{"title":"Improvement in Quality of Life and Dysphagia After Palliative External Beam Radiotherapy for Malignant Esophageal Stenosis of Esophageal Cancer.","authors":"Katsuyuki Sakanaka, Kota Fujii, Masaki Kokubo, Masakazu Ogura, Satoshi Itasaka, Takashi Sakamoto, Norio Araki, Takehisa Takagi, Yasuhiro Kosaka, Setsuko Okumura, Chikako Yamauchi, Hiroyuki Inoo, Hiroyasu Abe, Hideki Ishikawa, Takashi Mizowaki","doi":"10.1200/OP.24.00429","DOIUrl":"https://doi.org/10.1200/OP.24.00429","url":null,"abstract":"<p><strong>Purpose: </strong>This multi-institutional prospective cohort trial aimed to demonstrate the changes in physician-evaluated dysphagia and patient-reported outcomes (PROs) after palliative external beam radiotherapy (EBRT) in patients with incurable esophageal cancer presenting with dysphagia.</p><p><strong>Materials and methods: </strong>We evaluated the rates of freedom from physician-evaluated dysphagia progression and improvement along with longitudinal changes in PROs (European Organization for Research and Treatment of Cancer [EORTC] Quality of Life-Core 30 Questionnaire [QLQ-C30] and OES-18) after palliative EBRT. Multivariate analysis was used to identify the factors associated with freedom from physician-evaluated dysphagia progression at week 13.</p><p><strong>Results: </strong>A total of 519 patients with esophageal cancer were screened; the full analysis set comprised 93 patients with a baseline median dysphagia score of 2 (IQR, 1-3) whose possible range was 1-4. Squamous cell carcinoma accounted for 94% of the full analysis set. The median prescribed dose of palliative EBRT was 40 Gy (IQR, 37.5-50). The rates of freedom from physician-evaluated dysphagia progression and improvement at 13 weeks were 76% (95% CI, 66 to 85) and 50% (95% CI, 39 to 60), respectively. Multivariate analysis suggested that high-dose palliative EBRT was more effective in preventing deterioration of physician-evaluated dysphagia than the low-dose one. Role functioning, fatigue, dyspnea, and appetite were worsened at week 4 but recovered at week 13. Patient-reported dysphagia, as represented in EORTC OES-18, demonstrated clinically significant improvement from weeks 13 through 52, relieving dysphagia-associated symptoms and enhancing global health.</p><p><strong>Conclusion: </strong>Palliative EBRT could relieve physician-evaluated and patient-reported dysphagia and dysphagia-associated symptoms and enhance global health in patients with incurable esophageal cancer, especially for squamous cell carcinoma despite transient dysfunction and aggravations of symptoms attributable to acute toxicity from palliative EBRT.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2400429"},"PeriodicalIF":4.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Matthew P Banegas, Chandylen L Nightingale, Emily V Dressler, Mary E Cooley, Charles Kamen, Lynne I Wagner, Carol A Kittel, Efren J Flores, Ruth Carlos, Arissa Milton, Elyse Park, Susan K Parsons, Eden Gurganus Wood, Kah Poh Loh, Scott Ramsey
{"title":"Screening and Referral for Health-Related Social Needs and Financial Distress: Current Processes Among National Cancer Institute Community Oncology Research Program Practices.","authors":"Matthew P Banegas, Chandylen L Nightingale, Emily V Dressler, Mary E Cooley, Charles Kamen, Lynne I Wagner, Carol A Kittel, Efren J Flores, Ruth Carlos, Arissa Milton, Elyse Park, Susan K Parsons, Eden Gurganus Wood, Kah Poh Loh, Scott Ramsey","doi":"10.1200/OP-24-00902","DOIUrl":"https://doi.org/10.1200/OP-24-00902","url":null,"abstract":"<p><strong>Purpose: </strong>Health-related social needs (HRSNs) are associated with adverse cancer health outcomes. We assessed the processes for screening and responding to both HRSNs and financial distress and described the methods used across National Cancer Institute Community Oncology Research Program (NCORP) practices.</p><p><strong>Methods: </strong>The NCORP 2022 Landscape Assessment survey focused on services to screen for and respond to HRSNs and financial distress within a national network of community oncology practices. We calculated the proportions of oncology practices that screened for and responded to HRSNs and financial distress, separately, and described the staff, tools, and methods used for each process. Multivariable logistic regression models estimated the associations between oncology practice characteristics and screening for HRSNs and financial distress.</p><p><strong>Results: </strong>The majority of community oncology practices reported screening for HRSNs (79%), and of those, most inquired about transportation (96%), family and social support (93%), housing (80%), and food security (80%). Most oncology practices reported screening for financial distress (78%). Social worker evaluation was the most common method used to screen for both HRSNs (77%) and financial distress (65%). Most oncology practices reported social work referral as the method for responding to HRSNs (89%) and financial distress (96%). Oncology practice characteristics such as having a survivorship clinic and geographic region were associated with screening for HRSNs and financial distress.</p><p><strong>Conclusion: </strong>Research is needed to understand the impact of different HRSN screening and referral approaches on care delivery, clinic costs, care quality, and health outcomes of patients with cancer. These efforts are critical to generate evidence to inform best practices, clinical guidelines, and novel interventions aimed to improve cancer health equity.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2400902"},"PeriodicalIF":4.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Krunal Pandav, Sahar Almahfouz Nasser, Kristen H Kimball, Kristin Higgins, Anant Madabhushi
{"title":"Opportunities for Artificial Intelligence in Oncology: From the Lens of Clinicians and Patients.","authors":"Krunal Pandav, Sahar Almahfouz Nasser, Kristen H Kimball, Kristin Higgins, Anant Madabhushi","doi":"10.1200/OP-24-00797","DOIUrl":"https://doi.org/10.1200/OP-24-00797","url":null,"abstract":"<p><p>Much work has been published on artificial intelligence (AI) and oncology, with many focusing on an algorithm perspective. However, very few perspective articles have explicitly discussed the role of AI in oncology from the perspectives of the stakeholders-the clinicians and the patients. In this article, we delve into the opportunities of AI in oncology from the clinician's and patient's lens. From the clinician's perspective, we discuss reducing burnout, enhancing decision making, and leveraging vast data sets to provide evidence-based recommendations, eventually affecting diagnostic accuracy and treatment planning. From the patient's perspective, we discuss AI virtual concierge, which could improve the cancer care journey by facilitating patient education, mental health support, and personalized lifestyle wellness recommendations promoting a holistic approach to care. We aim to highlight the stakeholders' unmet needs and guide institutions to create innovative AI solutions in oncology. By addressing these perspectives, our article aims to bridge the gap between technological research advancements and their real-world AI-focused clinical applications in cancer care. Understanding and prioritizing the needs of the stakeholders will foster the development of impactful AI tools and intentional utilization of such technology, with an aim for clinical implementation and integration into workflows.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2400797"},"PeriodicalIF":4.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Antimicrobial Stewardship in Patients With Cancer: Interventions and Future Directions to Combat the Rise of Antimicrobial Resistance.","authors":"Aneela Majeed, Thomas Rust","doi":"10.1200/OP-25-00124","DOIUrl":"https://doi.org/10.1200/OP-25-00124","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500124"},"PeriodicalIF":4.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Overcoming Barriers to Cancer-Associated Cachexia Diagnosis and Management.","authors":"Alessio Molfino, Giovanni Imbimbo","doi":"10.1200/OP-25-00060","DOIUrl":"https://doi.org/10.1200/OP-25-00060","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500060"},"PeriodicalIF":4.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reply to: Overcoming Barriers to Cancer-Associated Cachexia Diagnosis and Management.","authors":"Marcus D Goncalves, Tobias Janowitz","doi":"10.1200/OP-25-00108","DOIUrl":"https://doi.org/10.1200/OP-25-00108","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500108"},"PeriodicalIF":4.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nicole E Caston, Luqin Deng, Courtney P Williams, Emily B Levitan, Andres Azuero, Russell Griffin, Karen L Smith, Antonio C Wolff, Michelle E Melisko, Eileen H Shinn, Kathleen Gallagher, Rebekah Angove, Stephanie B Wheeler, Gabrielle B Rocque
{"title":"System-Level Transformations to Increase Patient Participation in Clinical Trials.","authors":"Nicole E Caston, Luqin Deng, Courtney P Williams, Emily B Levitan, Andres Azuero, Russell Griffin, Karen L Smith, Antonio C Wolff, Michelle E Melisko, Eileen H Shinn, Kathleen Gallagher, Rebekah Angove, Stephanie B Wheeler, Gabrielle B Rocque","doi":"10.1200/OP-24-00736","DOIUrl":"https://doi.org/10.1200/OP-24-00736","url":null,"abstract":"<p><strong>Purpose: </strong>Over the course of the COVID-19 pandemic, the Food and Drug Administration allowed cancer clinical trials to make modifications. As policymakers consider sustaining these modifications, understanding patient perspectives on impact is critical.</p><p><strong>Methods: </strong>This cross-sectional study used survey data collected between August 2021 and September 2021 by the Translational Breast Cancer Research Consortium and December 2022 by Patient Advocate Foundation among female breast cancer survivors. Respondents reported how changes to location, telemedicine, convenience, and opting out of certain procedures would affect their willingness to participate in a trial. Respondents' county-level vulnerability was determined using five-digit Federal Information Processing Standard codes to link to the Social Vulnerability Index (SVI) overall theme (range, 0-1). According to the SVI, the most vulnerable counties are those in the upper 10% of the overall theme. Model-estimated odds ratios (ORs) and 95% CIs were estimated using multinomial logistic regression models to explore the association between county-level social vulnerability and willingness to participate.</p><p><strong>Results: </strong>Overall, 573 women were included, 12% lived in the most vulnerable counties, and 18% had previous trial participation. Over half (53%) reported that they would be very willing to participate in a trial that offered medication delivery to the home. When compared with all other counties, respondents in most vulnerable counties did not have increased willingness to participate in a trial using telemedicine (OR, 0.21 [95% CI, 0.07 to 0.63]). Results were similar for all other trial modifications, though not statistically significant.</p><p><strong>Conclusion: </strong>Our sample of breast cancer survivors viewed trial modifications favorably. However, respondents in the most vulnerable counties were less likely to be influenced by these modifications. Research is needed to understand if additional modifications would influence participation of this vulnerable population.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2400736"},"PeriodicalIF":4.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
David Lewis Pottinger, Soumya Niranjan, Nusrat Jahan, Aakash Desai
{"title":"Ensuring Representation: A Scoping Review of Interventions to Increase Minority Participation in Cancer-Related Research.","authors":"David Lewis Pottinger, Soumya Niranjan, Nusrat Jahan, Aakash Desai","doi":"10.1200/OP-24-00468","DOIUrl":"https://doi.org/10.1200/OP-24-00468","url":null,"abstract":"<p><strong>Purpose: </strong>Minority representation in cancer-related clinical trials (CCTs) is often inadequate. This poses a threat to the generalizability of studies and risks promoting health inequities. This scoping review set out to examine strategies to promote minority participation in CCTs and across the entire continuity of cancer-related care.</p><p><strong>Methods: </strong>We reviewed articles in the following databases: EMBASE, Scopus, and PubMed. For inclusion, studies were required to focus, to a significant extent, on interventions to increase minority enrollment/retention. They were also required to objectively report the strength of these interventions, and either compare them with a control, or with a different intervention attempted.</p><p><strong>Results: </strong>After initially identifying 817 articles, we reviewed 337 articles in their entirety, and found 37 that satisfied our full list of inclusion and exclusion criteria. Five general categories of interventions emerged in these studies. These included educational interventions (n = 17), patient navigation (n = 12), community engagement (n = 8), autonomous recruitment strategies (n = 4), and financial assistance/incentives (n = 4). We then examined rates of statistical significance (for studies that assessed this). Seven of 10 articles that used education intervention strategies and assessed statistical significance demonstrated improvement in at least one variable. For patient navigation, 5/5 showed significance. For community engagement, 1/1 found a significant difference. For studies using an autonomous recruitment strategy, 2/2 showed an improvement. Finally, for financial assistance/incentives, 1/3 found a significant improvement in minority enrollment.</p><p><strong>Conclusion: </strong>Our study highlights the critical role of tailored educational interventions and patient navigation in increasing minority participation in cancer-related clinical trials. However, all five categories of interventions showed promise. More research is needed, particularly in assessing the efficacy of multipronged approaches, to ensure adequate minority participation in CCTs.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2400468"},"PeriodicalIF":4.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Artificial Intelligence in Oncology: Fulfilling Its Promise While Avoiding Its Peril.","authors":"Chirag Shah, Stephen M Karlovits","doi":"10.1200/OP-25-00079","DOIUrl":"https://doi.org/10.1200/OP-25-00079","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500079"},"PeriodicalIF":4.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}