Quality Of Survival In Patients Research Articles

Cognition and health-related quality of life in long-term survivors of high-grade glioma: an interactive perspective from patient and caregiver

BackgroundThe health-related quality of life (HRQoL) and cognition are important indicators for the quality of survival in patients with high-grade glioma (HGG). However, data on long-term survivors and their caregivers are scarce. We aim to investigate the interaction between cognition and HRQoL in long-term survivors, their caregivers’ evaluations, and the effect on caregiver strain and burden.Methods21 long-term HGG (8 WHO grade III and 13 WHO grade IV) survivors (survival ≥ 5 years) and 15 caregivers were included. Cognition (verbal memory, attention, executive functioning, and language), HRQoL, anxiety and depression, caregiver strain, and caregiver burden were assessed with standardized measures. Questionnaires were completed by patients and/or their caregivers.ResultsMean survival was 12 years (grade III) and 8 years (grade IV). Cognition was significantly impaired with a large individual variety. Patients’ general HRQoL was not impaired but all functioning scales were deviant. Patient-proxy agreement was found in most HRQoL subscales. Three patients (14%) showed indications of anxiety or depression. One-third of the caregivers reported a high caregiver strain or a high burden. Test scores for attention, executive functioning, language, and/or verbal memory were correlated with perceived global health status, cognitive functioning, and/or communication deficits. Caregiver burden was not related to cognitive deficits.ConclusionsIn long-term HGG survivors maintained HRQoL seems possible even when cognition is impaired in a large variety at the individual level. A tailored approach is therefore recommended to investigate the cognitive impairments and HRQoL in patients and the need for patient and caregiver support.

A joint international consensus statement for measuring quality of survival for patients with childhood cancer.

The aim of treating childhood cancer remains to cure all. As survival rates improve, long-term health outcomes increasingly define quality of care. The International Childhood Cancer Outcome Project developed a set of core outcomes for most types of childhood cancers involving relevant international stakeholders (survivors; pediatric oncologists; other medical, nursing or paramedical care providers; and psychosocial or neurocognitive care providers) to allow outcome-based evaluation of childhood cancer care. A survey among healthcare providers (n = 87) and online focus groups of survivors (n = 22) resulted in unique candidate outcome lists for 17 types of childhood cancer (five hematological malignancies, four central nervous system tumors and eight solid tumors). In a two-round Delphi survey, 435 healthcare providers from 68 institutions internationally (response rates for round 1, 70-97%; round 2, 65-92%) contributed to the selection of four to eight physical core outcomes (for example, heart failure, subfertility and subsequent neoplasms) and three aspects of quality of life (physical, psychosocial and neurocognitive) per pediatric cancer subtype. Measurement instruments for the core outcomes consist of medical record abstraction, questionnaires and linkage with existing registries. This International Childhood Cancer Core Outcome Set represents outcomes of value to patients, survivors and healthcare providers and can be used to measure institutional progress and benchmark against peers.

Clinical Efficacy of Thoracoscopic Surgery with the da Vinci Surgical System versus Video-Assisted Thoracoscopic Surgery for Lung Cancer

Objective To assess the clinical efficacy of thoracoscopic surgery with the da Vinci surgical system versus video-assisted thoracoscopic surgery (VATS) for lung cancer. Methods From August 2019 to December 2020, 193 patients with lung cancer assessed for eligibility scheduled for surgery in our hospital were recruited and assigned at a ratio of 1 : 1 to receive VATS (control group) or thoracoscopic surgery with the da Vinci surgical system (research group). The primary measurement is the clinical efficacy of the two surgical modalities. Results The baseline features of the research group were comparable with those of the control group (P > 0.05). Besides, the two groups showed similar tumor types, tumor locations, and clinicopathological staging (P > 0.05). Da Vinci surgical system-assisted thoracoscopic surgery had short operative time, less intraoperative blood loss, better lymph node dissection, and lower intraoperative conversion rates compared to VATS. Compared with the control group, the research group had significantly higher postoperative forced expiratory volume in one second (FEV1), forced vital capacity (FVC), maximal voluntary ventilation (MVV), the functional assessment of cancer therapy-general module (FACT-G) of the FACT-lung (FACT-L) Chinese version V4.0, lung cancer-specific module scores, and total scores (P < 0.05). The research group showed better postoperative drainage volume, shorter intubation duration, and length of hospital stay and a lower incidence of complications versus the control group (P < 0.05). The da Vinci surgical system reduced the probability of intraoperative mistakes and better ensured a safe and satisfactory surgery. Conclusion The thoracoscopic surgery with the da Vinci surgical system better reduces intraoperative and postoperative bleeding, shortens drainage and intubation duration, enhances the lung function and survival quality of patients, and lowers the risk of surgical mistakes to ensure surgical safety versus VATS.

Long-term and quality of survival in patients treated for acute lymphoblastic leukemia during the pediatric age.

Long-term survival for acute lymphoblastic leukemia (ALL) in children improved over the last three decades up to 80-90% of affected patients. Consequently, the quality of life of survivors has become increasingly important. This study analyses the clinical features and outcome of 119 children with ALL, focusing on the quality of long-term survival in a subset of 22 patients over 18 years of age. Among this group, the 10-year event-free survival and overall survival were 83.1% (C.I. 74.0-89.2) and 88.4% (C.I. 80.9-93.1), respectively. Treatment related long-term medical complications were reported only in 2 patients (9.1%). Secondary school was completed successfully in 20 of 22 patients (89.9%). The remaining 2 patients were still attending at the time of the analysis. In conclusion, current treatment for ALL is well tolerated and does not compromise significantly the quality of life of survivors.

RNAi-mediated knockdown of PFK1 decreases the invasive capability and metastasis of nasopharyngeal carcinoma cell line, CNE-2

ABSTRACT Nasopharyngeal carcinoma (NPC) is the most prevailing malignancy of the head and neck with unique geographic distribution. Southern China has one of the highest incidence rates of NPC in the world. Although radiotherapy and chemotherapy are the most important treatment modalities for NPC, recurrence, and metastasis severely interfere with the survival quality of patients. It is much-needed to find an effective method of NPC treatment with a good prognosis such as gene therapy. PFK1, a key regulatory enzyme of glycolysis, is frequently shown to be amplified and overexpressed in a variety of human cancers. However, the function of PFK1 and molecular mechanism in NPC is elusive. Here, we knockdown PFK1 expression by utilizing DNA vector-based RNA Interference. Western blotting and real-time PCR show that the expression of PFK1 is efficiently down-regulated in both protein and mRNA levels by stable transfection with PFK1 siRNA expression vector. In addition, stable knockdown of PFK1 expression inhibits cell growth, induces apoptosis, decreases the invasive capability and metastasis in the CNE2 human NPC cell line. This present study finds the importance of PFK1 which can be worked as a novel target in NPC treatment and holds great potential to be extended to other malignant cancers.

Percutaneous Biliary External–Internal Drainage for Malignant Obstruction of Self-Expanding Uncovered Metal Stents Placed for Hilar Carcinoma: Retrospective Analysis of Long-Term Outcome in 160 Patients

Abstract Aims and Objectives We evaluated the safety and effectiveness of reestablishing adequate bile flow in patients with malignant obstruction of multilobar self-expanding uncovered metal stents (SEUMSs) inserted for palliative treatment of malignant hilar stenosis, an otherwise fatal setting. From September 1991 to January 2019, 160 patients (100 men and 60 women; median: 69 [range: 37–87] years) with malignant obstruction of multilobar SEUMSs were treated by percutaneous transhepatic external–internal biliary drainage. All patients were followed in their respective oncology services where they were treated (or not) according to local protocols adapted to their disease and overall general status. Result External–internal biliary drainage was successful in all 160 patients. All patients were discharged within 5 days. Both immediate (4 patients; 2.5%) and late complications (29 patients; 18%) were managed successfully with minimal morbidity and no mortality. After reestablishment of adequate bile flow, the median survival was 191 days (range: 2–5,668 days). Forty-one (25.6%) patients survived for more than 12 months, and 10 (6.2%) survived for more than 3 years. Conclusion In our series, external–internal biliary drainage was safe and effective; it was life-saving and afforded acceptable quality of survival for patients who otherwise would have been left untreated with short-term fatality.

Prediction of neoadjuvant chemotherapeutic efficacy in patients with locally advanced gastric cancer by serum IgG glycomics profiling

BackgroundNeoadjuvant chemotherapy (NACT) could improve prognosis and survival quality of patients with local advanced gastric cancer (LAGC) by providing an opportunity of radical operation for them. However, no effective method could predict the efficacy of NACT before surgery to avoid the potential toxicity, time-consuming and economic burden of ineffective chemotherapy. Some research has been investigated about the correlation between serum IgG glycosylation and gastric cancer, but the question of whether IgG glycome can reflect the tumor response to NACT is still unanswered.MethodSerum IgG glycome profiles were analyzed by Ultra Performance Liquid Chromatography in a cohort comprised of 49 LAGC patients of which 25 were categorized as belonging to the NACT response group and 24 patients were assigned to the non-response group. A logistic regression model was constructed to predict the response rate incorporating clinical features and differential N-glycans, while the precision of model was assessed by receiver operating characteristic (ROC) analysis.ResultsIgG N-glycome analysis in pretreatment serum of LAGC patients comprises 24 directly detected glycans and 17 summarized traits. Compared with IgG glycans of non-response group, agalactosylated N-glycans increased while monosialylated N-glycans and digalactosylated N-glycans decreased in the response group. We constructed a model combining patients’ age, histology, chemotherapy regimen, GP4(H3N4F1), GP6(H3N5F1), and GP18(H5N4F1S1), and ROC analysis showed this model has an accurate prediction of NACT response (AUC = 0.840) with the sensitivity of 64.00% and the specificity of 100%.ConclusionWe here firstly present the profiling of IgG N-glycans in pretreatment serum of LAGC. The alterations in IgG N-glycome may be personalized biomarkers to predict the response to NACT in LAGC and help to illustrate the relationship between immunity and effect of NACT.

Effect of traditional Chinese medicine five element music therapy on the nursing care of chronic hepatitis B patients with interferon treatment

Objective To observe the effect of traditional Chinese medicine five element music therapy on the nursing care of chronic hepatitis B(CHB) patients with interferon treatment. Methods A total of 90 cases of(CHB) patients with interferon treatment were randomly divided into three groups.One was the experimental group received therapy of traditional Chinese medicine five element music, the other was the control group received ordinary music intervention I, the third one was the control group received routine nursing care II.Patients in three groups were respectively intervened for 1 week, 3 weeks, 12 weeks and 24 weeks, the patients of the three groups were evaluated by Questionnaire on the Life Quality of CHB Patients, Self-rating Anxiety Scale, Self-rating Depression Scale(SDS). Results Compared the scores of patients before and after the therapy in 1 week, 3 weeks, 12 weeks and 24 weeks, the result shows that there were differences(P<0.05). Conclusions Five element music therapy can significantly improve the adverse reaction of interferon, improve the survival quality of patients, and deserve to be popularized in clinical practice. Key words: CHB patients; Effect of nursing care; TCM five element music therapy

Effect of extended care on cognitive function and quality of life in patients with Parkinson's disease

Objective To explore the effect of extended care on cognitive function and quality of life in patients with Parkinson's disease. Methods A total of 36 patients with Parkinson's disease who received treatment from October 2015 to April 2016 were treated as the control group, and the routine nursing intervention was given and the health guidance was given after discharge.A total of 35 patients with Parkinson's disease who received treatment from May to November 2016 were selected as the observation group.Cognitive function changes were assessed using the Montreal cognitive assessment scale (MoCA). The survival quality of patients was evaluated by Parkinson's disease survival quality questionnaire (PDQ-39). The Hamilton Depression Rating Scale (HAMD) was used to evaluate the changes of depression. Results After intervention, the observation group's attention, visual space and execution ability, language ability, orientation force, delayed recall naming ability and MoCA total score were significantly higher, and significantly higher than the control group.The differences were statistically significant (P<0.05). After treatment, the language ability, delayed recall, naming ability and MoCA score of the control group increased significantly (P<0.05). After the treatment, the two groups were significantly reduced in their daily life, cognitive ability, motor ability, interpersonal communication, physical discomfort, emotion, shame and total score (P<0.05). After treatment, the observation group was significantly lower than the control group in daily life, cognitive ability, exercise ability, interpersonal communication, physical discomfort, emotion, shame, and total score.The differences were statistically significant (P<0.05). After treatment, the HAMD scores of the two groups were significantly lower (P<0.05). After treatment, the HAMD score of the observation group was significantly lower than that of the control group.The difference was statistically significant (P<0.05). Conclusions Extended care can significantly improve the cognitive function and improve the quality of life in patients with Parkinson's disease. Key words: Extended care; Parkinson disease; Cognitive function; Quality of life

Resection of recurrent neck cancers with replacement of the carotid artery

The management of patients with recurrent neck cancer invading the carotid artery is controversial. The aim of this study was to evaluate the overall survival and healthy survival years (QALY) as well as the patency of carotid revascularization after enbloc tumor resection followed by complementary radiotherapy. From 2000 to 2016, 42 consecutive patients with recurrent neck cancer invading the carotid artery underwent resection of the tumor associated with reconstruction of the carotid artery with a PTFE prosthesis (n=31) or with a saphenous vein graft (n=11). In 11 cases, resection was associated with musculocutaneous flap coverage. The primary tumor was a squamous cell carcinoma of the larynx (20 patients) or of the pharynx (9 patients), undifferentiated carcinoma of unknown origin (10 patients) and anaplastic thyroid carcinoma (3 patients). All patients had postoperative radiotherapy (50-70Gy) supplemented in 16 of them by chemotherapy. Nine patients had metastatic dissemination at the time of reoperation with a recurrent tumor ulcerated to the skin in 5 of them. The combined 30-day mortality and stroke rate was nil. Postoperative morbidity included dysphagia (n=8), vocal cord paralysis (n=6), late wound healing delay (n=2), transient mandibular claudication (n=1) and partial necrosis of the musculocutaneous flap (n=1). No infection and no thrombosis of the bypass were observed during follow-up [median: 31 months, range: 8-167 months]. Twenty-one patients (50%) died from the consequences of the spread of cancer, which had become metastatic, but without local recurrence. The 5-year survival rate was 50.9±8.3%. The median healthy survival year (QALY) was 3.38 [95% CI: 1.70-4.54] with a significant difference between patients without metastasis at the time of reoperation [n=33; QALY=4.02] and those with metastases [n=9; QALY=0.43; P=0.005]. Healthy life expectancy was also significantly longer in patients with laryngeal cancer [n=20, QALY=4.95] compared to patients with other types of tumors [n=22, QALY=1.67; P=0.032]. In the absence of metastases, enbloc resection of recurrent neck cancers invading the carotid artery improves the duration and quality of patient survival.

New outlook on the diagnosis, treatment and follow-up of childhood-onset craniopharyngioma.

Childhood-onset craniopharyngiomas are rare embryonic tumours of low-grade histological malignancy. Novel insights into the molecular pathogenesis of human adamantinomatous craniopharyngioma have started to unveil the possibility of testing novel treatments targeting pathogenic pathways. Hypothalamic involvement and/or treatment-related lesions result in impaired physical and social functionality and in severe neuroendocrine sequelae. Quality of survival in patients with craniopharyngioma with hypothalamic involvement is impaired by severe obesity, physical fatigue and non-optimal psychosocial development. Patients with craniopharyngioma involving hypothalamic structures have reduced 20-year overall survival, but overall and progression-free survival are not related to the degree of surgical resection. Irradiation is effective in the prevention of tumour progression and recurrence. For favourably localized craniopharyngiomas, the preferred treatment of choice is to attempt complete resection with preservation of visual, hypothalamic and pituitary function. For unfavourably localized tumours in close proximity to optic and/or hypothalamic structures, a radical neurosurgical strategy attempting complete resection is not recommended owing to potential severe sequelae. As expertise has been shown to have an impact on post-treatment morbidity, medical societies should establish criteria for adequate professional expertise for the treatment of craniopharyngioma. On the basis of these criteria, health authorities should organize the certification of centres of excellence that are authorized to treat and care for patients with this chronic disease.

Nerve grafting is a new treatment option for stroke patients

Recently, New England Journal of Medicine published an article by the famous hand surgery specialists, Yudong Gu. The important medical achievements of Gu's team include transposition of C7 nerve root of the unaffected side on the upper limbs in stroke hemiplegia, changing the brain central dominance region, and rebuilding the function of hands with spastic paralysis. These achievements are admirable because worldwide medical problems, such as stroke sequela hemiplegia, require long-term arduous efforts for any progress to be made. Any result that improves the survival quality of patients has significant social value. Their success has enabled me to feel that Ⅰ am no longer alone in my years of exploration, and Ⅰ am grateful to them from the bottom of my heart. At this time, Ⅰ am reminded of the 40 years of my experience in this field. It has taken the efforts of many people to make this happen: Limb sequelae of stroke, especially spasmodic paralysis of upper limbs, often result in patients losing their ability to self-care, which can cause a great burden to their family and society. The need to rebuild and improve functions in such patients is urgent.

Comparison of on-line hemodiafiltration and high-flux hemodialysis for correcting calcium and phosphate metabolic disorder in uremia patients

Objective To compare the effect on correcting calcium and phosphate metabolic disorder and the impact on quality of life in uremia patients between on-line hemodiafiltration and high-flux hemodialysis. Methods 90 patients with uremia, digital watches were randomly divided into QL-HDF group and HFHD group, Ca2+ , P3+ , serum parathyroid hormone(PTH) level were measured before and after dialysis blood.The survival quality of patients were evaluated by the KDQOL-SFTM1.3 scale.The incidence of adverse reactions were collected.The similarities and differences of two groups were compared. Results The comparison of Ca2+ levels in the two groups before and after dialysis showed no significant difference(P>0.05); Of the QL-HDF group after treatment, P3+ was (1.82±0.19)mmol/L, PTH was (401.6±16.7)pg/L, which were significantly lower than those of QL-HDF group[P3+ (2.14±0.22)mmol/L, PTH(425.0±17.2)pg/L](t=24.256, 21.059, all P 0.05); 6 cases of adverse reactions was in the QL-HDF group (13.33%), 14 cases of adverse reactions was in the HFHD group(31.11%), there was significant difference between the two groups(χ2=5.361, P<0.05). Conclusion The two methods can improve the metabolic disorders of calcium and phosphorus in patients with uremia, and QL-HDF showed stronger ability to remove the ability, and the quality of life is higher, it is worth promoting in clinical practice. Key words: Calcium metabolism disorders; Phosphorus metabolism disorders; Uremia; Hemodiafiltration; Renal dialysis; Quality of life

Post-stroke dysphagia treated with acupuncture of meridian differentiation:a randomized controlled trial

To observe the effect on post-stroke dysphagia treated with acupuncture of meridian differentiation. One hundred and thirty patients of post-stroke dysphagia were randomized into an observation group (67 cases) and a control group (63 cases). Conventional medication and rehabilitation training were applied in the two groups. In the observation group, acupuncture based on meridian differentiation was adopted. The main acupoints were Neiguan (PC 6), Shuigou (GV 26), Sanyinjiao (SP 6), Fengchi (GB 20), Lianquan (CV 23), Jialianquan (Extra), Jinjin (EX-HN 12), Yuye (EX-HN 13), etc. The supplementary points were selected according to different patterns/syndromes. In the control group, the points were selected 5 cm lateral to the acupoints used in the observation groups and stimulated with shallow puncture. The needles were retained for 30 min, once daily, 5 treatments a week and continuously for 6 weeks in the two groups. Separately, before treatment, in 6 weeks after treatment and in follow-up after 3 months, the standardized swallowing assessment (SSA), the video fluoroscopic swallowing study (VFSS), the modified Barthel index (MBI) and the swallowing related quality of life (SWAL-QOL) were observed in the two groups and the efficacy was assessed. In 6 weeks of treatment, the scores of SSA, VFSS, MBI and SWAL-QOL were improved apparently as compared with those before treatment (P<0.01, P<0.05) in the patients of the two groups. The results in the observation group were better apparently than those in the control group (P<0.01, P<0.05). In follow-up after 3 months, the scores of SSA, MBI and SWAL-QOL were improved apparently as compared with those before treatment in thepatients of the two groups (all P<0.01), in which, MBI score was improved apparently as compared with that in 6 weeks of treatment in the patients of the two groups (both P<0.05). Those scores in the observation group were improved apparently as compared with those in the control group (P<0.01, P<0.05). In 6 weeks of treatment and in 3 months of follow-up, the effective rates in the observation group were 91.8% (56/61) and 93.4% (57/61), better than 80.0% (44/55) and 85.5% (47/55) in the control group separately, indicating the significant difference (both P<0.05). The acupuncture of meridian differentiation improves significantly swallowing function and survival quality in patients of stroke.

Noninvasive ventilation for neuromuscular respiratory failure: when to use and when to avoid.

Neuromuscular respiratory failure can occur from a variety of diseases, both acute and chronic with acute exacerbation. There is often a misunderstanding about how the nature of the neuromuscular disease should affect the decision on how to ventilate the patient. This review provides an update on the value and relative contraindications for the use of noninvasive ventilation in patients with various causes of primary neuromuscular respiratory failure. Myasthenic crisis represents the paradigmatic example of the neuromuscular condition that can be best treated with noninvasive ventilation. Timely use of noninvasive ventilation can substantially reduce the duration of ventilatory assistance in these patients. Noninvasive ventilation can also be very helpful after extubation in patients recovering from an acute cause of neuromuscular respiratory failure who have persistent weakness. Noninvasive ventilation can improve quality of survival in patients with advanced motor neuron disorder (such as amyotrophic lateral sclerosis) and muscular dystrophies, and can avoid intubation when these patients present to the hospital with acute respiratory failure. Attempting noninvasive ventilation is not only typically unsuccessful in patients with Guillain-Barre syndrome, but can also be dangerous in these cases. Noninvasive ventilation can be very effective to treat acute respiratory failure caused by myasthenia gravis and to prevent reintubation in other neuromuscular patients, but should be used cautiously for other indications, particularly Guillain-Barre syndrome.

Quality of survival the 1st year with glioblastoma: a longitudinal study of patient-reported quality of life.

By exploring longitudinal patient-reported health-related quality of life (HRQoL), the authors sought to assess the quality of survival for patients in the 1st year after diagnosis of glioblastoma. Thirty unselected patients ≥ 18 years who underwent primary surgery for glioblastoma in the period 2011-2013 were included. Using the generic HRQoL questionnaire EQ-5D 3L, baseline HRQoL was assessed before surgery and at postoperative follow-up after 1, 2, 4, 6, 8, 10, and 12 months. There was an apparent correlation between deterioration in HRQoL scores and tumor progression. Patients with permanent deterioration in HRQoL early after surgery represented a subgroup with rapid progression and short survival. Both positive and negative changes in HRQoL were more often seen after surgery than after radio- or chemotherapy. Patients with gross-total resection (GTR) reported better and more stable HRQoL. In a multivariable analysis preoperative cognitive symptoms (p = 0.02), preoperative functional status (p = 0.03), and GTR (p = 0.01) were independent predictors of quality of survival (area under the curve for EQ-5D 3L index values). The results indicate that progression-free survival is not only a surrogate marker for survival, but also for quality of survival. Quality of survival seems to be associated with GTR, which adds further support for opting for extensive resections in glioblastoma patients with good preoperative functional levels.

Should docetaxel be standard of care for patients with metastatic hormone-sensitive prostate cancer? Pro and contra.

Following the results of the TAX-327 study, questions have been raised as to whether administering chemotherapy to men with prostate cancer before symptomatic disease progression when receiving standard hormonal treatment can improve the duration and quality of patient survival. The GETUG-AFU-15 and CHAARTED studies both assessed the efficacy and tolerability of androgen deprivation therapy (ADT) with or without docetaxel in men with metastatic hormone-naive prostate cancer. Both studies included a mix of patients with de novo metastatic disease (∼75%) and patients who developed metastases following treatment of localized disease. A short course of ADT was allowed in both trials prior to accrual. Key differences between the two studies include the number of patients with high-volume metastases (GETUG-AFU-15: 52%; CHAARTED: 65%) and number of docetaxel cycles (GETUG-AFU-15: up to nine cycles; CHAARTED six cycles). Both studies reported an improvement in progression-free survival with docetaxel plus ADT versus ADT alone. The GETUG-AFU-15 did not find a significant difference in the primary end point of overall survival (OS) {hazard ratio (HR) 0.9 [95% confidence interval (CI) 0.7-1.2]; P = 0.44} for ADT plus docetaxel versus ADT alone. The CHAARTED study met the primary end point of OS [HR 0.61 (95% CI 0.47-0.80); P = 0.0003], and in a subset analysis reported the greatest improvement in OS for patients with high-volume disease [HR 0.60 (95% CI 0.45-0.81); P = 0.0006]. The following article debates the results from the GETUG-AFU-15 and CHAARTED studies and asks whether medical practice should be changed for patients with metastatic hormone-naive prostate cancer based on the results of one positive study.

Relationship between anxiety degrees and dimensionalities of survival quality of cancer patients with PICC

Objective To explore the influence PICC catheter factors of anxiety in patients with tumor, and analyze the effect of anxiety on patients survival quality.Methods Between December 2011 and January 2013, 280 patients with PICC catheter tumors received long-term intravenous chemotherapy, according to the anxiety self rating scale （ SAS） to assess the degree of anxiety patients, were divided into anxiety patients and non-anxiety patients, then collected the patient ’ s general information, conducted cancer patients life scale （ EORTC QLQ C30 ） survey, analyzed the results.Results Among 280 patients, according to SAS scores, 73 cases of normal （26.07%）, 207 cases with anxiety （73.93%）, in which 41 cases of mild anxiety （14.64%）, 106 cases of moderate anxiety （37.86%）,60 cases of severe anxiety （21.43%）.The onset of patients age, hospitalization payment method, culture degree, occupation, income and treatment time had significantly relationship with the incidence of anxiety （χ2 =3.673,128.354,28.566,35.363,38.455,3.257, respectively;P〈0.05）.In EORTC QLQ C30-scale survey, anxiety and non-anxiety patients in PF [（58.6 ± 21.3） vs （59.3 ±15.6）], RF[（61.4 ±26.1） vs （64.1 ±22.7）], DY scores [（41.6 ±28.9） vs （40.2 ± 27.5）] had no significant difference （t=-0.835,-1.256,0.248, respectively;P〉0.05）.And significant difference of 12 dimensions scores was found （ P〈0.05） .Conclusions Anxiety can affect 12 dimensions（ EF, CF, SF, FA, NV, PN, QL, SL, AP, CO, DI, FI ） of EORTC QLQ C30 scale, improving the patient’ s anxiety can help improve the quality of survival in patients with PICC catheter tumor. Key words: PICC; Anxiety; PICC; Cancer patients; Survival quality

Does Quality of Life Supplant Survival in Patients With Brain Metastasis?

Does Quality of Life Supplant Survival in Patients With Brain Metastasis?

Childhood craniopharyngioma

Craniopharyngiomas (CP) are partly cystic embryogenic malformations of the sellar and parasellar region. With an overall incidence of 0.5-2.0 new cases/million population/year, approximately 30-50% of all cases represent childhood CP. Typical manifestations at diagnosis are headache, visual impairment, polyuria/polydypsia, growth retardation, puberty development disturbances, and significant weight gain. Therapy of choice in children with favorable tumor localization is complete resection with the intention to maintain optic nerve and hypothalamic-pituitary functions. In children with unfavorable tumor localization (hypothalamic involvement), a limited resection followed by local irradiation is recommended. Although overall surgical survival rates are high (92%), recurrence after complete resection and progression after incomplete resection are typical post-surgical events. Particularly troublesome for the pediatric patient are the disturbances to their pubescent development and overall growth. Accordingly, the appropriate time point of irradiation after incomplete resection is under investigation in a randomized multinational trial (KRANIOPHARYNGEOM 2007). Quality of life is substantially reduced in approximately 50% of long-term survivors due to sequelae, notably morbid hypothalamic obesity. CP should be recognized as a chronic disease requiring constant monitoring of the early life as well as post-pubescent consequences and appropriate medical resources for treatment in order to provide optimal quality of survival for patients.