Preparation For Radiotherapy Research Articles

Using virtual reality to prepare patients for radiotherapy: A systematic review of interventional studies with educational sessions.

To understand the impact of radiotherapy educational sessions with virtual reality on oncologic adult patients' psychological and cognitive outcomes related to the treatment experience. This review was performed according to the Preferred Reporting Items for Systematic Reviews guidelines. A systematic electronic search in three databases, MEDLINE, Scopus, and Web of Science, was conducted in December 2021 to find interventional studies with adult patients undergoing external radiotherapy who received an educational session with virtual reality before or during the treatment. The studies that provided qualitative or quantitative information about the impact of educational sessions on patients' psychological and cognitive dimensions related to RT experience were retained for analysis. Of the 25 records found, eight articles about seven studies were analysed that involved 376 patients with different oncological pathologies. Most studies evaluated knowledge and treatment-related anxiety, mainly through self-reported questionnaires. The analysis showed a significant improvement in patients' knowledge and comprehension of radiotherapy treatment. Anxiety levels also decreased with virtual reality educational sessions and throughout the treatment in almost all the studies, although with less homogeneous results. Virtual reality methods in standard educational sessions can enhance cancer patients' preparation for radiation therapy by increasing their understanding of treatment and reducing anxiety.

FEATURES OF PSYCHO-EMOTIONAL ADAPTATION DURING PREPARING TO RADIOTHERAPY

Radiation therapy is a mandatory treatment tactic in almost 70 % of cancer patients, including those of head and neck, accounting for about 15−20 %. The radiotherapy prescribing causes certain complications in patients, so its need increases the level of anxiety and stress, forms a pessimistic perception of the prospects of anticancer treatment. An additional stressor is also the myths about radiation therapy, which can provoke the refusal of treatment. Therefore, an important task of medical care at the stage of radiation treatment is not only psychocorrection of the emotional sphere, but also correction of cognitive distortions, psychoeducation, the formation of a satisfactory therapeutic alliance and commitment to therapy. To study the features of psycho−emotional adaptation in preparation for radiation therapy in the patients with head and neck cancer, 60 patients were examined. To determine the psycho−emotional status of cancer patients there were used a clinical method (survey, collection of complaints and anamnestic data), a test of differentiated self−assessment of the functional state "Feeling, activity, mood", the method of "Distress Thermometer". It was found that during the procedures of radiation therapy in 90 % of patients the rate of distress increased and positively correlated with the test "Feeling, activity, and mood". The average indices of psycho−emotional state according to all scales of the test "Feeling, activity, mood" decreased. Criteria for adaptation to radiation therapy were identified: compliance with the basic rules and requirements related to nutrition, hygiene, keeping the regimen; timely and qualitatively informing the doctor about changes in the patient's condition; quality of relationships with staff. It is concluded that the need for psychocorrectional work at the stage of the course of radiation therapy with the selection of the main targets for psychotherapeutic interventions. Key words: psychoemotional adaptation, psychooncology, head and neck cancer, radiation therapy.

Features of immune status in patients with metastatic and glial brain tumors at the preparatory stage of radiotherapy

Background. Studies carried out in recent decades have shown that immune cells are essential participants in the cancer process as well as cancerrelated inflammation. Focus has been increased on understanding the way how immune cells affect a tumor at different stages of the disease: early neoplastic transformation, clinically detected tumors, metastatic spread, and at surgery and radiotherapy stages.
 Purpose – assessing the status of the immune system in patients with brain tumors before radiation therapy and radiosurgery and comparing the features of immunity in metastatic and glial brain tumors.
 Materials and methods. The study presents the immunogram findings of 61 patients. Out of those: 18 patients with primary glial tumors and 23 patients with secondary metastatic tumors to the brain. The outcomes of 20 conditionally healthy non-cancer patients are presented as a control group. The age of patients is 24–75. All patients were histologically diagnosed with the tumor. Surgery was performed 1.0–3.0 years before the examination. Assessment of the immune system in patients with brain tumors was performed taking into account the cellular, humoral and phagocytic component of innate immunity. When assessing cellular immunity, the relative and absolute count of major lymphocyte subpopulations, such as CD3+ – general T-lymphocytes, CD4+ – T-lymphocytes-helpers, CD8+ – cytotoxic lymphocytes, CD16+ – natural killer lymphocytes, CD19+-B-lymphocytes, were calculated. Determining the humoral parameters included an assessment of quantitative values of IgG, IgM and IgA. Quantitative assessment of the phagocytic component of innate immunity included phagocytic activity of neutrophils (i. e. NBT test (Nitroblue Tetrazolium test), inducing (Zymosanum) and spontaneous neutrophil myeloperoxidase activity).
 Results. When comparing the immune parameters of the number of T- and B-subpopulations of lymphocytes in patients with primary malignant brain tumors and secondary metastatic tumors, no statistically significant difference has been detected between these params. Glioblastomas show higher levels of СD4+- and CD8+-lymphocytes in comparison with other tumour groups as well as higher levels of IgG and IgA than in other tumors, while IgM concentration is almost at the same level in three groups of patients. There is a tendency for reducing IgG and IgM level in the blood of patients with metastatic tumors. Both groups of cancer patients under study show inhibition of myeloperoxidase activity of neutrophils in the setting of maintaining the function of NBT cell activity.
 Conclusions. According to the findings obtained via studying immunological indicators of brain tumors, both metastatic and primary malignant glial ones, there are partial changes in various immune system components such as cellular, humoral and phagocytic activity. However, no statistically significant difference was detected between immune status indicators, that substantiates the need for further study of this issue. At the stage of preparation for radiation therapy, no significant changes in the immune system of the patients with brain tumors, that would make such treatment impossible and be consiered as one of contraindications, are observed.

Evaluation of Alternate Patient Education Methods Regarding Treatment-Related Side Effects in Preparation for Radiation Therapy

The goal of this study was to evaluate and compare the effectiveness of the protocols for new patient education presently used by cancer centres in Northern Ontario, and to suggest improvements based on this information. Prior to their first radiation treatment, patients meet with many health care providers in order to receive information regarding potential side effects and coping mechanisms. It has been observed that many new patients are unable to recall the information delivered during these meetings.

A Qualitative Investigation on Patient Empowerment in Prostate Cancer.

Purpose: Men with prostate cancer often describe low levels of empowerment. eHealth interventions may represent useful tools to deliver care and education and to meet patients' needs within an empowerment framework. In order to design a platform for cancer patients' empowerment within the H2020 iManageCancer project, the perspective of the target population for the platform was assessed. The present study aims to assess the qualitative experience of prostate cancer patients during treatment in order to provide insights for clinical practice with a particular focus on the design of a web platform to promote cancer patients' empowerment.Methods: Ten patients undergoing radiation therapy treatment took part in a semi-structured interview to explore different aspects of patient empowerment. Four main thematic areas were addressed: patient-healthcare providers' communication, decision-making, needs, and resources. A qualitative approach using thematic analysis was followed.Results: Half of the patients reported little to no possibility to share information and questions with healthcare providers. With regards to decision-making, the role of healthcare providers was perceived as directive/informative, but half of the patients perceived to assume an active role in at least one interaction. Difficulties and needs included the choice of the specialist or of the structure after diagnosis, clinicians' support in self-management, surgical consequences, and side effects, preparation for radiation therapy. Resources included family and social support both from a practical and from an emotional perspective, coping style, and work schedule management.Conclusions: These results suggest that relations with healthcare providers should be supported, especially immediately after diagnosis and after surgery. Support to self-management after surgery and at the beginning of radiation therapy treatment also constitutes a priority. The adoption of a personalized approach from the beginning of prostate cancer care flow may promote patient empowerment, overcoming the aforementioned needs and mobilizing resources. The social network represents an important resource that could be integrated in interventions. These considerations will be taken into account in the design of a cancer self-management platform aiming to increase patients' empowerment.

Being informed: undergoing radiation therapy.

This article aims to give insight into the experience of an intensive course of radiation therapy and relate the findings to the nurses working with individuals receiving radiation therapy. The purpose of this article is to describe and interpret the experiences of individuals undergoing radiation therapy in the cancer center of a large teaching hospital. The philosophic basis of this study was hermeneutic phenomenology and draws on the experiences described by 20 individuals undergoing radiation therapy through a series of unstructured interviews. The findings indicate that there are deficits in the care delivered in some radiation therapy departments. Information and preparation for radiation therapy are often inadequate or do not meet the needs of the individuals in this study. Participants continue to adopt a "sick" or "patient" role even though they attend treatments on an outpatient basis and are required to manage their own care, which results in a feeling of not being in control. Moreover, the coping styles of the participants vary and are not clearly identified and assisted by relevant health professionals. Care is not always well coordinated between the various health professionals, resulting in the patient receiving mixed or confusing messages about their treatments.

Preoperative intra-arterial infusion chemotherapy for advanced squamous cell carcinoma of the mouth and oropharynx.

Twelve patients with advanced locoregional (Stage III and IV) squamous cell carcinoma of the oral cavity and oropharynx underwent treatment with cisplatin, vinblastine, bleomycin, and 5-fluorouracil, given by intra-arterial infusion, as primary adjuvant therapy, in preparation for radiation therapy and surgery. Responses were observed during or immediately after infusion therapy in 8 of 12 (67%) of patients (1 complete response, 7 partial responses). Infusion chemotherapy was followed by radiation therapy alone in five patients and by radiation and surgery in six patients. The protocol was initiated in August 1981, and six patients are now free of their primary cancer, at 21 to 36 months, whereas six have died with disease. Arterial infusion of a combination of effective antineoplastic agents is a promising method for the preparation of selected patients for radiation therapy and surgery, as it is less likely to produce serious systemic toxicity and it requires a shorter period than systemic neoadjuvant chemotherapy.