Expectations and preferences for palliative chemotherapy in head and neck cancers patients

Patil, Vijay; Joshi, Amit; Noronha, Vanita; Deodhar, Jayita; Bhattacharjee, Atanu; Dhumal, Sachin; Chandrakanth, M V; Karpe, Ashay; Talreja, Vikas; Chandrasekharan, Arun; Turkar, Siddharth; Ramaswamy, Anant; Prabhash, Kumar

doi:10.1016/j.oraloncology.2016.10.023

Cited by 18 publications

(15 citation statements)

References 17 publications

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“…Previous studies have investigated advanced cancer patients’ treatment goals using both closed- and open-ended questions. 9–17 However, these studies have been limited by small sample sizes, 9,11,15 including patients with serious illnesses other than advanced cancer, 11 including only a small subset of cancer types, 9,12,13 including only patients who expected to be offered palliative chemotherapy, 16 or using cross-sectional study designs. 9,10…”

Section: Introductionmentioning

confidence: 99%

Patients' Hopes for Advanced Cancer Treatment

DeMartini

Fenton

Epstein

et al. 2019

Journal of Pain and Symptom Management

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Context: Little is known about the hopes patients with advanced (incurable) cancer have for their treatment. Objectives: To describe the treatment hopes of advanced cancer patients, factors associated with expressing specific hopes, and the persons with whom hopes are discussed. Methods: We surveyed 265 advanced cancer patients in the USA about their hopes for treatment at baseline and after three months. We developed a taxonomy of hopes for treatment, which two investigators used to independently code patient responses. We explored associations between hopes for cure and patient covariates. Results: We developed 8 categories of hopes. We were able to apply these codes reliably, and 95% of the patient’s responses fit at least one hope category. The hope categories in order of descending baseline prevalence were: quality of life, life extension, tumor stabilization, remission, milestone, unqualified cure, control not otherwise specified (NOS), and cure tempered by realism. Most patients reported discussing hopes with partners, family/friends, and oncologists; a minority reported discussing hopes with nurses, primary care physicians (PCPs), clergy, or support groups. In logistic regression analysis, unqualified hopes for cure were more likely in younger patients and in those who did not endorse discussing their hopes with primary care physicians. Conclusion: Advanced cancer patients harbor a range of treatment hopes. These hopes often are not discussed with key members of the healthcare team. Younger age and lack of discussion of hopes with PCPs may lead to less realistic hopes for cure.

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Section: Introductionmentioning

confidence: 99%

Patients' Hopes for Advanced Cancer Treatment

DeMartini

Fenton

Epstein

et al. 2019

Journal of Pain and Symptom Management

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“…The expectations and preferences of these patients have already been published elsewhere. 13 This study concentrates on distress-related key secondary end points. Routine distress screening may not be feasible in developing nations because of limited manpower resources.…”

Section: Introductionmentioning

confidence: 99%

Distress Management in Patients With Head and Neck Cancer Before Start of Palliative Chemotherapy: A Practical Approach

Patil

Noronha

Joshi

et al. 2018

JGO

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PurposeThis study reports the incidence of distress, the factors associated with distress, and a practical strategy to resolve distress in patients with head and neck cancer who are starting palliative chemotherapy.MethodsAdult patients with head and neck cancer planned for palliative chemotherapy underwent distress screening before the start of treatment as part of this single-arm prospective study. Patients who had a distress score > 3 on the National Comprehensive Cancer Network (NCCN) distress thermometer were counseled initially by the clinician. Those who continued to have high distress after the clinician-led counseling were referred to a clinical psychologist and were started on palliative chemotherapy. After counseling, distress was measured again. The relation between baseline distress and compliance was tested using Fisher's exact test.ResultsTwo hundred patients were enrolled, and the number of patients with high distress was 89 (44.5% [95% CI, 37.8% to 51.4%]). The number of patients who had a decrease in distress after clinician-led counseling (n = 88) was 52 (59.1% [95% CI, 48.6% to 68.8%]) and after psychologist-led counseling (n = 32) was 24 (75.0% [95% CI, 57.6% to 72.2%]; P = .136). Compliance rates did not differ between the patients with or without a high level of distress at baseline (74.2% v 77.4%, P = .620).ConclusionThe incidence of baseline distress is high in patients awaiting the start of palliative chemotherapy. It can be resolved in a substantial number of patients using the strategy of clinician-led counseling, with additional referral to a clinical psychologist as required. Patients with a greater number of emotional problems usually require psychologist-led counseling.

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“…Anticancer drug treatment for HNSCC today is mostly reserved for palliative chemotherapy regimens, which include cytostatic agents such as cisplatin, 5-FU or docetaxel as well as monoclonal antibodies such as cetuximab. However, these drugs offer small benefit with respect to progression-free survival, while in turn inducing severe side effects further limiting the use in cancer patients (45). Therefore, research for identifying new treatment options with reduced toxicities is warranted.…”

Section: Discussionmentioning

confidence: 99%

Additive antitumor effects of celecoxib and simvastatin on head and neck squamous cell carcinoma in vitro

Gehrke

Scherzad

Hackenberg

et al. 2017

International Journal of Oncology

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Lipid-lowering statins as well as non-steroidal anti-inflammatory drugs (NSAIDs) have been reported to possess cancer-protective effects in many epidemiologic cohort studies. However, the underlying mechanisms of these findings are mostly unknown. To evaluate possible additive antitumor effects of statins and NSAIDs in vitro, PJ-41 and HLaC78 head and neck squamous cell carcinoma cells (HNSCC) were treated with 40 µM celecoxib, 50 µM simvastatin or a combination of both. Analysis of tumor viability, proliferation, apoptosis, cell cycle changes and secretion of interleukin-6 (IL-6) and interleukin-8 (IL-8) was conducted via MTT assay, Annexin V-propidium iodide test, cell cycle analysis, colony assay and enzyme-linked immunosorbent assay (ELISA). Celecoxib and simvastatin alone as well as a combined treatment showed a significant reduction in tumor cell viability, proliferation and secretion of IL-6 and IL-8 compared to the control group. The combined treatment even proved to have significantly greater effects. We postulate that simvastatin and celecoxib have additive antitumor effects on HNSCC in vitro, which warrants further investigation.

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Expectations and preferences for palliative chemotherapy in head and neck cancers patients

Cited by 18 publications

References 17 publications

Patients' Hopes for Advanced Cancer Treatment

Patients' Hopes for Advanced Cancer Treatment

Distress Management in Patients With Head and Neck Cancer Before Start of Palliative Chemotherapy: A Practical Approach

Additive antitumor effects of celecoxib and simvastatin on head and neck squamous cell carcinoma in vitro

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