Assessing patients' needs and preferences in the management of advanced colorectal cancer

Redmond, Kathy

doi:10.1038/bjc.1998.419

Cited by 23 publications

(8 citation statements)

References 17 publications

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“…2002), who have shown that chemotherapy causes short-and long-term side-effects that can provoke distress and even affect patients' quality of life. In addition, as in other studies (Redmond 1998;Batchelor 2001;Jacobsen et al . 2002), the nurses unanimously stated that patients receiving chemotherapy have psychological needs.…”

Section: Discussionsupporting

confidence: 81%

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The psychological needs of patients receiving chemotherapy: an exploration of nurse perceptions

Arantzamendi

Kearney

2004

Eur J Cancer Care

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This study explored the perceptions of a group of registered oncology nurses about the psychological needs of patients with cancer receiving chemotherapy and how the nurses meet these. Eight nurses who provided chemotherapy and were working in a local oncology centre participated. A semi-structured interview was used to explore nurses' perceptions, and how they meet these patients' needs. The analysis of interview transcripts revealed that these nurses agreed that patients with cancer receiving chemotherapy had psychological needs. Moreover, they were conscious that some of the physical side-effects could have a psychological impact on the patients. Although nurses did not use any assessment tool for psychological assessment, they identified two main stages during the treatment when patients needed more psychological support: at the beginning and at the end of the chemotherapy. They explained how they tried to meet patients' psychological needs but they also mentioned several factors that influenced the psychological support that patients received.

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Section: Discussionsupporting

confidence: 81%

“…1995; Seymour et al . 1997; Redmond 1998; Sitzia & Wood 1998b; Del Mastro et al . 2002; Jacobsen et al .…”

Section: Introductionmentioning

confidence: 99%

The psychological needs of patients receiving chemotherapy: an exploration of nurse perceptions

Arantzamendi

Kearney

2004

Eur J Cancer Care

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“…The trend with age and the lower rate of treatment in single persons may, however, reflect patient choice as recent studies show that it is younger patients and those with families who are more willing to accept chemotherapy for a limited clinical benefit. 19 Indeed, it is important to underline that the results reported in this paper represent a time when the clinical benefits of chemotherapy, although promising, were not yet fully established. The strong eVects of hospital of first admission are likely to be proxy measures of consultant eVects that reflect their own knowledge, experience and belief in the benefits proVered by chemotherapy, and it is to be expected that these eVects should decrease now that guidelines have been issued.…”

Section: Discussionmentioning

confidence: 90%

Variation in the provision of chemotherapy for colorectal cancer

McLeod

1999

Journal of Epidemiology & Community Health

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Methods-Multilevel logistic regression to separate eVects of patients, areas and hospitals.Results-During the study period, 8% (n=626) of the study population received chemotherapy within six months of their first admission. Adjusting for comorbidities and emergency admissions, both age and deprivation were significantly associated with the treatment. The odds ratios (OR) of chemotherapy relative to patients aged 65-74 were 2.13 and 4.50 for patients aged 55-64 and under 55 respectively. Relative to patients resident in the most aZuent areas, the OR of chemotherapy for patients resident in the most deprived areas was 0.73. Area level availability of the treatment was not significantly associated with a patient's odds of receiving the treatment while on site provision of chemotherapy at the hospital of first admission was (OR=4.32). There was significant unexplained variation between hospitals of first admission but not between areas of residence; between hospital variation decreased by 22% during the study period. Conclusion-DiVerences according to age may reflect both clinical and patient decisions regarding the benefits of the treatment relative to its toxicity. Lower treatment rates in deprived areas may indicate inequitable access to services. Hospital diVerences may reflect consultant eVects and it would be expected that these should decrease now that the eYcacy of the treatment has been recognised and guidelines have been issued. (J Epidemiol Community Health 1999;53:775-781)

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“…There is an increasing appreciation of the importance of the palliative effects of treatment in patients with advanced cancer; Redmond (1998) and Minsky (1998) have shown how the overall effectiveness of treatment can be enhanced by using therapies that combine increased well-being for patients with clinical efficacy in terms of objective response and survival. In the present phase III clinical trials, clinically significant palliative benefits were obtained to a similar extent with raltitrexed and 5-FU + LV in terms of weight gain, improvements in performance status and reductions in disease symptoms (e.g.…”

Section: Objective Response Ratesmentioning

confidence: 99%

Mature results from three large controlled studies with raltitrexed ('Tomudex')

Cunningham

1998

Br J Cancer

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Summary Since the publication of the results of phase I dose-finding studies, an extensive phase 11 and III clinical study programme has been undertaken to study the clinical efficacy and tolerability of the quinazoline folate analogue raltitrexed ('Tomudex'), a novel direct and specific inhibitor of thymidylate synthase. Two international phase III trials, studies 3 and 12, have compared raltitrexed 3 mg m-2 with 5-fluorouracil (5-FU) plus low-dose leucovorin (LV) (Mayo regimen) or high-dose LV (Machover regimen) respectively. A North American study (study 10) was originally set up to compare two raltitrexed dosage arms (3.0 and 4.0 mg m-2) with 5-FU and low-dose LV, but the 4.0 mg m-2 arm was discontinued prematurely because of excessive toxicity. Minimum follow-up times for studies 3, 10 and 12 were 15.5, 12 and 9 months, respectively (for data other than survival), with corresponding survival follow-up times of 26, 12 and 17 months. Objective response rates were similar for raltitrexed and 5-FU + LV, and palliative improvements were seen to a similar extent with both treatments in all phase III studies. Survival was statistically similar for raltitrexed and 5-FU + LV in both studies 3 and 12. Raltitrexed was, however, associated with inferior survival to 5-FU + low-dose LV in study 10, but there appears to be evidence that this was linked to an unconscious effect on investigator behaviour of early toxicity problems in this trial, in that patients appeared to be withdrawn from raltitrexed treatment without progression or protocolled toxicity. Moreover, it appeared that 5-FU + LV patients were continued on treatment after disease progression.5-FU-based therapy was associated with a higher incidence of mucositis than raltitrexed in all studies, with the attainment of statistical significance in studies 3 and 12. Elevations in hepatic transaminase levels were seen with raltitrexed, but these are thought to be of no clinical significance. Overall, much greater levels of toxicity were seen with 5-FU + LV than with raltitrexed in early treatment cycles. In addition, retrospective UK audit data have shown the monthly cost of raltitrexed therapy to be similar to that of Mayo and continuous infusion 5-FU regimens, and appreciably lower than that of the de Gramont regimen of 5-FU (bolus + 22-h infusion) + high-dose LV. Thus, raltitrexed is an effective alternative to 5-FU-based therapy in patients with advanced colorectal cancer, with an acceptable and, unlike 5-FU, predictable toxicity profile. In particular, patients receiving raltitrexed may benefit from the minimization or avoidance of mucositis, and both patients and healthcare providers may find the convenient administration schedule of the drug advantageous.

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Assessing patients' needs and preferences in the management of advanced colorectal cancer

Cited by 23 publications

References 17 publications

The psychological needs of patients receiving chemotherapy: an exploration of nurse perceptions

The psychological needs of patients receiving chemotherapy: an exploration of nurse perceptions

Variation in the provision of chemotherapy for colorectal cancer

Mature results from three large controlled studies with raltitrexed ('Tomudex')

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