Tag: pubmed

JCO Oncol Pract. 2025 Feb 11:OP2400898. doi: 10.1200/OP-24-00898. Online ahead of print.

ABSTRACT

PURPOSE: Treatment of limited-stage small cell lung cancer (LS-SCLC) with twice-a-day radiation therapy (RT) has remained the standard of care for many decades. Growing evidence suggests that outcomes with dose escalated twice-a-day RT may further improve outcomes. However, once-daily treatment remains common. The purpose of this study was to evaluate individual treatment facilities for utilization of twice-a-day RT.

METHODS: Patients with LS-SCLC treated with definitive chemoradiation from 2004 to 2019 were identified in the National Cancer Database. RT was classified as twice-a-day (45 Gy in 30 fractions) or once-daily (59.4-70.2 Gy in 30-39 fractions). Patients were excluded if surgery was performed. All patients received doublet chemotherapy. Unique treatment facilities delivering at least one twice-a-day treatment course during the study period were classified as BID-treating. Facilities not delivering any twice-a-day RT were classified as QD-only. The proportion of QD-only facilities was identified. Facility-level characteristics associated with QD-only classification were analyzed.

RESULTS: A total of 22,362 patients with LS-SCLC were treated at 1,222 unique facilities. A slight majority of facilities (n = 644, 52.7%) were BID-treating, whereas fewer (n = 578, 47.3%) were QD-only. A total of 73.9% of academic facilities were BID-treating versus 48.3% of nonacademic facility types (P < .001). Only 20.7% of low volume treatment facilities (lowest quartile of patients with LS-SCLC treated) used twice-a-day fractionation versus 78.2% of the highest quartile volume facilities (P < .001). On multivariable analysis, academic and high-volume facilities were statistically significantly associated with BID-treating classification (adjusted odds ratio, 2.5 [P < .001] and 4.2 [P < .001], respectively).

CONCLUSION: Nearly half of facilities treating LS-SCLC with definitive chemoradiation do not use twice-a-day fractionation schedules despite ongoing and growing evidence of superiority to once-daily fractionation. High-volume, academic facilities were more likely to offer twice-a-day fractionation.

PMID:39933118 | DOI:10.1200/OP-24-00898

Oncol Nurs Forum. 2024 Dec 12;52(1):61-69. doi: 10.1188/25.ONF.61-69.

ABSTRACT

OBJECTIVES: To retrospectively evaluate the incidence of palliative care (PC) consultations for older adults with lung cancer who died in the past five years, as well as the impact of social determinants of health (SDOHs) on PC consultations.

SAMPLE &AMP; SETTING: 63 participants aged 65 years or older with a lung cancer diagnosis who died in the past five years. Electronic health records were used to extract data.

METHODS &AMP; VARIABLES: A medical record extraction form was used to collect the following data: (a) lung cancer diagnosis, (b) PC consultations, (c) patient demographic information, and (d) SDOHs factors. All data were entered into a secure research electronic data capture management site.

RESULTS: Older adults who were married, White, and female and lived in a below-average rural or suburban area were more often benefactors of a PC consultation.

IMPLICATIONS FOR NURSING: It is imperative for nurses to support patients from diagnosis to end of life by facilitating PC consultations. This study highlights the importance of collecting SDOHs for all patients admitted to the hospital in the electronic health record. Awareness of SDOHs can help nurses facilitate end-of-life care plans.

PMID:39933111 | DOI:10.1188/25.ONF.61-69

Oncol Nurs Forum. 2024 Dec 12;52(1):51-60. doi: 10.1188/25.ONF.51-60.

ABSTRACT

OBJECTIVES: To explore and describe the health outcomes and levels of environmental enrichment (EE) in participants with brain tumors after radiation therapy (RT).

SAMPLE &AMP; SETTING: 39 participants with glioma (grades 2-3) treated with RT were recruited within five years of original diagnosis from a neuro-oncology clinic.

METHODS &AMP; VARIABLES: A cross-sectional design was employed. EE measures included social connectedness, physical activity, employment, and financial stability. Health outcome measures included the Montreal Cognitive Assessment, Symbol Digit Modalities Test, global cortical atrophy rate scale, Karnofsky Performance Status Scale, and MD Anderson Symptom Inventory-Brain Tumor Module. Descriptive statistics characterized the health outcomes between participants who received photon RT and proton beam RT.

RESULTS: Participants who received photon RT with high EE showed higher scores on the Montreal Cognitive Assessment, Symbol Digit Modalities Test, and Karnofsky Performance Status Scale, and lower scores on the global cortical atrophy rate scale and MD Anderson Symptom Inventory-Brain Tumor Module.

IMPLICATIONS FOR NURSING: EE may reduce symptom burden, promote healthy brain aging, and improve cognitive and functional status in glioma survivors receiving photon RT.

PMID:39933110 | DOI:10.1188/25.ONF.51-60

Oncol Nurs Forum. 2024 Dec 12;52(1):15-22. doi: 10.1188/25.ONF.15-22.

ABSTRACT

OBJECTIVES: To describe the trajectories of food insecurity and examine their associations with sociodemographic and health-related factors in older adult cancer survivors.

SAMPLE &AMP; SETTING: Data from 2015 to 2021 from the National Health and Aging Trends Study, a nationally representative cohort study of community-dwelling older adults aged 65 years or older, were extracted and analyzed.

METHODS &AMP; VARIABLES: Food insecurity was annually measured based on five self-reported items. Group-based trajectory modeling was used to identify food insecurity trajectory groups. Data analysis accounted for the complex survey design and analytic weights.

RESULTS: The sample consisted of 1,935 older adult cancer survivors. The weighted prevalence of food insecurity ranged from 2.46% to 4.73% from 2015 to 2021. The following two food insecurity trajectory groups were identified: low-stable (n = 1,796, 93%) and medium-stable (n = 139, 7%). Individuals who were younger, female, not non-Hispanic and White, and physically frail, and those with lower household income and higher levels of anxiety and depression, were more likely to experience persistent food insecurity.

IMPLICATIONS FOR NURSING: Food security in older adult survivors is persistent and distributed inequitably among those who are female, not non-Hispanic and White, and younger, and those with lower household income.

PMID:39933107 | DOI:10.1188/25.ONF.15-22

Oncol Nurs Forum. 2024 Dec 12;52(1):E1-E11. doi: 10.1188/25.ONF.E1-E11.

ABSTRACT

OBJECTIVES: To evaluate the safety and efficacy of aromatherapy on symptom burden and associated outcomes.

SAMPLE &AMP; SETTING: 92 inpatients who underwent hematopoietic stem cell transplantation on hematology-oncology units in an academic hospital.

METHODS &AMP; VARIABLES: Participants in this pilot randomized controlled trial received essential oil-infused or blank aromatherapy patches and completed a symptom journal. Mixed-model analysis of variance was used to analyze chemotherapy-induced nausea, vomiting, and retching (CINVR) and anxiety symptoms. A t test was used to analyze medications administered for CINVR. Descriptive statistics were used to analyze additional study aims.

RESULTS: There was no significant difference in mean symptom scores or medications administered between the intervention and control groups. On a 1-10 rating scale (10 = extremely satisfied/extremely likely), aromatherapy was rated 8 or higher for satisfaction (n = 50) and likeliness to use again (n = 53).

IMPLICATIONS FOR NURSING: Aromatherapy can be used for holistic symptom management to improve the patient experience.

PMID:39933106 | DOI:10.1188/25.ONF.E1-E11

Orthopedics. 2025 Feb 11:1-5. doi: 10.3928/01477447-20250206-02. Online ahead of print.

ABSTRACT

There is debate over the treatment of displaced femoral neck fractures with either hemiarthroplasty or total hip arthroplasty. This study aimed to evaluate the fragility index (FI) of randomized controlled trials (RCTs) comparing these methods. We queried for these RCTs containing dichotomous outcomes, finding 11 RCTs with 63 dichotomous outcomes. The median FI for all outcomes was 6, signifying that 6 event reversals would change the statistical significance of an outcome. The median FI was 2 for significant outcomes and 6 for nonsignificant outcomes, indicating that outcomes favoring one surgical method are more statistically fragile than those demonstrating equivalency. [Orthopedics. 202x;4x(x):xx-xx.].

PMID:39933103 | DOI:10.3928/01477447-20250206-02

Clin J Oncol Nurs. 2025 Jan 17;29(1):72-78. doi: 10.1188/25.CJON.72-78.

ABSTRACT

BACKGROUND: Despite guidelines from the U.S. Preventive Services Task Force, millions of Americans at high risk for lung cancer go unscreened every year.

OBJECTIVES: The purpose of this quality improvement project was to identify individuals at high risk for the development of lung cancer using a lung cancer screening tool. All patients who were identified as at risk received an order for screening via a low-dose computed tomography (LDCT) scan.

METHODS: A quality improvement team educated providers at a primary care clinic about administering a lung cancer screening tool to all patients at their annual physical examination. For eligible patients, providers could order an LDCT scan to detect early lung cancer. Pre- and postintervention data were collected to determine whether there was a statistically significant increase in the number of LDCT scans ordered for eligible patients.

FINDINGS: There was no statistically significant increase in the number of LDCT scans ordered from pre- to postintervention. The use of a lung cancer screening tool more comprehensively addressed patients’ smoking status, which can increase the identification of at-risk patients.

PMID:39933084 | DOI:10.1188/25.CJON.72-78

Clin J Oncol Nurs. 2025 Jan 17;29(1):65-71. doi: 10.1188/25.CJON.65-71.

ABSTRACT

BACKGROUND: Virtual reality (VR) is a useful therapeutic tool in various patient populations. Patients with cancer may benefit from VR during chemotherapy to address concerns like negative affect, stress, and physical side effects.

OBJECTIVES: The aim of this study was to evaluate the effects of VR on pain, stress, and affect in patients with cancer receiving chemotherapy.

METHODS: Ninety patients were randomized into control and study groups. The study group received a 12-minute VR session while undergoing chemotherapy. Participants took surveys measuring stress, pain, affect, cybersickness, and satisfaction, and heart rates were measured before and halfway through.

FINDINGS: There were statistically significant decreases in stress and pain among patients using VR. Positive affect was significantly elevated, and negative affect was significantly reduced. Heart rate measurements indicated reduced stress. Most patients reported high satisfaction with VR and experienced no feelings of cybersickness.

PMID:39933083 | DOI:10.1188/25.CJON.65-71

Clin J Oncol Nurs. 2025 Jan 17;29(1):E28-E36. doi: 10.1188/25.CJON.E28-E36.

ABSTRACT

BACKGROUND: Newly diagnosed patients with lung cancer experience significant challenges navigating a fragmented health system. Nurse navigators can use clinical expertise and coordination to address barriers to care.

OBJECTIVES: This quality improvement project aimed to expedite the selection and initiation of first-line treatment for patients with stage III or IV lung cancer. Using a nurse navigator process early on in care, coupled with liquid biopsy, this project focused on reducing the time from tissue biopsy to treatment decision.

METHODS: The team performed a retrospective chart review 12 months preimplementation and 8 months postimplementation.

FINDINGS: Using liquid biopsy, the time to treatment initiation was 21 days compared to 36 days with tissue biopsy only (p = 0.003). Postimplementation, median days to treatment decreased from 34 to 23.5 (p = 0.027), and treatment decisions made during the initial medical oncology visit increased from 38% to 55%.

PMID:39933081 | DOI:10.1188/25.CJON.E28-E36

Pancreas. 2025 Feb 12. doi: 10.1097/MPA.0000000000002476. Online ahead of print.

ABSTRACT

OBJECTIVES: Pancreatitis is common following endoscopic retrograde cholangiopancreatography (ERCP). Despite increased vigilance of post-ERCP pancreatitis (PEP), both its incidence and associated mortality are rising. Risk prediction models may provide more accurate stratification of patient risk and proactive mitigation of PEP incidence and/or severe associated outcomes.

METHODS: We conducted an electronic search of MEDLINE, PubMEd, Cochrane, and CINAHL from inception through April 9, 2024 for studies evaluating the details and performances of available PEP prediction models. Studies were eligible if they used statistical measures to quantify their model’s predictive ability. Risk of bias was determined using the PROBAST tool.

RESULTS: Nineteen studies met eligibility criteria and were included. Logistic regression models were used in 15 studies, with machine learning models representing the second most commonly employed approach. Ten studies reported the performance of their risk prediction models using derivation data, with areas under the receiver operating curve (AUC) ranging from 0.68 to 0.86. Fifteen studies reported the performance of their risk prediction models on internally validated data, with AUCs ranging from 0.66 to 0.97. Eight studies reported on the performance of their risk prediction models on external validation data, with AUCs ranging from 0.67 to 0.98.

DISCUSSION: Numerous PEP clinical prediction models exist with variable performances. The use of PEP prediction tools can support the management of patients following ERCP. Implementation studies assessing the optimal usability of these tools, followed by prospective evaluations, are needed to evaluate their potential impacts on reducing PEP in real-world practice.

PMID:39933053 | DOI:10.1097/MPA.0000000000002476