Chemotherapy In Patients Research Articles

Development and validation of a comprehensive needs assessment tool to assess the burden of cancer chemotherapy patients attending a tertiary care hospital.

In India in 2020, there were an estimated 1.39 million cancers present in the country. Chemotherapy patients experience several problems such as ADRs (adverse drug reactions), and because of this, many dropouts have been happening. Also, there is a lack of communication between the patient and care providers (doctors). Development and validation of a comprehensive needs assessment tool to assess the burden of chemotherapy on patients attending tertiary level health care facilities. Development and validation of comprehensive needs assessment in cancer chemotherapy involve several steps, including problem statement and literature review regarding the problem, domain generation, development of the preliminary questionnaire, face validation, statistical validation, and final draft of the tool. A total of 10 experts are involved in face validation. The majority (80%) of the experts agreed with the grammar, clarity, and content of the tool. A few experts (20%) disagreed regarding the construction of the questionnaire, the appropriate level of understanding for the participants, and the content of the tool and suggested changes in the physical and psychological domains. The questionnaire has been re-structured according to the expert's suggestion before going for statistical validation. Internal consistency of the CNAT-CC was optimal, with a satisfactory Cronbach's alpha of 0.7 for the total scale. The current study was focused on the development and validation of needs assessment in cancer chemotherapy patients. The CNAT-CC promises to be a comprehensive needs assessment tool that applies to a comparatively vast majority of patients undergoing cancer chemotherapy.

Clinicopathologic Features and Prognosis of Female Early Breast Cancer With HER2 Low Expression: A Propensity Score Matched Analysis.

Metastatic breast cancer (MBC) patients with low expression of human epidermal growth factor 2 (HER2) have been proven to benefit from HER2 targeted therapy. We aimed to determine how HER2-low status affected survival and metastatic risk as well as how it affected pathological complete response (pCR) in neoadjuvant chemotherapy (NAC) patients. According to the results of immunohistochemistry (IHC) and in situ hybridization (ISH) testing, 321 female patients were sorted into HER2-low (IHC 1+/2+ with ISH negative) and HER2-zero (IHC 0) groups using propensity score matching (PSM). Overall survival (OS), disease-free survival (DFS), and distant disease-free survival (DDFS) were compared for both groups, while pCR was only analyzed for NAC patients. In total, 97 patients in each group after PSM were included. We discovered that pCR was not associated with HER2 expression status in 45 patients who underwent NAC. Five-year OS in the HER2-low group was significantly higher (98.99%) than in the HER2-zero group (95.87%, P = .044); however, this difference was not reflected in the 5-year DFS (90.61 vs 90.52%, P = .868) and 5-year DDFS (93.67 vs 91.53%, P = .757). Meanwhile, multivariate analysis revealed that HER2-low expression could indicate better OS (P = .047, hazard ratios [HRs] = 16.121, 95% confidence interval [CI] = 1.035-251.046), but it had no prognostic value for DFS or DDFS. When compared with HER2-zero expression, HER2-low expression was not connected to pCR and could not modify metastasis risk in female patients with early-stage breast cancer (BC), but it may prolong patient survival.

Initial observations on sexual dysfunction as a symptom of chemotherapy-induced peripheral neuropathy.

Peripheral neuropathy (PNP) in feet and/or hands and sexual dysfunction are common side effects of cancer therapies. In patients with other diseases, there is evidence of an association between peripheral nervous system disorders and sexual dysfunction due to the impact of impaired neuronal control on genital organ sensitivity. In cancer patient interviews, it has now been observed that PNP and sexual dysfunction may be related. The aim of the study was to investigate the potential association between PNP, sexual dysfunction, and physical activity behavior. Ninety-three patients with PNP of the feet and/or hands were interviewed in August/September 2020 in a cross-sectional study regarding medical history, sexual dysfunction and functionality of the genital organs. Thirty-one persons who participated in the survey provided seventeen evaluable questionnaires (four men, thirteen women). Nine women (69%) and three men (75%) reported sensory disorders of the genital organs. Three men (75%) had erectile dysfunction. All men who had sensory symptoms of the genital organs received chemotherapy, and one man also received immunotherapy. Eight women were sexually active. Five (63%) of them reported genital organ symptoms and mainly lubrication disorders. Four (80%) of the five sexually inactive women reported genital organ symptoms. Eight of the nine women with sensory symptoms of the genital organs received chemotherapy, and one woman received immunotherapy. Our limited data suggest genital organ sensory symptoms in chemotherapy and immunotherapy patients. Genital organ symptoms do not appear to be directly related to sexual dysfunction, and the association between PNP and genital organ symptoms appears to be more pronounced in sexually inactive women. Chemotherapy could cause sensory symptoms of the genital organs and sexual dysfunction by damaging genital organ nerve fibers. Chemotherapy and anti-hormone therapy (AHT) could trigger a disturbance of the hormone balance, which in turn could be causative for sexual dysfunction. It remains open whether the cause of these disorders is the symptomatology of the genital organs or the altered hormone balance. The significance of the results is limited due to the small number of cases. To our knowledge, this study is the first of its kind in cancer patients and allows a better understanding of the association between PNP, sensory symptoms of the genital organs, and sexual dysfunction. In order to be able to narrow down the cause of these initial observations in cancer patients more precisely, larger studies are needed that can relate the influence of cancer therapy-induced PNP, physical activity level and hormone balance to sensory symptoms of the genital organs and sexual dysfunction. The methodology of further studies should take into account the frequent problem of low response rates in surveys on sexuality.

Adjuvant chemotherapy for high-grade appendiceal cancer after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy.

There are no available data on the efficacy of adjuvant chemotherapy (ACT) in stage IVA/B high-grade mucinous appendiceal cancer treated with CRS/HIPEC. We evaluated the association between ACT and survival in this cohort. A single-institution retrospective cohort study using a prospective database was conducted. Stage IVA/B high-grade mucinous appendiceal cancer patients who underwent CRS/HIPEC with CC-0/1 were included. Survival was compared between ACT and no chemotherapy (NoCT) patients. Subgroup analysis was performed with adjustment for confounding variables. We identified 180 patients: 77 ACT and 103 NoCT. ACT regimens included 5-FU/capecitabine (13%), oxaliplatin-based (63%), and irinotecan-based (21%), combined with bevacizumab in 27% of cases. Median number of cycles was 9 (IQR: 6-12). Median overall survival (OS) did not significantly differ between ACT and NoCT (53 vs 75 months, p=0.566). Multivariable Cox regression showed no OS benefit for ACT vs NoCT in patients with neoadjuvant chemotherapy (HR 1.14; 95%CI: 0.38-3.39) or without it (HR 1.33; 95%CI: 0.69-2.57), with signet ring cell (HR 0.89; 95%CI: 0.38-2.06) or other histologies (HR 1.11; 95%CI: 0.50-2.46), positive lymph nodes (HR 1.60; 95%CI: 0.74-3.49), or peritoneal cancer index ≥20 (HR 1.08; 95%CI: 0.55-2.11) after adjusting for other factors. In our cohort, colon-type ACT was not associated with better OS in stage IVA/B mucinous appendiceal cancer after CRS/HIPEC, even after adjusting for confounders. This may be due to different tumor biology than colon cancer or small sample size. Prospective collaborative studies are needed.

Evaluation of the Role of Axillary Lymph Node Fine-Needle Aspiration Cytology in Early Breast Cancer With or Without Neoadjuvant Chemotherapy.

Fine-needle aspiration cytology (FNAC) of axillary lymph nodes (AxLNs) is performed to diagnose nodal metastasis in patients with breast cancer. Although the sensitivity of ultrasound-guided FNAC for identifying AxLN metastasis is in the range of 36%-99%, whether sentinel lymph node biopsy (SLNB) should be performed for neoadjuvant chemotherapy (NAC) patients with negative FNAC results is uncertain. This study aimed to determine the role of FNAC before NAC in the evaluation and management of AxLN in early breast cancer patients. We retrospectively analyzed 3,810 clinically node-negative (a lymph node with no clinical metastasis without FNAC or radiological suspicion of metastasis with negative FNAC results) patients with breast cancer who underwent SLNB between 2008 and 2019. We compared the positivity rate of sentinel lymph nodes (SLNs) between patients who received and those who did not receive NAC with negative FNAC results or without FNAC and axillary recurrence rate in the neoadjuvant group with negative SLNB results. In the non-neoadjuvant (primary surgery) group, the positivity rate of SLNs in patients with negative FNAC results was higher than that in patients without FNAC (33.2% vs. 12.9%; p < 0.001). However, the SLN positivity rate of patients with negative FNAC results (false-negative rate for FNAC) in the neoadjuvant group was lower than that in the primary surgery group (3.0% vs. 33.2%; p < 0.001). After a median follow-up of 3 years, one axillary nodal recurrence was observed, which was a case from the neoadjuvant non-FNAC group. None of the patients in the neoadjuvant group with negative FNAC results had axillary recurrence. The false-negative rate for FNAC in the primary surgery group was high; however, SLNB was the proper axillary staging procedure for NAC patients who have clinically suspicious AxLN metastases on radiologic examination but negative FNAC results.

Multi-tracer sentinel node biopsy for patients with breast cancer after neoadjuvant chemotherapy

Background: For post-neoadjuvant chemotherapy patients with breast cancer, sentinel lymph node biopsy (SLNB) was recommended using the dual-tracer mapping technique (radioisotope plus blue dye) or placing a biopsy clip into the positive node at diagnosis and identifying it at the time of surgery due to SLN identification rates were lower and false negative rates were greater for patients with local advanced BC than those of patients with early-stage BC in the absence of NAC. Our previous clinical trial has indicated that the real-time ICG fluorescence (RT-ICG) imaging technique could improve the diagnostic sensitivity and detection accuracy for SLNB. Methods: The SLNs was detected by conventional procedures of blue-dye (Indigo carmine) plus 99mTc radioisotope (dual-tracer) and combined with concurrent RT-ICG technique. The positivity of each single SN by each single tracer (blue dye, ICG, or radioisotope alone) was counted and identified, respectively. 51 enrolled cN1patients after NAC are required to undergo SNB followed by completion axillary lymph node dissection (CND). The identification rate and false negative rate of each single tracer and their summation (triple tracer) were calculated by comparing the results of the SLNB and the histopathology of the resection specimens of CND. Results: post-neoadjuvant patients, the identification rate and false negative rate of each single procedure for SLNB was 84.3% and 5.9% when used Indigo Carmine blue, 94.1% and 0 when used ICG fluorescence, 92.2% and 3.9% when used RI, respectively. In contrast, the total calculation of triple tracer showed that identification rate reached to 96.1% and false negative rate was 0, respectively. Conclusions: Our results suggested that the multitracer technique combining blue dye, ICG, and radioisotope is effective method for detection of SLNs in post-neoadjuvant cN+ BC pts. The identification rate and false negative rate of SLNB might be improved by this multiple tracer mapping technique, particularly for patients with ypN(+) after NAC. It is considered that the multi-tracer can complement each other for what was not able to be traced and detected by the single tracer with one mapping material, and that result in totally the improvement of identification rate of SLNB.

The DMRTA1-SOX2 positive feedback loop promotes progression and chemotherapy resistance of esophageal squamous cell carcinoma.

Esophageal squamous cell carcinoma (ESCC) is among the most prevalent causes of cancer-related death in patients worldwide. Resistance to immunotherapy and chemotherapy results in worse survival outcomes in ESCC. It is urgent to explore the underlying molecular mechanism of immune evasion and chemoresistance in ESCC. Here, we conducted RNA-sequencing analysis in ten ESCC tissues from cisplatin-based neoadjuvant chemotherapy patients. We found that DMRTA1 was extremely upregulated in the non-pathologic complete response (non-pCR) group. The proliferation rate of esophageal squamous carcinoma cells was markedly decreased after knockdown of DMRTA1 expression, which could increase cisplatin sensitivity in ESCC. Additionally, suppression of DMRTA1 could decrease the immune escape of esophageal squamous carcinoma cells. Further mechanistic studies suggest that DMRTA1 can promote its expression by binding to the promoter of SOX2, which plays important roles in the progression and chemoresistance of ESCC in the form of positive feedback. Therefore, DMRTA1 could be a potential target to suppress immune escape and overcome chemoresistance in ESCC.

Study on the Influencing Factors of Chemotherapeutic-Related Taste Changes in Cancer Patients

Objective: To investigate the current situation of chemotherapy-related taste changes of cancer patients in Jingzhou area, and analyze the influencing factors of chemotherapy-related taste changes of cancer patients. Methods: In this study, 233 patients with malignant tumors who were confirmed by pathological examination and expected survival time of more than 6 months after admission to a tertiary general hospital in Jingzhou from January 2018 to October 2018 were selected by convenience sampling method. The Chinese version of The chemotherapy-induced Taste Alternation Scale (CiTAS) was used to investigate the baseline data and occurrence status, and multiple regression analysis was used to explore the influencing factors. Results: In this study, 171 tumor patients experienced chemotherapy related taste changes, accounting for 73.4% (171/233); The vast majority of chemotherapy patients have different types and severity of taste changes; Multiple regression analysis showed that the duration of chemotherapy, the number of consecutive days of chemotherapy, and dry mouth were the main influencing factors for chemotherapy related taste changes in cancer patients (p < 0.05). Conclusion: Nursing personnel should pay attention to the occurrence of chemotherapy-related taste changes in tumor patients, and provide predictive nursing interventions to improve their taste experience for tumor patients who have a long course of chemotherapy, many consecutive days of chemotherapy, or have dry mouth conditions.

The Effects of Laughter Yoga on Perceived Stress, Positive Psychological Capital, and Exercise Capacity in Lung Cancer Chemotherapy Patients: A Pilot Randomized Trial

Background: Lung cancer is the malignant tumor with the highest morbidity and mortality rate in China. Although chemotherapy is effective in improving clinical symptoms, it causes a variety of acute and chronic side effects, seriously aggravating the psychological stress of patients. Laughter Yoga as a new type of aerobic exercise can effectively reduce stress levels and increase positive mood in patients. This study aimed to examine the effects of laughter yoga on perceived stress, positive psychological capital, and exercise capacity in lung cancer patients. Methods: This study was a randomized, single-blind, parallel-group trial. The study enrolled 84 lung cancer chemotherapy patients from a general hospital in central China. These patients were randomly allocated to control and intervention groups (n = 42 per group) after baseline assessments. Patients in the control group received routine care and those in the intervention group received laughter yoga intervention. Perceived stress, positive psychological capital, and exercise capacity were assessed at baseline, immediately post-intervention. Results: During the implementation of the study, there were 2 dropouts in each of the intervention and control groups. Ultimately, 80 patients in the control and intervention groups completed the trial. Patients who received laughter yoga intervention had significantly higher scores in positive psychological capital ( P &lt; .01, Cohen’s d = 0.692) and exercise capacity ( P &lt; .01, Cohen’s d = 0.659). Discernible differences were also observed in perceived stress ( P &lt; .01, Cohen’s d = 1.087) between the 2 groups. Conclusions: The results of this study suggest that laughter yoga is an effective way and may produce beneficial effects on perceived stress, positive psychological capital and exercise capacity.

Az onkokardiológia kialakulása

In our days, the worldwide leading cause of mortality is cardiovascular, and the second place is held by cancer diseases. Actually, we achieved a significant breakthrough in cancer treatment through multi-disciplinary cooperation but parallel there were emerging cardiac side effects. Several hundred years earlier all cancer patients were considered uncurable, and they were labelled this way through many centuries. Some people are thinking the same way even in our days. The first therapeutic initiatives were surgical operations aiming to remove cancer tissues. These therapeutic approach flourished in the surgeons’ century by spreading of general anaesthesia. At the end of the 19th century, a new diagnostic and therapeutic approach used the X-ray technique which spread fast throughout the world. In the middle of the 20th century, scientist started to investigate the chemical weapons of warfare and discovered, that these lessened the progression of some cancer types. Thanks to these discoveries, there was introduced the first anti-cancer drug aminoptein that opened the era of chemotherapy. However, after a few years, it was realized that some patients treated by pharmaceuticals of the antraciklin groups developed heart failure. This phenomenon instigated more scientists to investigate heart-related side effects. Later, there were observed similar side effects as developing high blood pressure and ECG anomalies in patients treated with further chemicals such as HER-2 blocking herceptin and multi-kinase inhibitors. These researcher outcomes were more and more noticed in the practical cardiology in patients treated previously by chemotherapy. Finally, in 2016 the European Society of Cardiology issued the first guideline about the side effects of cancer chemotherapy patients, which started the era of on-cardiology. Since 2016, the once-cardiology become a new medical discipline that concerns the prevention of complications, and the recognition and treatment of heart-related side effects. In the same year was founded the Hungarian Onko-cardiology Society which is translating, spreading and exposing the actual guidelines and holds annual conferences for postgraduate training.

The protective effect of Boesenbergia rotunda extract on cisplatin-exposed human embryonic kidney-293 cells by inhibiting the expression of kidney injury molecule-1, neutrophil gelatinase associated-lipocalin, NF-κB, and caspases

Introduction: Acute kidney injury (AKI) is a major problem in platinum-based chemotherapy patients. Boesenbergia rotunda can induce the generation of osteoblast cells and significantly increase pancreatic antioxidant enzyme activities; therefore, this study aimed to investigate the cytotoxicity of cisplatin on human embryonic kidney-293 (HEK-293) cells and the protective impact of the ethanol extract of B. rotunda (EEBR) against such conditions. Methods: Cytotoxicity was assessed using the CCK-8/WST-8 reagent, while the protective activity was assayed on 1 µg/mL cisplatin-exposed HEK-293 cells by quantifying the expression of nephrotoxicity biomarkers, e.g., kidney injury molecule-1 (Kim-1) and neutrophil gelatinase associated-lipocalin (NGAL), nuclear factor-kappaB (NF-κB), apoptotic caspase-3, and caspase-7 genes, in cisplatin-exposed HEK-293 cells. Results: Cisplatin was confirmed as highly toxic against the HEK-293 cells (IC50 = 2.5145 μg/ mL), whereas quercetin was of moderate toxicity (IC50 = 185.6225 μg/mL). EEBR revealed an IC50 = 40.0655 μg/mL. Moreover, EEBR concentrations of 5, 10, and 20 µg/mL confirmed its remarkable protective activity against cisplatin-exposed HEK-293 cells (P=0.031, 0.014, 0.046, respectively) compared to the cisplatin-treated cell lines without treatment. The quantitative real-time polymerase chain reaction (PCR) revealed that a higher concentration of EEBR significantly suppressed the expression of Kim-1, while lower concentrations of EEBR significantly inhibited NGAL and NF-κB genes. Higher concentrations of EEBR reduced the expression of caspase-3. All concentrations of EEBR stimulated the expression of caspase-7. Conclusion: The significant protective activity observed in this study indicated that EEBR might be beneficial in protecting kidney cells against cisplatin.

Risk factors to port-a-cat damage/removal in patients in antineoplastic chemotherapy: a retrospective observational study

Objective: To identify the prevalence and risk factors for damage or removal of fully implanted long-term catheters from patients undergoing antineoplastic chemotherapy. Methods: This is an observational, cross-sectional study that evaluated medical records of patients undergoing placement of a fully implanted catheter for antineoplastic chemotherapy from January 2015 to December 2019. Clinical and sociodemographic data were collected that were associated with catheter survival using Log-Rank Mantel-Cox and Cox Regression tests (SPSS, p&lt;0.05). Results: Of 58 devices evaluated, most patients were higher educated married females, younger than 60 years old. The most frequent side of catheter implantation was the right side, and the most prevalent implantation site was the internal jugular vein. Less than 1/3 of patients (29.3%) had port-a-cath loss due to complications with a five-year follow-up survival of 35.73±3.76 (95% CI = 28.35-43.11). Two patients (4.7%) needed removal due to device exposure, three (7.0%) due to obstruction, and 12 (27.9%) due to infection. Female patients (p=0.019) and patients with breast tumors (p=0.049) had a shorter mean survival time. The women showed port-a-cath survival 9.25 times (95% CI = 1.35-50.25) shorter in the multivariate analysis. Conclusion: port-a-cath catheter loss is around 30% and being female is a determining risk factor.

Taxanes induced hypersensitivity reactions in cancer chemotherapy patients reported at adverse drug reaction monitoring centre at a tertiary care hospital

Background: Cancer chemotherapy involves highly complex regimens using antineoplastic agents like taxanes (paclitaxel, docetaxel) etc. Taxanes cause hypersensitivity reactions (HSRs) like redness, rashes, dyspnoea, severe anaphylaxis and death. In this study, adverse drug reactions (ADRs) associated with taxanes are described &amp; analysed on their severity and preventability. The present study aims to analyse and determine the prevalence of ADRs, especially HSRs in patients treated with taxanes.Methods: After getting IEC approval, the present study is done retrospectively by assessing the HSRs in suspected ADR reporting forms from December 2019 to February 2022 in ADR monitoring centre (AMC) in the Department of Pharmacology at Kurnool Medical College, Kurnool. Descriptive statistics used to analyse patient demography, frequency, various carcinomas under treatment &amp; organ involved, causality assessment using WHO-UMC Scale and Naranjo's Algorithm, severity assessment using modified Hartwig &amp; Siegel’s scale and preventability by modified Schumock &amp; Thornton scale.Results: A total of 258 ADRs were recorded, of which 30 cases reported HSRs with taxanes-paclitaxel (22) and docetaxel (8). The most commonly occurred HSR is shortness of breath. Naranjo’s algorithm showed 52.5% possible (score 1-4) HSRs. WHO-UMC causality assessment scale showed 56.4% as probable HSRs. Modified Hartwig &amp; Siegel severity scale showed 46.6% moderate (level 3). Modified Schumock and Thornton scale showed 76.9% as not preventable.Conclusions: Chemotherapy-related ADRs among cancer patients urges the oncologists to be actively involved in ADR reporting, in the need of the hour in order to mitigate, avoid their occurrence and reducing morbidity and mortality, when practiced with diligence.

Internet of Things for Monitoring Infusion Fluids in Intravenous Chemotherapy Patients: Literature Review

Administration of intravenous chemotherapy drugs to cancer patients requires sophisticated infusion fluid monitoring tools so that the therapy process is smooth, safe, and comfortable. Internet-based technology of things to monitor intravenous chemotherapy drug infusion fluids more accurately and easily. Non-systematic review literature, using online data base: Elsevier (ScienceDirect), IEEE Xplore, ProQuest, Sage Journal with keywords: "internet of things" AND "infusion monitoring" AND "chemotherapy", "infusion monitoring system" with filter: " full text”, “Published in the last 5 years”, “journal” AND “2017-2022”. Literature review of 10 journals using the internet of things to accurately monitor infusion fluids is beneficial for chemotherapy patients. Making a monitoring system for chemotherapy drug infusions in Indonesia based on the internet of things that is accurate, easy and cheap.

Pharmacological Mechanism of Pingxiao Formula against Colorectal Cancer.

Colorectal cancer (CRC) is the most common cancer worldwide and develops due to a broad range of causative factors. Pingxiao (PX) formula and Xihuang (XH) formula are two commonly used drugs to treat CRC, especially as an alternative therapy for those patients who could not suffer surgery, chemotherapy, or immunotherapy, namely, elder or advanced CRC patients. However, the pertinent pharmacological mechanisms are still elusive. The investigation was designed to explain the pharmacological mechanisms of the PX formula. A murine model of CRC was established by injecting CT26.WT cells into the caecum of 4-week-old male Balb/c mice, following PX or XH treatment for 30 days. Network pharmacology analysis combined with weighted gene coexpression network analysis (WGCNA) predicted the pharmacological mechanisms and therapeutic value. High-throughput 16S rRNA sequencing determined the alterations in the gut microbiota communities. Western blotting, immunofluorescence, and flow cytometry examined the influence of PX on the tumor microenvironment (TME). Injection of CT26.WT-induced CRC in Balb/c mice was markedly attenuated by PX treatment. Compared with XH administration, PX exhibited a stronger antitumor effect, such as smaller tumor volume, lower interleukin 17 (IL-17), IL-6 and tumor necrosis factor-alpha (TNFα) serum levels, and higher interferon-gamma (IFN-γ) concentration. Network pharmacology analysis demonstrated that both PX and XH targets were enriched in cancers and inflammatory responses. RNA sequencing confirmed that PX treatment induced cancer cell apoptosis and inhibited inflammatory reactions within the tumor. Moreover, the PX formula considerably restored homeostasis of the gut microbiota, which was not observed in the XH group. PX targets, those associated with the survival probability of CRC patients, correlated with macrophage (Mφ) infiltration, which presented an independent risk factor for the CRC outcome. PX treatment promoted the transition of alternatively activated Mφs (M2 Mφs) to classically activated Mφs (M1 Mφs). Moreover, the peritoneal Mφs from the PX group inhibited the migration of CW26.WT cells, as evidenced by the wound healing experiment and transwell assay, which was consistent with the decreased expression of the vascular endothelial growth factor (VEGF). Furthermore, the coculturing system confirmed that PX-treated Mφs suppressed colorectal tumor-derived organoid proliferation. PX formula exhibits a potential antitumor effect against CRC by suppressing the colonization of pathological microorganisms, reshaping Mφ effector functions and hence inhibiting cancer cell proliferation.

Représentations et pratiques du jeûne et des régimes restrictifs pendant la chimiothérapie

Introduction&#160;: The idea of therapeutic fasting with healing virtues is circulating among cancer patients. Our study aims to improve knowledge of this practice, which is contraindicated in France during chemotherapy, and to establish recommendations to facilitate exchanges between doctors and patients.Methods&#160;: Chemotherapy patients completed a self-questionnaire on diet, therapeutic fasting and alternative medicine. A subsample of patients intending to follow dietary restrictions were interviewed.Results&#160;: Among the 133 participants, more than half had changed their diet and/or had heard of therapeutic fasting. Twenty-one patients intended to fast or have dietary restrictions during chemotherapy. These were mainly women, with an average age of 56 years, being treated for breast cancer, using alternative medications. They had little interaction with the health care team but would have liked to have had some with their oncologist. Nine patients were interviewed. They had tested short fasting and/or a ketogenic diet to improve treatment efficacy, reduce side effects and/or gain more control over their management. They did not dare to talk about it with the oncologist but regretted their silence. They are often advised by naturopaths and have tested homeopathy to accompany their treatment.Conclusions&#160;: Patients explain that they want to put all the odds in their favor. They would like the medical profession to offer times for discussion on fasting, silence being perceived as potentially harmful.

Medication errors in an oncology inpatient setting in India-Audit by clinical pharmacists.

Good clinical practices and strict vigilance are needed, especially for patients receiving chemotherapy. Regular audits using a specially developed tool need to be conducted in the oncology wards to identify lapses in the use of chemotherapy drugs. Observational study was conducted in the adult and paediatric oncology inpatient settings in an Indian tertiary care hospital for a period of 2.5 years. It was an audit of case files of chemotherapy patients for their drug prescriptions, medication reconciliation records and adverse drug reports. Data was presented as frequencies and percentages. 1.3% medication errors and 0.23% adverse drug reactions were reported during the study period. Majority were transcription (38%) and drug reconstitution errors (29%) and were either in the near-miss or no-harm category. Medication errors were found in the oncology wards, but due to the vigilance of clinical pharmacists, none of the patients were harmed as a consequence of these errors.

COVID19-induced immunosuppression and aggressive progression of primary cranial vault lymphoma presenting as a management challenge, a case report, and a literature review

BackgroundWe needs to study Primary Large cell Non-Hodgkin’s Lymphoma of the cranial vault, which is rare, and its association with COVID19 has not been reported, which may have an immunosuppressive effect to aggravate its progression.Patient detailsOur patient, a 53-year-old male, noticed fast growth of posterior cranial vault lesion from 2 to 10 cm size in last 6 months after COVID 19 affliction. MRI brain with contrast revealed lesions suggesting meningioma. The whole-body PET scan was normal. Following Subtotal excision of the mass, histopathology revealed large B-cell Non-Hodgkin’s lymphoma (DLBCL). Immunohistochemistry showed positive results for CD10, CD20, CD45 (LCA), ALK, and BCL-VE with a Ki-67 index of 90–95%. Following radiotherapy and chemotherapy patient is disease-free on imaging and doing well at 5 months of follow-up.ConclusionsEarly intervention with excisional biopsy and timely chemo and radiotherapy in favorable immunostaining may add survival benefits even in malignant features induced by immunosuppressing diseases such as COVID19 in diffuse large B-cell lymphoma (DLBCL) of the scalp.

The rhythm of chemotherapy and cancer patients' time perspectives.

While it is well known that illnesses such as cancer modify the experience of time, the impact of the rhythm and length of treatment on patients' time perspectives remains unknown. A short version of Zimbardo Time Perspective Inventory and Transcendental Future Perspective Questionnaire as well as a demographic questionnaire on a convenience sample of 259 patients (66.8% female, mean age 52.36) with various cancers and undergoing chemotherapy with different frequencies (1, 2, 3 weeks) and mean time in treatment 23.4 months. The temporal perspectives mean scores of cancer patients are: positive past 3.69, negative past 3.13, present hedonism 3.08, future 3.77, transcendental future 3.40. Patients tend only slightly to lose faith alongside the course of oncological treatment regardless of their age (ρ=-0.210, p<0.01). The frequency of chemotherapy mildly differentiates temporal perspectives of patients regarding present hedonism and transcendental future: a weekly treatment is more disturbing than the triweekly one and no treatment in terms of hedonism, while patients not in chemo score significantly higher in transcendental future than patients in biweekly and triweekly chemo. The variations of treatment rhythm are less significant than predicted, although still relevant. Since most sociodemographic variables are of no relevance, cancer experience likely unifies temporal perspectives among people of different backgrounds.

Application of Box-Behnken design for optimization of A RP-HPLC method for determination of palonosetron and netupitant in their combined dosage form in presence of their impurities

The use of (Netupitant and Palonosetron) combination to treat nausea and vomiting in cancer chemotherapy patients has been authorized by the Food and Drug Administration. For the simultaneous determination of Netupitant (NET) and palonosetron (PAL) in the presence of two of their related substances and in their dosage form, a sensitive and selective RP-HPLC method has been developed and validated. The aforementioned medications were separated and quantified with the help of experimental design. The Box-Behnken design was used in the experiment to optimize the chromatographic method’s analytical parameters. It employed RP-HPLC with a UV detector. Waters ODS-C18 column (3.5 µm, 75 × 4.6 mm) with a mobile phase composed of acetonitrile: 25 mM phosphate buffer (pH = 3.5) in a gradient mode at 254 nm was employed to separate the cited drugs and their impurities. Palonosetron was linear over the concentration range (1–50 µg/mL) and Netupitant (10–100 µg/mL). According to ICH guidelines, the new method underwent thorough validation. Between the proposed method’s results and those from the reported method, there was no significant difference. It is easy to apply the technique to the analysis of the specified drugs in their combination dosage form for quality control considerations.