and June 2022 were included, and patient medical records were reviewed. Key outcomes were overall response rate (ORR), time-to-treatment failure (TTF), and tolerability.ResultsA total of 343 patients on first-line afatinib were eligible for the study. EGFR exon 19 deletion (Del19) alone was detected in 46.9% of patients, L858R mutation alone in 26.3%, and other uncommon EGFR mutations, including compound mutations, in 26.8%. Patients with brain metastases at baseline were 25.4%. Patients who received 40 mg, 30 mg, and 20 mg as starting doses of afatinib were 58.6%, 39.9%, and 1.5%, respectively. The ORR was 78.1% in the overall population, 82.6% in the Del19 mutation subgroup, 73.3% in the L858R mutation subgroup, and 75.0% in the uncommon mutation subgroup (p > 0.05). The univariate and multivariate analyses indicate that the ORR increased when the starting dose was 40 mg compared to starting doses below 40 mg (83.9% vs. 74.3%, p = 0.034). The median TTF (mTTF) was 16.7 months (CI 95%: 14.8–18.5) in all patients, with a median follow-up time of 26.2 months. The mTTF was longer in patients in the common EGFR mutation subgroup (Del19/L858R) than in those in the uncommon mutation subgroup (17.5 vs. 13.8 months, p = 0.045) and in those without versus with brain metastases at baseline (17.5 vs. 15.1 months, p = 0.049). There were no significant differences in the mTTF between subgroups based on the starting dose of 40 mg and < 40 mg (16.7 vs. 16.9 months, p > 0.05). The most common treatment-related adverse events (any grade/grade ≥ 3) were diarrhea (55.4%/3.5%), rash (51.9%/3.2%), paronychia (35.3%/5.0%), and stomatitis (22.2%/1.2%).ConclusionsAfatinib demonstrated clinical effectiveness and good tolerability in Vietnamese EGFR-mutant NSCLC patients. In our real-world setting, administering a starting dose below 40 mg might result in a reduction in ORR; however, it might not have a significant impact on TTF.

Understanding decision-making experience regarding hematopoietic stem cell transplantation in adult patients with blood cancer in Vietnam: Through the perspectives of relational autonomy

Understanding decision-making experience regarding hematopoietic stem cell transplantation in adult patients with blood cancer in Vietnam: Through the perspectives of relational autonomy

Gut Microbiome of Patients With Breast Cancer in Vietnam.

Gut microbiota play an important role in human health, including cancer. Cancer and its treatment, in turn, may alter the gut microbiome. To understand this complex relationship, we profiled the gut microbiome of 356 Vietnamese patients with breast cancer. Stool samples were collected before chemotherapy, with 162 pre- and 194 postsurgery. The gut microbiome was measured by shotgun metagenomic sequencing. Associations of gut microbial diversity, taxa abundance, and gut microbiome health index (GMHI) with sociodemographic, clinical factors, and tumor characteristics were evaluated. Postsurgery samples were associated with significantly lower α- and β-diversities (P < .001) and showed significant differences in the abundance of 15% of 2,864 investigated taxa (false discovery rate [FDR] <0.1) compared with presurgery samples. An unhealthy gut microbiome was prevalent among patients with breast cancer, with a mean GMHI of -0.79 and -2.81 in pre- and postsurgery stool samples, respectively. In an analysis of 162 presurgery stool samples, diagnosis delay was significantly associated with lower α-diversity, variation in β-diversity, an increased abundance of species Enorma massiliensis, and a decreased abundance of Faecalicoccus pleomorphus. High intake of fiber was significantly associated with lower α-diversity and a higher abundance of species belonging to Bifidobacterium, Prevotella, and Bacteroides gena (FDR < 0.1). We did not find that cancer stage and subtype, menopausal status, comorbidity, antibiotic use during 3 months before stool collection, or physical activity was significantly associated with α- and β-diversities or GMHI although a few significant differences were observed in taxa abundance. Our study revealed that diagnosis delay, high fiber intake, and breast cancer surgery, which is always followed by antibiotic prophylaxis in Vietnam, led to a less diverse and unhealthy gut microbiome among patients with breast cancer.

Health-state utility of patients with HER2-positive breast cancer in Vietnam: A multicenter cross-sectional study.

Patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer may have poor prognoses and short overall and disease-free survival. Most previous studies focused on assessing the quality of life and health-state utility of the general population of breast cancer patients. The number of studies for HER2-positive breast cancer patients is negligible. This study investigated the health-state utility and its associated factors among Vietnamese patients with HER2-positive breast cancer. We conducted face-to-face interviews with 301 HER2-positive breast cancer patients to collect data. Their health-state utility was measured via the EQ-5D-5L instrument. The Mann-Whitney U and Kruskal-Wallis tests were employed to compare the differences in utility scores between two groups and among three groups or more, respectively. Factors associated with patients' heath-state utility were identified via Tobit regression models. Pain/discomfort (56.1%) and anxiety/depression (39.5%) were the two issues that patients suffered from the most, especially among metastatic breast cancer patients. The severity of distress (depression, anxiety, and stress) in patients was relatively mild. Of 301 patients, their average utility score was 0.86±0.17 (range: 0.03-1.00), and the average EQ-visual analogue scale (VAS) score was 69.12±12.60 (range: 30-100). These figures were 0.79±0.21 and 65.20±13.20 for 102 metastatic breast cancer patients, significantly lower than those of 199 non-metastatic cancer patients (0.89±0.13 and 71.13±11.78) (p<0.001), respectively. Lower health-state utility scores were significantly associated with older age (p = 0.002), lower education level (p = 0.006), lower monthly income (p = 0.036), metastatic cancer (p = 0.001), lower EQ-VAS score (p<0.001), and more severe level of distress (p<0.001). Our findings showed a significant decrement in utility scores among metastatic breast cancer patients. Patients' health-state utility differed by their demographic characteristics (age, education level, and income) and clinical characteristics (stage of cancer and distress). Their utility scores may support further cost-effectiveness analysis in Vietnam.

Exploring the Mental Health Challenges of Women Diagnosed with Breast Cancer in Vietnam: A Qualitative Study

ABSTRACT Breast cancer is the most frequently diagnosed cancer among Vietnamese women. This qualitative study describes and discusses the mental health challenges of women with breast cancer in Vietnam. Two-rounds of semi-structured in-depth interviews were conducted among thirteen women with breast cancer and four caregivers from northern and southern Vietnam. Participants were recruited using purposive sampling technique. Data was collaboratively analyzed by qualitative content analysis using the Open Code Software version 4.02 and discussed among a team of local and international researchers. Women in the study experienced significant mental health challenges associated with their breast cancer diagnosis. Both psychological and emotional health were adversely affected. Women with breast cancer had profound concerns about how the diagnosis impacted their families. They experienced challenges in spousal relationships as well as facing social stigma and discrimination. Appropriate public health interventions should be implemented to raise society’s awareness and help improve the mental health of women with breast cancer.

Translation and Validation of the Vietnamese Version of the Barriers Questionnaire II in Patients with Cancer

Background: The Barriers Questionnaire II (BQII) was developed to assess barriers to effective pain management. Objective: This study aims to translate and validate the BQII into Vietnamese. Method: The Viet-BQII was evaluated for content validity and reliability by 6 experts and 30 patients with cancer. The content validity of the questionnaire was measured by Item - content validity index and Scale - content validity index; the test-retest reliability was measured using Intra-Class Correlation; the internal consistency of the scale items was assessed by calculating Cronbach's α value. Results: The Viet - BQII had a content validity in each question that ranges from 0.83 to 1.0, the content value for the scale was 0.92, Cronbach's α was 0.89, and the test-retest reliability with ICC was 0.82 (p &lt;0.001). Conclusions: The Viet-BQII ensures the validity and reliability for measuring patient barriers to pain management in patients with cancer in Vietnam.

EP12.01-54 Single-Center Real-World Study of First Line Afatinib Treatment in Advanced EGFR-mutated Non-small Cell Lung Cancer in Vietnam

EP12.01-54 Single-Center Real-World Study of First Line Afatinib Treatment in Advanced EGFR-mutated Non-small Cell Lung Cancer in Vietnam

EP12.01-67 A Real World Cohort Study of First Line Afatinib in Patients with EGFR mutant Advanced Non Small Cell Lung Cancer in Vietnam

EP12.01-67 A Real World Cohort Study of First Line Afatinib in Patients with EGFR mutant Advanced Non Small Cell Lung Cancer in Vietnam

Helicteres isora Ethanol Extract Induces Apoptotic Cell Death in HepG2 Cells

Background: H. isora is a species of the genus Helicteres, a medicinal plant known to be used in the treatment of liver cancer in Vietnam. However, there has been no recorded about biological activity of H. isora species in Vietnam. The current study aimed to study the antitumor activity through its antioxidant activity and inhibitory properties on hepatocellular carcinoma cells. Methods: Arial parts of Helicteres isora were collected from Dak Nong province. Samples were extracted maceration method in ethanol solvent. The antitumor activity were identified though the DPPH radical scavenging activity (Brand-Williams et al., (1995) and WST-1 assay, Real- time PCR, Hoechst 33258 spectrofluorometric assay and Annexin V-FITC Apoptosis Assay on the human liver cancer cells (HepG2) and non-malignant cells of Chang’s Live. Result: The ethanol extract of H. isora exhibited antioxidant activity with IC50=21.16 µg/ml. H. isora extract also exhibited inhibitory activity on HepG2 cell division with IC50=37 µg/ml after 48 h. The expression of DNA fragmentation of the extract also increased with time (48-72h). Apoptosis induction of extract was associated with up-regulation of pro-apoptotic Bax gene expression and down-regulation of anti-apoptotic Bcl-2 gene expression. The H. isora extract was found to induce the apoptotic process in HepG2 cells through the up and down regulation of the Bax/Bcl-2 gene.

Distress and its Correlation with Potential Factors among Patients with Cancer in Vietnam

A cancer diagnosis and treatment are stressful for patients. Evidence has shown that the prevalence of mental health problems among cancer patients is very high globally. To our knowledge, there are no studies related to cancer diagnosis and treatment in Vietnam, where the rate of death caused by cancer is at the 50th in the world. This study investigates the prevalence of distress and its correlations with potential factors among Vietnamese cancer patients. This is a cross-sectional study using a self-report questionnaire for cancer patients focused on examining socio-demographic characteristics, satisfaction with current marital status, current job, life in general, cancer-related distress, diagnosis, cancer stage, acceptance of illness, treatment methods, and perceived social support. The prevalence of distress among cancer patients was very high (91.7%). There were significantly higher distress scores in patients living in rural areas and not receiving chemotherapy and radiotherapy. Patients with higher satisfaction with their current employment status or satisfaction with life were less likely to have psychological distress. The patients’ belief in treatment methods and cancer also reduced the risk of experiencing distress. Rural Vietnamese cancer patients impacted by social determinants of health along with cancer-related factors might be experiencing higher psychological distress.

Stromal Tumor-Infiltrating Lymphocytes Associated with Immunohistopathology and Molecular Subtypes of Breast Cancer in Vietnam.

Breast cancer is a heterogeneous disease with varied symptoms and pathogenesis, as well as variable prognosis and therapeutic outcomes. Stromal tumor-infiltrating lymphocytes, one of the tumor microenvironment factors, has been recognized as an important immunological biomarker that reflected the antitumor immune response in breast cancer. We analyzed 207 invasive breast cancer patients who had lumpectomy or mastectomy and have not received any pre-operative treatment. Clinicopathological characteristics, immunohistochemistry characteristics, molecular subtypes classification and stromal TILs evaluation were investigated. Stromal TILs correlated with well-established prognostic markers. Tumor grade showed significantly higher sTILs percentages in high-grade tumors than in low-grade tumors (p<0.001). There was a statistically significant association between intermediate and high levels of sTILs and a high Ki-67 index (p< 0.001). ER/PR negative was significantly related to high sTILs. Mean sTILs score was significantly higher in TNBC (40.1±31.6%) compared to others, statistically significant (p<0.001). In HER2-negative breast cancer, sTILs were significantly associated with histologic grade, ER status, PR status, and Ki67 index. sTILs played an important role, associated with unfavorable factors in breast cancer. Our findings support the use of stromal sTILs to identify a more aggressive phenotype of tumors.

Associations between KRAS status and clinical features in non-polyp colon cancer patients

Background Mutations of the KRAS gene are common in cancers; they are detected at a very high rate in colon cancer (CC) and are considered a negative disease factor. CC is among the deadliest cancers in Vietnam, and KRAS status for non-polyp colon cancer (NPCC) was rarely reported from the country. In this study, we aim to determine KRAS mutations and the associations of mutation status with clinicopathological features in Vietnamese NPCC patients. Methods Patients with NPCC (stages II or III) and without historical or current polyp appearance were included. Genomic DNA samples were prepared from dissected tumors, and specific sequences of the KRAS gene were amplified by PCR. The mutations at codons 12, 13, 59, 60, 61, 117, and 146 of the gene were determined by using a commercial kit. Possible associations of the KRAS mutation with clinicopathological properties were analyzed using SPSS and GraphPad Prism. Results The KRAS mutation rate was 47.9% in NPCC patients; mutations in exon 2 accounted for 91.4% of all detected mutations. Moreover, the KRAS mutation rate was higher in females (57.1%) than in males (39.8%). The association of KRAS mutation with female NPCC patients was further confirmed by multivariate regression data with OR=2.144 and p = 0.012. Conclusion The KRAS mutation rate was also higher in patients with right colon cancers. The mutated-KRAS-carrying patients potentially experienced anemia. The data provide important scientific background for the treatment and management of the disease.