Chemotherapy In Cancer Patients Research Articles

Association between BMI and success of transaxillary venous port implantation: A retrospective cohort study.

Totally implanted venous access device are widely used for long-term chemotherapy in cancer patients. Previous studies have only focused on the analysis of complications associated with infusion port implantation, ignoring the causes of unsuccessful infusion port implantation. The purpose of this study was to investigate the association between body mass index (BMI) and the success rate of transaxillary intravenous port implantation in breast cancer patients. To review 361 breast cancer patients who underwent intravenous port implantation from January 2021 to September 2021. Baseline data, and surgical data were collected from the patients, and the success rate of puncture of the axillary vein was recorded. The logistic regression analysis and smoothed curve fitting were used to assess the relationship between BMI and the success rate of axillary venipuncture. In addition, subgroup analyses were performed to explore potential interactions. Under ultrasound guidance, 67.3% of patients (243/361) had an infusion port implanted by axillary vein puncture. There was a roughly linear relationship between BMI and the success rate of axillary venipuncture. In the multiple regression equation, BMI was significantly and negatively associated with the success rate of axillary venipuncture (OR = 0.83; 95% CI = 0.77-0.89; p < 0.001). Stratified analysis showed that the relationship between BMI and the success rate of axillary venipuncture was stable and unaffected by other variables. The higher the patient's BMI, the higher the chance of difficult axillary venipuncture or failed cannulation.

Literature Review: Effectiveness of Aromatherapy on Nausea and Vomiting in Chemotherapy Cancer Patients as an Application of Holistic Care

ABSTRACT Chemotherapy is a treatment that has the property of killing cancer cells thoroughly and is a more effective choice in dealing with cancer, especially in advanced cancer patients. However, cancer patients who undergo chemotherapy will have severe side effects that can cause baldness, lack of blood, mouth sores, nausea, vomiting, pain, fatigue, anorexia, malnutrition and others. Complementary therapy that can be used to treat nausea and vomiting in chemotherapy patients is aromatherapy. This article uses 6 steps including: formulating research questions and objectives, searching existing literature, filtering data according to inclusion, assessing article quality, extracting data and analyzing data. The results of five databases obtained 12 articles with details of 5 articles from Google Scholar, 1 article from Research Gate, 4 articles from Pubmed, 1 article from Atlantis Press and 1 article from Science direct. It was found that aromatherapy has an influence to overcome nausea and vomiting in patients undergoing chemotherapy, in the order of peppermint, lavender, lemon, cardamom, salvia officinalis and rose aromatherapy. Aromatherapy can be used as an alternative treatment in overcoming nausea and vomiting in patients undergoing chemotherapy. Of the 7 aromatherapies inhaled during chemotherapy or when the effects of nausea and vomiting arise, it is done by inhaling sec. Keywords: Cancer, Chemotheraphy, Nausea and Vomiting, Aromatheraphy ABSTRAK Kemoterapi adalah pengobatan yang memiliki sifat mematikan sel kanker secara menyeluruh dan merupakan pilihan yang lebih efektif dalam mengatasi kanker, terutama pada pasien kanker stadium lanjut. Namun penderita kanker yang menjalani kemoterapi akan memilliki efek samping yang parah hingga dapat menimbulkan kebotakan, kurang darah, sariawan, mual, muntah, nyeri, kelelahan, anoreksia, malnutrisi dan lain-lainnya. Terapi komplementer yang dapat digunakan untuk mengatasi mual muntah pada pasien kemoterapi adalah aromaterapi. Artikel ini menggunakan 6 langkah diantaranya : merumuskan pertanyaan penelitian dan tujuan penelitian, mencari literatur yang ada, menyaring data sesuai inklusi, menilai kualitas artikel, mengekstrak data dan menganilisis data. Didapat hasil dari lima database diperoleh 12 artikel dengan rincian 5 artikel dari Google Scholar , 1 artikel dari Research Gate, 4 artikel dari Pubmed, 1 artikel dari Atlantis Press dan 1 artikel dari Science direct. didapatkan bahwa aromaterapi memiliki pengaruh untuk mengatasi mual dan muntah pada pasien yang menjalani kemoterapi, dengan urutan aromaterapi peppermint, lavender, lemon, kapulaga, lavender dan mawar. Aromaterapi dapat dijadikan salah satu pengobatan alternatif dalam mengatasi mual dan muntah pada pasien yang menjalani kemoterapi. Dari 7 aromaterapi yang dihirup selama kemoterapi atau saat efek mual dan muntah timbul maka dilakukan adalah dengan menghirup secara berulang. Dan dari hasil review aromaterapi Peppermint yang paling efektif dalam menurunkan mual dan muntah. bahwa aromaterapi terbukti efektif untuk mengurangi mual muntah pada pasien kanker yang sedang menjani kemoterapi. Kata Kunci: Kanker, Kemoterapi, Mual dan Muntah, Aromaterapi

Nail Toxicity Related to Taxane Treatment

Taxanes are a diverse class of chemotherapeutic agents. Cutaneous toxicity has been reported with taxanes and includes erythema and desquamation, involving primarily the hands. Nail changes are described in different series and case reports, but the real incidence of this side-effect is probably underestimated, literature reports that adverse events occur in up to 89% of patients. The nail changes caused by chemotherapy in cancer patients are difficult to assess and often overlooked by clinicians.

P-367 Letrozole or Tamoxifen co-administration during fertility preservation of breast cancer patients: a retrospective cohort study

Abstract Study question How do fertility preservation (FP) outcomes differ between breast cancer patients stimulated with FSH and Tamoxifen versus FSH and Letrozole? Summary answer Letrozole and Tamoxifen co-administration yielded similar number of retrieved and cryopreserved oocytes/embryos, as well as similar oocyte maturation and fertilization and rates. What is known already Oocyte/embryo cryopreservation is recommended before initiation of chemotherapy in cancer patients. The co-administration of Tamoxifen, a selective estrogen receptor modulator, or Letrozole, an aromatase inhibitor, during ovarian stimulation with gonadotropins, are used to limit the potentially harmful effects of a supra-physiological rise in estrogen levels on hormone-sensitive cancers. However, the optimal choice between the two is still unclear and with no sound evidence. Study design, size, duration Retrospective cohort study of all FP treatments of newly diagnosed breast cancer patients in two tertiary centers between 2000-2022. Collected data included 354 FP cycles of 290 patients and compared treatment parameters and outcomes of Tamoxifen or Letrozole co-administration. Participants/materials, setting, methods Breast cancer patients who underwent FP before chemotherapy were included. Patients with a history of radiation or gonadotoxic treatment, as well as those undergoing other fertility preservation treatments, such as ovarian tissue cryopreservation were excluded. Main results and the role of chance Overall, 215 Letrozole and 139 Tamoxifen treatment cycles were compared, with no significant demographic differences. Treatments with Letrozole had higher FSH dosages (3970IU vs. 2839IU, p &amp;lt; 0.001) but shorter duration (9.7 vs. 10.5 days, p &amp;lt; 0.001). The Letrozole group achieved lower peak E2 levels and endometrial thickness (1508pmol/L, 8.1mm vs. 8760pmol/L, 9.5mm, p &amp;lt; 0.001). The mean number of retrieved oocytes was comparable between the groups (13.6 with Letrozole vs 14.7 with Tamoxifen, p = 0.06). In 122 Letrozole and 46 Tamoxifen patients that underwent strictly oocytes cryopreservation the mean number of cryopreserved oocytes was comparable (11 vs. 12.1, p = 0.21). Moreover, in embryo cryopreservation cycles of 71 patients treated with Letrozole compared to 76 patients with Tamoxifen, no difference was observed in the number of cryopreserved embryos (6.2 vs. 7.0, p = 0.12). Oocyte maturation rate among strictly oocyte preservation cycles was comparable (86% with Letrozole vs. 83% with Tamoxifen, p = 0.80), as were fertilization rates in embryo cryopreservation cycles (62% vs. 63%, p = 0.8 and 71% vs. 76%, p = 0.3 in IVF and ICSI with Letrozole and Tamoxifen, respectively). Multivariate analysis, controlling for potential confounders showed no significant correlations between Tamoxifen or Letrozole co-administration and the number of retrieved oocytes or oocyte maturation rate. Limitations, reasons for caution The primary limitation of our study is its retrospective design and the variation in treatment duration and gonadotrophin dosages among groups. Wider implications of the findings This study provides reassurance that both Tamoxifen and Letrozole are equally effective options when co-administered in FP treatments of breast cancer patients. Trial registration number not applicable

Risk factors for arrhythmias occurred in cancer patients after chemotherapy: An evidence-based systematic review and meta-analysis

ObjectivesThis study aimed to summarize the existing literature on risk factors for arrhythmias after chemotherapy in cancer patients. To provide reliable evidence for treating arrhythmias after chemotherapy in oncology patients by assessing multiple biasing factors in the literature and quantifying the risk factors. MethodsThe risk factors for arrhythmia following tumor chemotherapy were systematically collected from various reputable databases, including PubMed, Cochrane Library, MEDLINE, EMBASE, and multiple Chinese databases, covering the period from inception to May 2023. Two independent reviewers performed rigorous article screening, data extraction, and assessment of research quality. Data analysis was conducted using Review Manager 5.4 software, ensuring a standardized and robust approach to evaluate the gathered evidence. ResultsThe analysis of chemotherapy-induced arrhythmias included 16 articles, encompassing 14,785 cancer patients. Among the patients, 3295 belonged to the arrhythmia group, while 11,490 were in the non-arrhythmia group. These studies identified 12 significant risk factors associated with arrhythmias following chemotherapy in cancer patients. The findings of the analysis are as follows. General patient characteristicsThe incidence of post-chemotherapy arrhythmias was 14.33 times higher in oncology patients aged ≥60 years compared to patients <60 years of age [OR = 14.33, 95%CI (8.51, 24.13), P＜0.00001]. Patients with a smoking history exhibited a 1.67-fold higher risk of arrhythmia after chemotherapy [OR = 1.67, 95%CI (1.24, 2.25), P = 0.0007]. However, there was no significant correlation between gender and body mass index (BMI) with arrhythmia after chemotherapy in oncology patients (P = 0.52; P = 0.19) Disease-related factorsPatients with a history of hypertension, diabetes, and cardiovascular disease had a 1.93-fold, 1.30-fold, and 1.76-fold increased risk of arrhythmia after chemotherapy, respectively [OR = 1.93, 95%CI (1.66, 2.24), P＜0.00001; OR = 1.30, 95%CI (1.10, 2.52), P = 0.002; OR = 1.76, 95%CI (1.51, 2.05), P＜0.00001]. Additionally, the incidence of arrhythmia increased 1.97 times in patients with electrolyte and acid-base balance disorders following chemotherapy [OR = 1.97, 95%CI (1.41, 2.76), P＜0.00001] Chemotherapy-related factorsSeven articles examined the association between chemotherapy drugs and post-chemotherapy arrhythmias. The results indicated that oncology patients were 3.03 times more likely to develop arrhythmias with chemotherapy drugs compared to non-chemotherapy drugs [OR = 3.03, 95%CI (2.59, 3.54), P＜0.00001]. Notably, anthracyclines and fluorouracil chemotherapy demonstrated a 2.98-fold and 3.35-fold increased risk of arrhythmia after chemotherapy, respectively [OR = 2.98, 95%CI (2.51, 3.03), P＜0.00001; OR = 3.35, 95%CI (2.20, 5.10), P＜0.00001]. The risk of arrhythmia after chemotherapy was 1.72 times higher in patients with chemotherapy cycles longer than 4 weeks than those with cycles shorter than 4 weeks [OR = 1.72, 95%CI (1.30, 2.28), P = 0.0001] ConclusionThe occurrence of arrhythmia after chemotherapy in cancer patients was significantly associated with the patient's age, history of smoking, history of hypertension, history of diabetes, history of cardiovascular disease, chemotherapy drug use, and cycle. However, further high-quality evidence is needed to support these results.

Combinination Essential Ginger Oil and Acupressure Relaxation Techniques to Nausea and Vomiting

Introduction: Nausea and vomiting are effects of chemotherapy that can decrease in the health condition of cancer patients. Objective: The aim of this study was to determine the effect of the combination of essential ginger oil therapy and acupuncture relaxation techniques on nausea and vomiting in cancer patients undergoing chemotherapy. Methods: This research used a quasi-experimental design. The population of this study was 124 adults undergoing chemotherapy. Sampling used purpose-based sampling with a sample size of 34 respondents (17 people in the treatment group and 17 people in the control group). Nausea and vomiting were measured using the Rhodes Index Nausea, Vomitting and Retching instrument. Results: The study results showed that before receiving the intervention, the intervention group's nausea and vomiting score averaged around a score of 6, in the control group the mean score was around 6. After the intervention, the nausea and vomiting score of the intervention group was 2, in the control group 10. The Wilcoxon test showed a significant value (p &lt; 0.001). Conclusion: The combination of essential ginger oil and Acupressure relaxation techniques helped to reduce nausea and vomiting due to chemotherapy in cancer patients. This means that an intervention given regularly can educe nausea and vomiting. Oncology nurses could give recommendation to the hospital to provide this intervention to the chemotherapy patients.

Symptom cluster study undergoing chemotherapy in breast cancer patients: Latent class analysis and contemporaneous network analysis

ObjectiveThis study aims to explore the subgroups and networks of symptom clusters in breast cancer patients undergoing chemotherapy, and to provide effective interventions for the core symptoms. MethodsA cross-sectional survey was conducted at four comprehensive hospitals in Foshan City, China, from August to November 2023. A total of 292 participants completed the social determinants of health questionnaire, the numerical rating scale (NRS), the Pittsburgh sleep quality index (PSQI), the Chinese version of the cancer fatigue scale (CFS), and the hospital anxiety and depression Scale (HADS). Latent class analysis (LCA) was utilized to distinguish subgroups, and network analysis was utilized to identify core symptoms among different subgroups. ResultsBreast cancer patients undergoing chemotherapy exhibit symptoms were divided into two subgroups: the high burden group of symptoms (72.3%, Class 1) and the low burden group of symptoms (27.7%, Class 2). Education attainment, work status, family monthly income per capita, and daily sleep duration (hours) were associated with subgroup membership. “Panic feelings” (# HADS-A11) were the core symptom in both the full sample and Class 2, while “tension or pain” (# HADS-A1) was the core symptom in Class 1. ConclusionsThe core symptoms of fear, enjoyment, nervousness, and pain varied across subgroups of patients and could inform the current strategies for symptom management in breast cancer chemotherapy patients.

Proteomics Approach to Identify Anthracycline-induced Cardiotoxicity Mechanisms in Human Cardiac Fibroblasts

Doxorubicin-induced cardiotoxicity (DIC) is a major life-threatening side-effect of chemotherapy in cancer patients. DIC leading to heart failure is caused by numerous mechanisms, including impaired mitochondrial function, disruption of calcium homeostasis, and altered gene and protein response that triggers cell death and, eventually, fibrosis. We performed a preliminary investigation of the effect of doxorubicin (DOX) on the cardiac fibroblast proteome using mass-spectrometry. Quantitative analysis showed significantly altered expression of 186 proteins. Nine out of forty-two Dox-upregulated proteins and seventeen out of twenty-four Dox-downregulated proteins showed a reciprocal trend in expression upon inhibiting a structural scaffold protein involved in cardiac calcium channel regulation. Overall, our data suggests the involvement of pathways in regulating mitochondrial energy metabolism, matrix remodeling, cell cycle/arrest, and cell survival via Rho/Rac nuclear exchanger proteins. DIC is multifactorial, and based on our pilot data, modulation of calcium channel regulators may be a promising strategy to mitigate the progression of DIC to heart failure. Research support received from the American Heart Association, NIH and the University of Arkansas for Medical Sciences. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Electrical acupoint stimulation for the treatment of chemotherapy-induced nausea and vomiting: A systematic review and meta-analysis

BackgroundChemotherapy-induced nausea and vomiting (CINV) is the most common adverse effect of chemotherapy and affects the continuation of chemotherapy in cancer patients. Electrical acupoint stimulation (EAS), which includes electroacupuncture and transcutaneous electrical stimulation (TES), has been used to treat CINV. This meta-analysis aimed to evaluate the efficacy of EAS in the treatment of CINV. MethodsRandomized controlled trials (RCTs) of EAS for CINV retrieved form five key databases. Two researchers independently performed article screening, data extraction and data integration. The Cochrane Collaboration's tool for assessing risk of bias was used to assesse the methodological quality according to Cochrane Handbook for Systematic Reviews of Interventions. RevMan 5.4 was used to perform analyses. Results10 RCTs with a total of 950 participants were included. The results showed that there was no significant difference between EAS compared to sham EAS in terms of increasing the rate of complete control of CINV and decreasing the overall incidence of CINV [RR = 1.26, 95 % CI (0.96, 1.66), P = 0.95; RR = 1.16, 95 % CI (0.97, 1.40), p = 0.71]. In terms of CINV severity, EAS reduced the occurrence of moderate-to-severe CINV [RR = 0.60, 95 % CI (0.38, 0.94), P = 0.03; RR = 0.50, 95 % CI (0.33, 0.76), P = 0.001]. ConclusionEAS could improve moderate-to-severe CINV. However, EAS did not show a significant difference in reducing overall incidence and improving complete control rates compared with sham EAS. Due to limitations in the quality of the included articles, the available studies are insufficient to have sufficient evidence to confirm the efficacy of EAS for CINV. Validation with rigorously designed, large-sample, high-quality clinical trial studies may also be needed.

Factors influencing self-regulatory fatigue in patients undergoing chemotherapy for gynecologic cancer: a cross-sectional study.

To understand the current status of self-regulatory fatigue among gynecologic cancer chemotherapy patients and explore influencing factors. Using convenient sampling, a total of 232 gynecological cancer chemotherapy patients from two tertiary hospitals in Zhengzhou, Henan, China, were selected as study subjects from February 2023 to April 2023. General information questionnaire, Self-Regulatory Fatigue Scale (SRF-S), Strategies Used by People to Promote Health (SUPPH) Scale, Connor-Davidson resilience scale (CD-RISC) and Perceived Social Support Scale (PSSS) were employed for data collection. The data were analyzed using SPSS 26.0 software. Chi-square test and binary logistic regression were executed to explore the correlates of self-regulatory fatigue, the significance level (α) was set at 0.05. The self-regulatory fatigue score of the 232 patients was 44 (36, 56). Binary logistic regression analyses revealed significant associations, demonstrating that residing in urban areas (OR=0.241, P=0.015), having no comorbidities (OR=0.158, P=0.015), increased perceived social support (OR=0.937, P=0.001), strong self-efficacy (OR=0.959, P=0.021), and heightened psychological resilience (OR=0.895, P<0.001) acted as protective factors against self-regulatory fatigue (P < 0.05). Patients residing in rural areas, having more than two comorbidities, lower self-efficacy and psychological resilience levels, and lower perceived social support are indicative of higher levels of self-regulatory fatigue. Identifying these influencing factors can provide references and support for developing individualized support and intervention measures to improve patients' physical and mental well-being.

Implementation of personalized multidisciplinary neuropathy management program for chemotherapy-induced peripheral neuropathy symptoms in breast cancer patients

Objective To construct a personalized multidisciplinary neurotoxicity management program for chemotherapy-induced peripheral neuropathy (CIPN) symptoms in breast cancer patients and evaluate its application effects. Methods A retrospective analysis was conducted on clinical data of 133 breast cancer chemotherapy patients admitted to our hospital from January 2022 to January 2024. Based on the nursing protocols received, patients were divided into a control group (n = 66) and an intervention group (n = 67). The control group received conventional nursing interventions, while the intervention group received personalized nursing interventions in addition to the control group interventions. The nursing programs were carried out during chemotherapy. A comparison was made between the two groups before chemotherapy and 3 months after chemotherapy in terms of the degree of neuropathy, cancer-related fatigue, negative emotional status, and symptom management knowledge, attitudes, and practices (KAP). Results The intervention group showed significantly lower neuropathy severity (FACT/GOG-Ntx), cancer-related fatigue (CFS), and negative emotions (PHQ-9, GAD-7) scores after chemotherapy compared to the control group (p < 0.05). Additionally, the intervention group exhibited higher scores for symptom management knowledge, beliefs, and behaviors (p < 0.05). Conclusion Personalized multidisciplinary neurotoxicity management program significantly improved neuropathy severity, reduced cancer-related fatigue and negative emotions, and enhanced symptom management knowledge, attitudes, and practices among breast cancer patients undergoing chemotherapy.

The associates of anxiety among lung cancer patients: Dehydroepiandrosterone (DHEA) as a potential biomarker

ObjectiveAnxiety is a prevalent comorbidity in lung cancer (LC) patients associated with a decline in quality of life. Dehydroepiandrosterone (DHEA), a neuroactive steroid, levels rise in response to stress. Prior research on the association between DHEA and anxiety has yielded contradictory results and no study has investigated this association in LC patients.MethodsA total of 213 patients with LC were recruited from a general hospital. Data on demographic and cancer-related variables were collected. Using the Chinese version of the Hospital Anxiety and Depression Scale (HADS), the degree of anxiety was determined. Cortisol, DHEA, and Dehydroepiandrosterone sulfate (DHEA-S) levels in saliva were measured. Adjusting for confounding variables, a multivariate regression analysis was conducted.Results147 men and 66 women comprised our group with an average age of 63.75 years. After accounting for demographic and treatment-related factors, anxiety levels were significantly correlated with, post-traumatic stress symptoms (PTSSs) (β = 0.332, p < 0.001) and fatigue (β = 0.247, p = 0.02). Association between anxiety and three factors, including DHEA, PTSSs, and fatigue, was observed in patients with advanced cancer stages (III and IV) (DHEA β = 0.319, p = 0.004; PTSS β = 0.396, p = 0.001; fatigue β = 0.289, p = 0.027) and those undergoing chemotherapy (DHEA β = 0.346, p = 0.001; PTSS β = 0.407, p = 0.001; fatigue β = 0.326, p = 0.011).ConclusionsThe association between anxiety and DHEA remained positive in advanced cancer stages and chemotherapy patients. Further study is necessary to determine whether DHEA is a potential biomarker of anxiety in LC patients.

A Prospective Observational Study on Neurotoxicity of Chemotherapy - A Critical Analysis

Background: Cancer treatment frequently depends on the intricate and potent effects that are acknowledged for their potential to save lives. Chemotherapy can have adverse effects on both the central and peripheral nervous systems, posing significant challenges. Objective: • To assess the causative agent, development, and timing of occurrence. • To improve management of neurological complications. • To discriminate the iatrogenic effects of cancer therapy and neurological progression. Method: A prospective observational study was conducted in a hospital setting, focusing on the neurotoxic effects of chemotherapy in cancer patients over a span of six months. The research involved participants from both the oncology in-patient and daycare departments. After obtaining informed consent, individuals in the study population were interviewed to gather information about any neurological symptoms they encountered following their chemotherapy sessions. Results and discussion: Within our study population, a predominant 67% comprised female patients, while male patients constituted 33%. Of the total participants, 66% reported experiencing neurological symptoms. Among these symptoms, the majority of patients encountered sensations such as tingling, numbness, and a burning sensation. Other reported symptoms included headaches, distal weakness, myalgia, seizures, and ataxia. Conclusion: In this current study, 66% of the study population encountered neurological side effects. Generally, the presence of comorbidities, vitamin deficiencies, and advanced age can significantly contribute to the development of peripheral neuropathy. Depending on the severity of neuropathy, recommendations for interventions include the prescription of vitamin supplements, calcium supplements, duloxetine, and pregabalin.

Predictive model for pancreatic steatosis after neoadjuvant chemotherapy in breast cancer: Construction and ultrasound validation

ObjectiveTo develop and verify a nomogram model for predicting occurrence of pancreatic steatosis (PS) after chemotherapy in breast cancer patients. MethodsA total of 215 breast cancer (BC) patients who underwent neoadjuvant chemotherapy in the hospital from February 2018 to November 2018 were prospectively collected for imaging and clinical data. Subjects were randomly divided into a training set (172 cases) and a validation set (43 cases) according to a random number table in a 4:1 ratio, and independent risk factors associated with PS were screened and modeled in a nomogram model after using single-factor and multifactorial logistic regression analyses on the training set. The model's performance was evaluated through various analyses, including subject operating characteristic curve(ROC), calibration curves, decision curve (DCA), and clinical impact curve (CIC), assessing its predictive performance, precision, and practical value in a clinical setting. ResultsThe results of univariate and multifactorial binary logistic regression analyses showed that age, triglycerides, and whether or not neoadjuvant chemotherapy was an independent risk factor for the development of PS, and these three independent risk factors were used to further construct a nomogram model. The model demonstrated strong predictive efficacy with an area under the ROC curve of 0.817 (95% CI = 0.753–0.880) in the training set and 0.762 (95% CI = 0.615–0.901) in the validation set. Calibration curve analysis confirmed accurate prediction of PS, and both DCA and CIC confirmed the model's clinical utility and validity. ConclusionThe nomogram model developed in this study shows strong prediction effect, discriminatory power, and clinical applicability, serving as an intuitive and visual tool for assessing the risk of PS in breast cancer chemotherapy patients.

Ayurveda &amp; Bioactives as Adjuvant for Dna Modulation in Cancer Treatment &amp; Adverse Drug Reaction [ADR] – A Glimpse of Traditional Indian Nanotechnology

Bioactives such as Curcumin and Quercetin and herbs such as “Tulsi”/ Holy basil [_Occimum sanctum_ L.] can provide relief from Adverse drug reaction [ADR] caused by chemotherapy in cancer patients. About 50% patients face moderate ADR issues such as nausea, vomiting, headache, and fewer [20-30%] serious ones [hair loss, loss of fertility and immunity]. The growing recurrence or resistance of cancers to chemotherapy and antimicrobial resistance [AMR] are other emerging challenges in addressing the global cancer burden, among the top causes of death. Two targets of herbal/ bioactive actions include topoisomerase that affects cell replication and telomere length and it may reduce resistance/ recurrence also. Patients with special conditions the old, children and less developed countries with low health budgets can especially develop from it.

Exploring Malnutrition Risk in Cancer Chemotherapy Patients: An Assessment of Associated Factors in a Tertiary Care Cancer Center

Objectives: This study aimed to assess the risk of malnutrition in cancer chemotherapy patients and identify the associated factors. Materials and Methods: It is a cross-sectional study. Purposive sampling was used to collect data from a tertiary care cancer centre. The study collected data from 101 participants and used a malnutrition screening tool (MST) to assess the risk of malnutrition. Results: The majority of participants in the study were female (61.4%) and in the 3rd or 4th stage of cancer (57.4% and 41.6%, respectively). Of the participants, 63.4% experienced weight loss without trying chemotherapy, and 60.4% were at risk for malnutrition. Cancer stage was associated with malnutrition risk, but other clinical variables were not. Conclusion: Malnutrition is a significant issue among cancer chemotherapy patients in the study’s population. The findings of this study can be used to develop interventions to prevent and manage malnutrition in patients with cancer and improve the effectiveness of cancer treatment in the Indian population.

Safety and efficacy of pre-emptive antifungal therapy versus empirical therapy in patients with febrile neutropenia – A meta-analysis

Febrile neutropenia is a life-threatening complication usually seen in cancer chemotherapy patients. Bacterial agents are the most common etiology of sepsis in febrile neutropenia and warrants empirical antibiotic treatment. However, the efficacy of pre-emptive therapy over empirical therapy is debatable. The objectives of this study were to evaluate the efficacy (difference in mortality rate) of pre-emptive antifungal therapy in patients with febrile neutropenia compared to empirical antifungal therapy and to evaluate the safety (antifungal exposure, adverse effects, and duration of hospital stay) of pre-emptive antifungal therapy. The data source used for the study is only PubMed. Only full-text articles in English language since the year 2000 were included. Unpublished studies will not be sought. Searches will be re-run before analysis. Data extraction was guided by a predetermined checklist. Using RevMan 5 software, the effect of intervention is null (95% CI 0.66–1.91, P = 0.57)]. An insignificant Q statistic (P &gt; 0.66) indicates the absence of heterogeneity (I2 = 0%) as there is not much difference in the mortality rates between two groups. Data analyses were performed from June 2023 to August 2023. The primary outcome is an insignificant Q statistic (P &gt; 0.66) indicates the absence of heterogeneity (I2 = 0%) as there is not much difference in the mortality rates between two groups. Hence, pre-emptive therapy can be considered in place of empirical therapy to avoid over treatment with antifungal agents in patients with febrile neutropenia. A meta-analysis of five eligible comparative studies involving 588 subjects who had pre-emptive antifungal therapy and 587 subjects who had empirical therapy signifies the effect of intervention is null (95% CI 0.66–1.91, P = 0.57). An insignificant Q statistic (P &gt; 0.66) indicates the absence of heterogeneity (I2 = 0%) as there is not much difference in the mortality rates between two groups. Hence, pre-emptive therapy can be considered in place of empirical therapy to avoid over treatment with antifungal agents in patients with febrile neutropenia. This systematic review and meta-analysis demonstrated that pre-emptive therapy can be considered in place of empirical therapy to avoid over treatment with antifungal agents in patients with febrile neutropenia. Trial Registration: PROSPERO receipt number-443707.

Investigation into quality of life of patient receiving chemotherapeutic regimen in selected hospital in South East Nigeria: A pilot study

In 2008 approximately 12.7million cancers were diagnosed and 7.6million people died due to cancer worldwide. People living with cancer experience a variety of reactions as such quality of life and chemotherapy for cancer patients and its associated side effects are topical issues in oncology practice. A survey was conducted among 264 breast cancer patients selected by Purposive sampling technique, the instrument for the study was (EORTC QLQ - C30 &amp; BR 23). This instrument was used to determine the quality of life of cancer patients and breast cancer in particular. It has a total of 53 items. The first 30 items (i.e. EORTC QLQ - C30), bothers on patients perception of health, the last 23 items which are numbered 31 – 53 (i.e. BR 23). QOL of breast cancer patients using EORTC QLQE30-BR23, revealed that they have trouble taking a long walk, they have you had pains, they need to rest with a mean of 1.9, 2.7 and 2.8 respectively. Also, 15.9% of the respondents had an excellent quality of life in the past week, 78.0% have good quality of life in the past week, it also further revealed that 14.8% had an overall excellent quality of life during the past week. Also, findings revealed that most of the respondents 57.95% had a very bad/poor QOL. Furthermore, findings further revealed that the patients’ perception of overall health past weeks was good, 206(78.03%). Cancer patients experienced many adverse reactions that affected their QOL. There is a need to develop strategies for managing their adverse event resulting from interventions for cancer, thus improving the patient quality of life.

Formulation Development and Evaluation of Sustained Release Rectal Suppository of Domperidone Maleate

The aim of present research was formulation development and evaluation of sustained release rectal suppository of domperidone maleate. By using Hot fusion method in that combination of PEG 4000 and poloxamer 188 was used as polymer and HPMC K4M was used for sustained released effect and surfactant was utilized for increasing bioavailability. The formulation was optimized based on Design expert software and Central Composite Design was used for study. Fourier transform infrared spectroscopy (FTIR) and differential scanning calorimetry (DSC) were performed to check any interaction between drug and excipients. The hardness, weight variation, friability, micro melting range test, disintegration time, dissolution studies and uniformity content of formulated batches were evaluated. All the results were within the acceptable pharmacopeial limits and were evaluated statistically by using one way ANOVA test for quadratic model. From the result, S7 batch was observed optimized formulation because upto 8 hrs 90.82% drug was released. kinetic studies of the drug release for optimized formulation follows zero order kinetics. This study was concluded that rectal route was more beneficial than oral route because it avoids first pass metabolism and enhance bioavailability of Domperidone maleate. The prepared Domperidone maleate suppository will be used for emesis caused due to chemotherapy in cancer patient and effective in the treatment of nausea and vomiting induced by drugs, migration and radiation sickness.

Symptomatic adverse events of chemotherapy in breast cancer patients:Using CTCAE, PRO-CTCAE, and EORTC QLQ-C30.

The Common Terminology Criteria for Adverse Events (CTCAE) is used as a tool to evaluate the adverse events (AE) of chemotherapy in cancer patients. Since CTCAE by medical providers underestimates AE more than patient-reported outcomes (PRO), the National Cancer Institute developed PRO-CTCAE. The present study investigated differences between symptoms detected using CTCAE by medical providers and PRO-CTCAE by breast cancer patients. Patients received chemotherapy comprising epirubicin and cyclophosphamide pre- or postoperatively. AE were evaluated using 4 questionnaires:PRO-CTCAE, CTCAE, the European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire (EORTC-QLQ-30), and Hospital Anxiety and Depression Scale (HADS) after 1, 2, and 3 courses of chemotherapy. Forty-two patients were registered. Regarding the recognition of psychological symptoms, such as fatigue, anxiety, and discouragement, and subjective symptoms, including heart palpitations and shortness of breath, PRO using PRO-CTCAE was significantly higher than medical provider-recognized outcomes using CTCAE. Concerning the recognition of regimen-specific symptoms, such as vomiting, nausea, and decreased appetite, medical provider- recognized outcomes were the same or higher than PRO. In QLQ-C30, the physical and role functions, fatigue and dyspnea significantly worsened after 2 and 3 courses of chemotherapy. J. Med. Invest. 71 : 82-91, February, 2024.