A partir d'une revue systématique des essais randomisés, cette étude analyse les recommandations pour la pratique clinique relatives à la prévention et au traitement d'une infection à Clostridium difficile chez les enfants et adolescents atteints de cancer ainsi que chez les patients pédiatriques recevant une greffe de cellules souches hématopoïétiques

Guideline for the Management of Clostridium Difficile Infection in Children and Adolescents With Cancer and Pediatric Hematopoietic Stem-Cell Transplantation Recipients

Caroline Diorio ; Paula D. Robinson ; Roland A. Ammann ; Elio Castagnola ; Kelley Erickson ; Adam Esbenshade ; Brian T. Fisher ; Gabrielle M. Haeusler ; Susan Kuczynski ; Thomas Lehrnbecher ; Robert Phillips ; Sandra Cabral ; L. Lee Dupuis ; Lillian Sung

Purpose : The aim of this work was to develop a clinical practice guideline for the prevention and treatment of Clostridium difficile infection (CDI) in children and adolescents with cancer and pediatric hematopoietic stem-cell transplantation (HSCT) patients. Methods : An international multidisciplinary panel of experts in pediatric oncology and infectious diseases with patient advocate representation was convened. We performed systematic reviews of randomized controlled trials for the [...]

Menée à partir des données du registre danois du cancer colorectal et à partir de questionnaires auprès de 3 295 patients présentant une tumeur colorectale ou un polype, cette étude analyse les effets d'une résection du côlon sigmoïde sur les fonctions intestinales et la qualité de vie des patients

Bowel dysfunction after sigmoid resection for cancer and its impact on quality of life

Elfeki, H. ; Larsen, H. M. ; Emmertsen, K. J. ; Christensen, P. ; Youssef, M. ; Khafagy, W. ; Omar, W. ; Laurberg, S.

Background : Several studies have explored functional outcomes after rectal cancer surgery, but bowel dysfunction after sigmoid resection for cancer has hardly been considered. The aim of this study was to identify the prevalence and pattern of bowel dysfunction after resection for sigmoid cancer, and the impact of bowel function on quality of life (QoL) by comparison with patients who had polypectomy for cancer. Methods : This was a national cross-sectional study. Data were collected from the [...]

Menée aux Etats-Unis à partir de données portant sur 24 355 patients ayant survécu à un cancer pédiatique diagnostiqué entre 1970 et 1999 (âge médian : 28,7 ans ; durée médiane depuis le diagnostic : 21,3 ans) et sur 5 051 témoins, cette étude analyse les facteurs associés au risque de maladie thromboembolique veineuse

Long-Term Risk of Venous Thromboembolism in Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study

Arin L. Madenci ; Brent R. Weil ; Qi Liu ; Andrew J. Murphy ; Todd M. Gibson ; Yutaka Yasui ; Wendy M. Leisenring ; Rebecca M. Howell ; Christopher L. Tinkle ; Larissa Nekhlyudov ; Lisa R. Diller ; Gregory T. Armstrong ; Kevin C. Oeffinger ; Christopher B. Weldon

Purpose : To estimate the incidence of late-occurring venous thromboembolism (VTE) among survivors of childhood cancer and to identify risk factors for VTE to facilitate diagnosis and prevention. Methods : The Childhood Cancer Survivor Study is a multi-institutional cohort of 24,355 5-year childhood cancer survivors (diagnosed between 1970 and 1999; median age at last follow-up, 28.7 years [range, 5.6 to 58.9 years]; median follow-up since diagnosis, 21.3 years [range, 5.0 to 39.2 years]) and [...]

Menée aux Etats-Unis à partir de données portant sur 1 280 patientes atteintes d'un cancer primitif du sein HR+ de stade I-III et âgées entre 20 et 74 ans, cette étude analyse les disparités ethniques dans la non-adhésion à une hormonothérapie ou son arrêt

Endocrine Therapy Nonadherence and Discontinuation in Black and White Women

Wheeler, Stephanie B. ; Spencer, Jennifer ; Pinheiro, Laura C. ; Murphy, Caitlin C. ; Earp, Jo Anne ; Carey, Lisa ; Olshan, Andrew ; Tse, Chiu Kit ; Bell, Mary E. ; Weinberger, Morris ; Reeder-Hayes, Katherine E.

Background : Differential use of endocrine therapy (ET) by race may contribute to breast cancer outcome disparities, but racial differences in ET behaviors are poorly understood. Methods : Women aged 20–74 years with a first primary, stage I–III, hormone receptor–positive (HR+) breast cancer were included. At 2 years postdiagnosis, we assessed nonadherence, defined as not taking ET every day or missing more than two pills in the past 14 days, discontinuation, and a composite measure of [...]

Menée aux Etats-Unis à partir de données portant sur 1 011 patients atteints d'un cancer du côlon de stade III, cette étude prospective évalue l'association entre une alimentation riche en graisses (animales, végétales, saturées, polyinsaturées, etc...) après le diagnostic, la survie sans maladie et le risque de récidive (durée médiane de suivi : 7 ans ; 305 décès, 81 récidives)

Dietary Fat Intake after Colon Cancer Diagnosis in Relation to Cancer Recurrence and Survival: CALGB 89803 (Alliance)

Van Blarigan, Erin L. ; Ou, Fang-Shu ; Niedzwiecki, Donna ; Zhang, Sui ; Fuchs, Charles S. ; Saltz, Leonard ; Mayer, Robert J. ; Venook, Alan ; Ogino, Shuji ; Song, Mingyang ; Benson, Al ; Hantel, Alexander ; Atkins, James N. ; Giovannucci, Edward L. ; Meyerhardt, Jeffrey A.

Background: Higher intake of long-chain ω-3 polyunsaturated fatty acids and nuts, rich plant sources of unsaturated fats, after colon cancer diagnosis are associated with improved survival. It is not known whether the amount or the distribution of other types of fat is associated with survival after colon cancer. Methods: We prospectively examined postdiagnostic total, animal, and vegetable fats, as well as the saturated, monounsaturated, polyunsaturated, and trans fat in relation to [...]

Menée aux Etats-Unis par enquête auprès de 78 enfants atteints d'un cancer de stade avancé, cette étude de cohorte évalue l'association entre les revenus financiers de leur foyer familial, leurs symptômes de détresse psychologique et leur qualité de vie

The Relationship Between Household Income and Patient-Reported Symptom Distress and Quality of Life in Children With Advanced Cancer: A Report From the PediQUEST Study

Ilowite, Maya F. ; Al-Sayegh, Hasan ; Ma, Clement ; Dussel, Veronica ; Rosenberg, Abby R. ; Feudtner, Chris ; Kang, Tammy I. ; Wolfe, Joanne ; Bona, Kira

Background : Children with advanced cancer experience high symptom distress, which negatively impacts their health-related quality of life (HRQOL). To the authors’ knowledge, the relationship between income and symptom distress and HRQOL is not well described. Methods : The Pediatric Quality of Life and Symptoms Technology (PediQUEST) multisite clinical trial evaluated an electronic patient-reported outcome system to describe symptom distress and HRQOL in children with advanced cancer via [...]

Menée à Taïwan à partir de données portant sur 96 470 patients atteints d'un cancer colorectal entre 2000 et 2010 et auprès d'un groupe témoin, cette étude de cohorte rétrospective analyse le risque de suicide

Risk of suicide attempts among colorectal cancer patients: A nationwide population-based matched cohort study

Sun, Li-Min ; Lin, Cheng-Li ; Hsu, Chung-Y. ; Kao, Chia-Hung

Background : Patients with colorectal cancer (CRC) have been found to have a higher risk of suicide in limited-number studies. However, data on the actual incidence rate of suicide remain scarce. Methods : Using Taiwan's National Health Insurance Research Database, we examined whether patients with CRC in Taiwan are at increased risk of suicide attempts. In this retrospective matched cohort study, data of 96,470 cases of CRC during January 1, 2000–December 31, 2010 were collected. The control [...]

Menée aux Etats-Unis auprès de 30 patientes ayant survécu à un cancer du sein (âge moyen : 62,2 ans), cette étude évalue l'association entre des comportements sédentaires et le fonctionnement cognitif (attention, mémoire, fonctions exécutives...)

Dimensions of sedentary behavior and objective cognitive functioning in breast cancer survivors

Marinac, Catherine R. ; Nelson, Sandahl H. ; Cadmus-Bertram, Lisa ; Kerr, Jacqueline ; Natarajan, Loki ; Godbole, Suneeta ; Hartman, Sheri J.

Purpose : To examine associations between dimensions of sedentary behavior and cognitive function in breast cancer survivors. Methods : Sedentary behavior variables were measured using thigh-worn activPALs, and included total daily sitting time, time in long sitting bouts, sit-to-stand transitions, and standing time. Cognitive function was assessed using the NIH Toolbox Cognitive Domain. Separate multivariable linear regression models were used to examine associations between sedentary behavior [...]

Menée aux Etats-Unis à partir de données portant sur 71 541 patients hospitalisés pour un cancer de la tête et du cou diagnostiqué entre 2008 et 2013, cette étude rétrospective analyse les facteurs sociodémographiques et cliniques associés à la présence de symptômes dépressifs

Prevalence and sociodemographic factors associated with depression among hospitalized patients with head and neck cancer—results from a national study

Rohde, Rebecca L. ; Adjei Boakye, Eric ; Challapalli, Sai Deepika ; Patel, Shivam H. ; Geneus, Christian J. ; Tobo, Betelihem B. ; Simpson, Matthew C. ; Mohammed, Kahee A. ; Deshields, Teresa ; Varvares, Mark A. ; Osazuwa-Peters, Nosayaba

Objective : Depression is a significant problem for patients with head and neck cancer (HNC). This study explored the prevalence of, and sociodemographic and clinical factors associated with, depression, among patients with HNC. Methods : We performed a retrospective analysis of 71,541 cases of HNC using a national dataset, the Nationwide Inpatient Sample 2008–2013 data. Weighted, multivariate logistic regression analysis estimated association between sociodemographic/clinical factors and tumor [...]

Cet article présente les recommandations de l'American Society of Clinical Oncology" pour lever les freins financiers à la participation à des essais cliniques et réduire les coûts restant à la charge des patients

Addressing Financial Barriers to Patient Participation in Clinical Trials: ASCO Policy Statement

Karen M. Winkfield ; Jonathan K. Phillips ; Steven Joffe ; Michael T. Halpern ; Dana S. Wollins ; Beverly Moy

Research conducted through clinical trials is essential for evaluating new treatment modalities, establishing new standards of cancer care, and ultimately improving and prolonging the lives of patients with cancer. However, participation in trials has been low, and this is attributable to various factors including patient financial barriers. Such financial barriers include the rising cost of cancer care; a lack of transparency in coverage policy; and the perception of ethical, compliance, or [...]

Menée dans un contexte américain, cette étude analyse le rapport coût-efficacité du tisagenlecleucel, une immunothérapie par lymphocytes CAR-T ciblant l'antigène CD19, pour traiter les patients pédiatriques atteints d'une leucémie lymphoblastique aiguë à cellules B réfractaire ou récidivante

Cost Effectiveness of Chimeric Antigen Receptor T-Cell Therapy in Relapsed or Refractory Pediatric B-Cell Acute Lymphoblastic Leukemia

John K. Lin ; Benjamin J. Lerman ; James I. Barnes ; Brian C. Boursiquot ; Yuan Jin Tan ; Alex Q.L. Robinson ; Kara L. Davis ; Douglas K. Owens ; Jeremy D. Goldhaber-Fiebert

Purpose : The anti-CD19 chimeric antigen receptor T-cell therapy tisagenlecleucel was recently approved to treat relapsed or refractory pediatric acute lymphoblastic leukemia. With a one-time infusion cost of $475,000, tisagenlecleucel is currently the most expensive oncologic therapy. We aimed to determine whether tisagenlecleucel is cost effective compared with currently available treatments. Methods : Markov modeling was used to evaluate tisagenlecleucel in pediatric relapsed or refractory [...]

Menée aux Etats-Unis à partir de données portant sur 8 247 patients atteints d'un lymphome diffus à grandes cellules B sur la période 2004-2011, cette étude analyse l'association entre le nombre de patients traités par l'oncologue, l'adhésion du patient aux traitements systémiques, le taux d'hospitalisations et la survie globale

Oncologist Volume and Outcomes in Older Adults Diagnosed With Diffuse Large B Cell Lymphoma

Huntington, Scott F. ; Hoag, Jessica R. ; Zhu, Weiwei ; Wang, Rong ; Zeidan, Amer M. ; Giri, Smith ; Podoltsev, Nikolai A. ; Gore, Steven D. ; Ma, Xiaomei ; Gross, Cary P. ; Davidoff, Amy J.

Background : Although provider-level volume is frequently associated with outcomes in cancers requiring complex surgeries, whether similar relations exist for cancers treated primarily with systemic therapy is unknown. Methods : Using a population-based cohort analysis of older adults diagnosed with diffuse large B cell lymphoma (DLBCL) during the years 2004-2011, we evaluated the association between oncologist volume and 4 clinical outcomes (receipt of any chemotherapy, receipt of an [...]

Menée en Allemagne auprès de 576 patients atteints d'un cancer de la prostate, cette étude analyse l'association entre leur participation à un groupe de parole et de soutien (441 membres d'un groupe de soutien) et leurs connaissances sur la maladie, sur les soins et leur organisation et leurs capacités à comprendre l'information en santé

Participation in a prostate cancer support group and health literacy

Haack, Marius ; Kofahl, Christopher ; Kramer, Silke ; Seidel, Gabriele ; Knesebeck, Olaf ; Dierks, Marie-Luise

Background : To cope with prostate cancer (PC) and its consequences and to be certain about therapeutic alternatives, some patients seek mutual help in prostate cancer support groups (PCSGs), where they share information and find social support. Our study was intended to assess whether group participation is associated with health literacy (HL). Methods : We compared PCSG members (n = 441) with PC patients without support group experiences (n = 135) in a cross-sectional design. For this [...]

A partir d'une revue de la littérature, cet article évalue les enjeux organisationnels et humains pour intégrer les soins palliatifs dans la pratique oncologique

Improving Patient and Caregiver Outcomes in Oncology: Team-Based, Timely, and Targeted Palliative Care

Hui, David ; Hannon, Breffni L. ; Zimmermann, Camilla ; Bruera, Eduardo

Over the past decade, a large body of evidence has accumulated supporting the integration of palliative care into oncology practice for patients with advanced cancer. The question is no longer whether palliative care should be offered, but what is the optimal model of delivery, when is the ideal time to refer, who is in greatest need of a referral, and how much palliative care should oncologists themselves be providing. These questions are particularly relevant given the scarcity of palliative [...]