Management of orphan symptoms: ESMO Clinical Practice Guidelines for diagnosis and treatment†

Santini, Daniele; Armento, Grazia; Giusti, Raffaele; Ferrara, Maria; Moro, Cecilia; Fulfaro, Fabio; Bossi, Paolo; Arena, Francesco; Ripamonti, Carla

doi:10.1136/esmoopen-2020-000933

Cited by 9 publications

(6 citation statements)

References 102 publications

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“…Moreover, patients’ preferences should be included in the treatment decision-making process 24. Greater attention is also warranted to address side effects of chemotherapy 25 26…”

Section: Discussionmentioning

confidence: 99%

Symptom burden and quality of life with chemotherapy for recurrent ovarian cancer: the Gynecologic Cancer InterGroup-Symptom Benefit Study

Lee

King

O’Connell

et al. 2022

International Journal of Gynecological Cancer

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ObjectiveThe Gynecologic Cancer InterGroup (GCIG)-Symptom Benefit Study was designed to evaluate the effects of chemotherapy on symptoms and health-related quality of life (HRQL) in women having chemotherapy for platinum resistant/refractory recurrent ovarian cancer (PRR-ROC) and potentially platinum sensitive with ≥3 lines of chemotherapy (PPS-ROC ≥3).MethodsParticipants completed the Measure of Ovarian Cancer Symptoms and Treatment (MOST) and European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire QLQ-C30 questionnaires at baseline and every 3–4 weeks until progression. Participants were classified symptomatic if they rated ≥4 of 10 in at least one-third of symptoms in the MOST index. Improvement in MOST was defined as two consecutive scores of ≤3 in at least half of the symptomatic items at baseline. Improvement in HRQL was defined as two consecutive scores ≥10 points above baseline in the QLQ-C30 summary score scale (range 0–100).ResultsOf 948 participants enrolled, 910 (96%) completed baseline questionnaires: 546 with PRR-ROC and 364 with PPS-ROC ≥3. The proportions of participants symptomatic at baseline as per MOST indexes were: abdominal 54%, psychological 53%, and disease- or treatment-related 35%. Improvement was reported in MOST indexes: abdominal 40%, psychological 35%, and disease- or treatment-related 38%. Median time to improvement in abdominal symptoms occurred earlier for PRR-ROC than for PPS-ROC ≥3 (4 vs 6 weeks, p=0.044); median duration of improvement was also similar (9.0 vs 11.7 weeks, p=0.65). Progression-free survival was longer among those with improvement in abdominal symptoms than in those without (median 7.2 vs 2.5 months, p<0.0001). Improvements in HRQL were reported by 77/448 (17%) with PRR-ROC and 61/301 (20%) with PPS-ROC ≥3 (p=0.29), and 102/481 (21%) of those with abdominal symptoms at baseline.ConclusionOver 50% of participants reported abdominal and psychological symptoms at baseline. Of those, 40% reported an improvement within 2 months of starting chemotherapy. Approximately one in six participants reported an improvement in HRQL. Symptom monitoring and supportive care is important as chemotherapy palliated less than half of symptomatic participants.

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“…Moreover, patients’ preferences should be included in the treatment decision-making process 24. Greater attention is also warranted to address side effects of chemotherapy 25 26…”

Section: Discussionmentioning

confidence: 99%

Symptom burden and quality of life with chemotherapy for recurrent ovarian cancer: the Gynecologic Cancer InterGroup-Symptom Benefit Study

Lee

King

O’Connell

et al. 2022

International Journal of Gynecological Cancer

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“…Symptom assessment tools can improve clinical practice through the improved/earlier identification of troublesome “orphan” symptoms (i.e. symptoms not usually reported or assessed) [ 39 ]. The “ideal” symptom assessment tool should be valid, reliable, relevant (for the population/specific scenario), comprehensive (for the specific scenario), multidimensional, and easy to administer/complete [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Oral symptom assessment tools in patients with advanced cancer: a scoping review

Cleary

Mulkerrin

Davies

2022

Support Care Cancer

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Purpose Oral symptoms are common in patients with advanced cancer. The aim of this scoping review was to identify oral symptom assessment tools that have been specifically utilised in patients with “advanced cancer”. Methods The review was conducted/reported according to international guidelines for undertaking scoping reviews. PubMed, Embase, and CINAHL were searched for articles involving adult patients with advanced cancer, which involved assessment of ≥ 2 oral symptoms, and which involved patients with > 1 type of cancer. Results The review identified four validated symptom assessment scales, including one cancer-specific quality of life scale (EORTC QLQ OH-15), one generic tool for assessing the “social impact” of specific oral problems (OHIP), one cancer-specific generic symptom assessment scale (MSAS), and one cancer-specific oral symptom assessment scale (OSAS). Conclusion Symptom assessment tools can facilitate good symptom control in clinical practice, and are an integral component of clinical research. The review identified four validated symptom assessment scales that could be utilised to assess oral symptoms in patients with advanced cancer.

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“…While the incidence and prevalence of tenesmus in patients with rectal cancer is unknown, the reported prevalence is around 14% in patients with recurrent rectal carcinoma. However, there are few reported statistics about this symptom and probably the real prevalence, particularly for distal rectal cancer, is higher [26]. Therefore, prioritizing RT can be considered in patients with sphincter invasion, intractable bleeding, pain and tenesmus to achieve best tumour response and more importantly to control the unsettling symptoms; and thus, to increase patient's compliance to therapy.…”

Section: Sequencing In Total Neoadjuvant Treatmentmentioning

confidence: 99%

Tailored total neoadjuvant therapy for locally advanced rectal cancer: One size may not fit for all!

et al. 2021

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While current neoadjuvant protocols have proven benefits on local control for majority of patients with locally advanced rectal cancer, there are certain clinical conditions that require future advances for improving the outcomes. Total neoadjuvant therapy incorporates systemic chemotherapy planned within standard neoadjuvant protocols either before or after radiotherapy for locally advanced rectal cancer as a whole. Enhanced compliance with planned oncological therapy, tumour downstaging, administration of chemotherapy at the earliest time in the disease course to help assessing chemosensitivity are the proposed benefits of total neoadjuvant therapy in patients with locally advanced rectal cancer. Patient selection criteria for administration of total neoadjuvant therapy in the recent guidelines are unclear. Since current literature is inconclusive for the optimal sequence and type of radiotherapy and chemotherapy, premature incorporation of total neoadjuvant therapy for all locally advanced rectal cancers may result in overtreatment and subsequently toxicity. This article aims to discuss the current literature and to propose a future perspective by considering real-life scenarios reflecting patients' needs for treatment of locally advanced rectal cancer.

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Management of orphan symptoms: ESMO Clinical Practice Guidelines for diagnosis and treatment†

Cited by 9 publications

References 102 publications

Symptom burden and quality of life with chemotherapy for recurrent ovarian cancer: the Gynecologic Cancer InterGroup-Symptom Benefit Study

Symptom burden and quality of life with chemotherapy for recurrent ovarian cancer: the Gynecologic Cancer InterGroup-Symptom Benefit Study

Oral symptom assessment tools in patients with advanced cancer: a scoping review

Tailored total neoadjuvant therapy for locally advanced rectal cancer: One size may not fit for all!

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