Oncology Research and Treatment

By definition, palliative care (PC) is applicable already in early stages of incurable and life-threatening diseases, in conjunction with therapies that are intended to prolong life, such as for example chemo- or radiotherapy. Many patients suffer from distressing symptoms or problems in early phases of such illness. Therefore, it is not a question of "if" PC should be integrated early into oncology, but "how." General PC is defined as an approach that should be delivered by healthcare professionals regardless of their discipline...

Patients with advanced lung cancer and their caregivers are confronted with a complex situation as their disease-related burden comprises physical, psychosocial, and spiritual needs. During the illness trajectory with limited prognosis, they are exposed to different multidisciplinary healthcare settings and providers that challenge the continuity and coordination of care. Additionally, decision-making between active cancer treatment and end-of-life care constitutes a continuous balancing act. Several studies have shown that early integration of palliative care and adequate advance care planning improve quality of life and satisfaction with care...

AIM: The aim of this study was to determine the clinicopathological characteristics, treatment details and outcome of patients with brain metastasis from epithelial ovarian carcinoma (EOC). METHODS: This study included 21 patients diagnosed with brain metastasis from EOC between 1999 and 2009. RESULTS: Median age was 61 years (range 38-77). The median time elapsed from EOC diagnosis to brain metastasis detection was 32 months. Single brain metastases were found in 10 (48%) cases, and there was extra-cranial disease in 11 (52%) cases...

BACKGROUND: This study assessed the quality of life (QoL) and the implication of time effort of everolimus treatment in patients with metastatic renal cell carcinoma (mRCC). METHODS: Adult patients with mRCC were eligible for everolimus treatment after first-line vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors or bevacizumab therapy. The primary end-point, QoL, was assessed by means of the NCCN-FACT FKSI-19 questionnaire. RESULTS: In total, 202 patients (24% of female patients; median age, 71 years) were evaluable for QoL analyses...

Eliciting and integrating patients' preferences in decision-making in palliative oncology is an important criterion for the quality of end-of-life care. It is an essential prerequisite in supporting the integrity of patients' decision-making process, enhancing patients' right to self-determination and facilitating patients' autonomy. In this review we summarize the data on: (1) patients' preference for a decisional model in advanced cancer, (2) patients' preferences for quality versus length of life and the enrollment of patients in early-phase clinical studies, and (3) preferences for caregiver involvement in decision-making...

In recent years, the term "value-based healthcare" has been increasingly used in debates about costs and outcomes of health interventions in cancer care. This paper distinguishes 2 meanings of the term "value" and explores the relevance of both meanings of the word for assessing the "value" of cancer drugs. At the focus of the analysis are value judgments which form an integral part of the assessment of benefit of cancer drugs. The review concludes with a reflection on individual competences and systemic factors which are relevant to decision making about the value of treatment in situations of non-curative cancer...

For almost a decade, 'early integration' has become a buzzword in the palliative care community. Can this still be an issue of controversy? The goals of care in palliative medicine are beyond any criticism and in fact should be, at least in theory, goals of good oncological care. However, the reality presents a different picture. The care of cancer patients requires improvement, and the studies on the early integration of palliative care (EIPC) reveal deficits in the oncological practice. However, the limitations and methodological weaknesses of these EIPC studies are insufficiently analyzed and discussed...

INTRODUCTION: Breast cancer is responsible for more than 50% of cutaneous metastases. One of the treatment options is electrochemotherapy (ECT). It is an effective method of local tumor ablation through the application of electroporation. The primary objective of the study was to demonstrate a response to the treatment in our group of patients. METHODS: Between February 2015 and October 2016, in 3 centers in Poland, 47 ECT procedures were performed in 38 patients with metastasis of breast cancer to the skin...

Patients with hematologic malignancies (HM) nowadays rarely receive palliative or hospice care, and studies on potential effects of integrated palliative care are rare. This narrative review provides a comprehensive overview on their current end-of-life care, first data on integrated specialist palliative care (SPC) and potential barriers. Symptom burden and distress in patients with HM seem to be comparable to other cancer patients, but their performance status and specific symptoms are even worse. Prolongation of life usually remains the main focus until the last days or weeks of life...

BACKGROUND: There are no standard cytotoxic treatments for non-small-cell lung cancer (NSCLC) patients beyond third-line therapy. The purpose of this study was to evaluate the efficacy and safety of amrubicin in pretreated NSCLC patients. METHODS: The records of NSCLC patients who received amrubicin monotherapy as a third or later line of chemotherapy at Shizuoka General Hospital between April 2007 and March 2015 were retrospectively reviewed. Tumor response was evaluated according to the Response Evaluation Criteria in Solid Tumors version 1...

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