Supportive Care in Cancer最新文献

{"title":"The role of combined adjuvant therapeutic drugs in modulating opioid dosage and pain status in cancer patients: a systematic review and meta-analysis.","authors":"Xiao Zhang, Da-Sheng Dang, Xue Sun, Ye Kang","doi":"10.1007/s00520-025-09998-2","DOIUrl":"https://doi.org/10.1007/s00520-025-09998-2","url":null,"abstract":"<p><strong>Background: </strong>The management of cancer-related pain primarily relies on opioid analgesics, yet their use is frequently complicated by adverse effects and inadequate pain relief at higher doses.</p><p><strong>Objectives: </strong>To assess the effectiveness and safety of adjunctive medications in reducing opioid requirements and improving pain management in patients with cancer-related pain.</p><p><strong>Methods: </strong>A comprehensive literature search was performed in PubMed, Embase, and the Cochrane Library up to June 2024, encompassing all relevant records. Studies were included if they were randomized controlled trials (RCTs) or observational studies that compared the efficacy of combined adjuvant therapy with monotherapy using opioid analgesics for the management of cancer-related pain in adults and reported at least one pertinent outcome measure.</p><p><strong>Results: </strong>This analysis included 13 studies (10 RCTs, n = 711; 3 retrospective studies, n = 314) evaluating adjunctive therapies including NSAIDs, anticonvulsants, antidepressants, and corticosteroids. Combination therapy significantly reduced daily opioid consumption versus monotherapy ([MD] -18.84 mg; 95% CI -28.19 to -9.52; P < 0.0001), with significant reductions specifically for NSAIDs (MD -17.27; 95% CI -30.26 to -4.27; P = 0.009) and anticonvulsants (MD -28.02; 95% CI -47.42 to -8.62; P = 0.005). Adjunctive therapy also significantly improved pain scores with NSAIDs (MD -0.79; 95% CI -0.97 to -0.62; P < 0.00001), dexamethasone (MD -1.43; 95% CI -2.23 to -0.63; P = 0.0004), and anticonvulsants (MD -0.23; 95% CI -0.42 to -0.03; P = 0.02). NSAIDs and antidepressants reduced dizziness (OR 0.34; 95% CI 0.19-0.59; P = 0.0002), while anticonvulsants increased its risk (OR 3.55; 95% CI 1.98-6.39; P < 0.0001). NSAIDs were associated with lower drowsiness (OR 0.28; 95% CI 0.13-0.57; P = 0.0005), whereas anticonvulsants and antidepressants increased drowsiness incidence (OR 3.49; 95% CI 2.02-6.01; P < 0.00001). No significant differences were observed in nausea/vomiting (OR 0.80; P = 0.19) or constipation (OR 0.73; P = 0.53). Meta-analysis of safety outcomes revealed no significant increase in the risk of serious adverse events with combination therapy compared to opioid monotherapy.</p><p><strong>Discussion: </strong>The findings indicate that combined adjuvant therapy exhibits favorable efficacy and safety profiles in the management of cancer pain. Nevertheless, the selection of drug combinations requires an individualized approach. Future research should focus on further exploring optimized combination strategies to enhance the therapeutic effect.</p><p><strong>Conclusion: </strong>The findings indicate that combined adjuvant therapy exhibits favorable efficacy and safety profiles in the management of cancer pain.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 11","pages":"931"},"PeriodicalIF":3.0,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275972","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":"Bibliometric and visual analysis of cancer-related insomnia research from 2015 to 2025.","authors":"Lu Chen, Rulin Wang, Xu Feng, Jinying Zhao, Fuchun Wang, Dan Zhou","doi":"10.1007/s00520-025-09909-5","DOIUrl":"https://doi.org/10.1007/s00520-025-09909-5","url":null,"abstract":"<p><strong>Background: </strong>As the second most prevalent cancer-related symptom, insomnia has a long-lasting detrimental effect on cancer patients' and survivors' quality of life. This study is intended to examine the current research status and emerging hotspots of cancer-related insomnia from January 1, 2015, to March 25, 2025, to provide a valuable reference for future investigations.</p><p><strong>Methods: </strong>Literature related to cancer-associated insomnia was retrieved from the Web of Science Core Collection and visually analyzed using CiteSpace, VOSviewer, and Scimago Graphica.</p><p><strong>Results: </strong>A total of 732 articles were retrieved. Research on cancer-related insomnia has exhibited a generally upward trend. Among these, the United States ranks first in publication volume, while Laval University in Canada is identified as the most productive institution. The Journal of Clinical Oncology is the most frequently cited, whereas Supportive Care in Cancer has the highest number of published articles. Garland, Sheila N was the most published author, while Mao, Jun J had the highest average number of citations in publications. The current research hotspots have been identified as insomnia in breast and lung cancer, quality of life among patients with cancer-related insomnia, and therapeutic approaches to its management. Future investigations are anticipated to emphasize the screening and assessment of insomnia in oncology populations, along with broader issues in supportive care.</p><p><strong>Conclusion: </strong>Insomnia has increasingly been recognized for its detrimental impact on treatment efficacy and overall quality of life among individuals diagnosed with cancer and those in post-treatment survivorship. This study presents an in-depth bibliometric analysis of cancer-related insomnia literature published between 2015 and 2025, serving as a foundational reference for subsequent investigations.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 11","pages":"929"},"PeriodicalIF":3.0,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275922","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":"Effects of relaxation training combined with music-based intervention on anxiety and depression in patients undergoing hematopoietic stem cell transplantation: a quasi-experimental study.","authors":"Huiling Xia, Jiulian Yuan, Jiawen Hou, Xue Han, Yuanyuan Feng, Weiwei Qian","doi":"10.1007/s00520-025-09992-8","DOIUrl":"https://doi.org/10.1007/s00520-025-09992-8","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effects of relaxation training combined with music-based intervention on anxiety and depression in patients undergoing hematopoietic stem cell transplantation (HSCT).</p><p><strong>Method: </strong>This quasi-experimental study included patients with hematologic tumors who underwent HSCT at the Affiliated Hospital of Xuzhou Medical University between July 2022 and November 2023. Participants were divided into a control group and an experimental group. The control group received conventional care, while the experimental group received relaxation training combined with music-based intervention in addition to conventional care. A total of 62 patients completed the study. Anxiety and depression levels were assessed using the 7-item Generalized Anxiety Disorder Scale (GAD-7) and the 9-item Patient Health Questionnaire (PHQ-9), respectively. Biological indicators related to anxiety and depression, including blood pressure, heart rate, and cytokines such as interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α), were also evaluated.</p><p><strong>Results: </strong>Compared with the control group, the experimental group demonstrated significant reductions in depression, blood pressure, and cytokine levels of IL-1β, IL-6, and TNF-α. However, no statistically significant changes were observed in anxiety or heart rate.</p><p><strong>Conclusion: </strong>Relaxation training combined with music-based intervention effectively alleviated depression in HSCT patients and influenced biological markers associated with anxiety and depression, including blood pressure and cytokines IL-1β, IL-6, and TNF-α. Nonetheless, no significant changes was noted in anxiety or heart rate.</p><p><strong>Trial and protocol registration: </strong>This study has been registered on the International Traditional Medicine Clinical Trial Registry, with the clinical trial registration number ITMCTR2025000412.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 11","pages":"935"},"PeriodicalIF":3.0,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275937","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":"Indicators of maladaptive emotions in patients with cancer as assessed by oncologists and nurses.","authors":"G Elise Doppenberg-Smit, Myra E van Linde, Femke Lamers, Adriaan W Hoogendoorn, Annemarie M J Braamse, Evelien J M Kuip, Mariette Labots, Rune A W van de Wetering, Inge M Werter, Aartjan T F Beekman, Henk M W Verheul, Joost Dekker","doi":"10.1007/s00520-025-09917-5","DOIUrl":"10.1007/s00520-025-09917-5","url":null,"abstract":"<p><strong>Purpose: </strong>The clinical management of patients with cancer by oncologists and nurses needs to differentiate between maladaptive emotions that do require professional mental health care and adaptive emotions that do not require such care. Previous qualitative research identified six symptoms as potential indicators of maladaptive emotions. These included lingering, increasing or extreme emotions, emotions that interfere with daily life or with treatment, and unexplained somatic symptoms. The present study tested the validity of these symptoms as indicators of maladaptive emotions in patients with cancer.</p><p><strong>Methods: </strong>Patients with a solid malignancy were assessed 3 to 7 months after the start of chemo- or immunotherapy. Patients were categorized as experiencing either adaptive or maladaptive emotions, using two reference standards: (a) a psychiatric diagnostic assessment or (b) patient's subjective need for professional mental health care. Oncologists and nurses assessed the presence of the six symptoms, using a checklist. A total count was made of the number of symptoms that were rated as present.</p><p><strong>Results: </strong>As hypothesized, the total symptom count was statistically significantly greater in patients with maladaptive emotions than in patients with adaptive emotions. This was consistently observed for the ratings by oncologists as well as nurses, and for both reference standards.</p><p><strong>Conclusion: </strong>The current study confirmed six symptoms assessed by oncologists and nurses as valid indicators of maladaptive emotions in patients with cancer. We recommend assessing these symptoms in the broader context of managing emotional well-being of patients with cancer.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 11","pages":"930"},"PeriodicalIF":3.0,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12513930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: StrataXRT for the prevention of acute radiation dermatitis in breast cancer: a pilot study.","authors":"Mingyu Li","doi":"10.1007/s00520-025-10023-9","DOIUrl":"https://doi.org/10.1007/s00520-025-10023-9","url":null,"abstract":"","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 11","pages":"933"},"PeriodicalIF":3.0,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275949","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":"Younger age as a risk factor for rash development in pemetrexed and carboplatin treatment with dexamethasone prophylaxis.","authors":"Yoshitaka Saito, Osamu Taniguchi, Yoh Takekuma, Jun Sakakibara-Konishi, Yasushi Shimizu, Ichiro Kinoshita, Mitsuru Sugawara","doi":"10.1007/s00520-025-09953-1","DOIUrl":"https://doi.org/10.1007/s00520-025-09953-1","url":null,"abstract":"<p><strong>Purpose: </strong>Carboplatin (CBDCA) plus pemetrexed (PEM) is one of the most effective regimens for treating thoracic cancer. Rash, which is mainly caused by PEM, occurs in 15-30% of patients. Dexamethasone administration for 3 days is recommended to manage rash, chemotherapy-induced nausea, and vomiting in this regimen. However, the nature of the PEM-induced rashes is not fully understood. Consequently, we aimed to identify the risk factors associated with rash development under dexamethasone prophylaxis in CBDCA + PEM treatment.</p><p><strong>Methods: </strong>Patients with thoracic cancer who underwent CBDCA + PEM treatment (n = 133) were retrospectively assessed. The primary endpoint of the present study was to identify the risk factor(s) for the incidence of all-grade rash in the first cycle. Factors affecting the incidence during all treatment cycles were also evaluated.</p><p><strong>Results: </strong>The incidence of all-grade rash in the first cycle was 24.1%, including 16.5% for grade 1, 5.3% for grade 2, and 2.3% for grade 3, respectively. Moreover, that in all cycles, it was 27.1%, with 18.8% for grade 1, 6.0% for grade 2, and 2.3% for grade 3. Multivariate logistic regression analyses identified that age < 65 years was the singular independent risk factor for rash development in the first and all cycles (adjusted odds ratio, 2.79; 95% confidence interval, 1.17-6.67; p = 0.02 for the first cycle, 3.03, 1.29-7.09; p = 0.01 for all cycles).</p><p><strong>Conclusion: </strong>Our study revealed that patients aged < 65 years were at a significantly higher risk of rash development during CBDCA + PEM chemotherapy with dexamethasone prophylaxis than patients ≥ 65 years of age.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 11","pages":"932"},"PeriodicalIF":3.0,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275961","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":"Examining the effectiveness of combination therapy in alleviating peripheral neuropathy and sleep disorders in breast cancer patients receiving chemotherapy.","authors":"Yu Xiaoqian, Ji Hongmei, Zhou Lizhi, Hao Xijun","doi":"10.1007/s00520-025-09987-5","DOIUrl":"https://doi.org/10.1007/s00520-025-09987-5","url":null,"abstract":"<p><strong>Objective: </strong>Exploring the efficacy of compression therapy and combined therapies in alleviating chemotherapy-induced peripheral neuropathy and sleep disturbances in breast cancer patients.</p><p><strong>Methods: </strong>A total of 120 breast cancer patients who developed chemotherapy-induced peripheral neuropathy (CIPN) after receiving chemotherapy at Tangshan People's Hospital were consecutively enrolled and randomly assigned into three groups. The control group received standard treatment, while the compression group received a three-level pressure compression therapy in addition to standard treatment. The combination group received a combined therapy (compression combined with exercise). Assessments were conducted using the National Cancer Institute-Common Toxicity Criteria (NCI-CTC version 4.0) and the Pittsburgh Sleep Quality Index (PSQI) before intervention, after four cycles of intervention, and at a 6-month follow-up. Comparisons were made among the three groups in terms of the incidence of CIPN and differences in PSQI scores.</p><p><strong>Results: </strong>We proposed a novel \"dual-target intervention\" strategy: reducing chemotherapy drug retention (mechanical protection) through hand and foot compression (with a pressure of 30-48 mmHg) and promoting nerve repair (functional repair) through progressive EXCAP exercise (with a weekly step count increase of 5-20%). In the combination group, the proportion of patients with grade 1 CIPN was significantly higher than that in the compression group and the control group after four cycles of intervention (100.0 vs. 75.0 vs. 50.0%, P < 0.001), while the proportion of patients with grade 2 CIPN was significantly lower than that in the compression group and the control group (0.0 vs. 25.0 vs. 50.0%, P < 0.001). Moreover, this effect persisted until the 6-month follow-up (grade 0 72.2 vs. 44.4 vs. 19.4%, P < 0.001; grade 1 27.8 vs. 38.9 vs. 41.7%, P < 0.001; grade 2 0.0 vs. 16.7 vs. 38.9%, P < 0.001). The reduction in total PSQI score was significantly greater in the combination group versus the control at the 4-cycle assessment (P < 0.001). A generalized estimating equation (GEE) confirmed significant effects of time, group, and their interaction (all P < 0.001). At the four-cycle intervention point and the 6-month follow-up, the total HADS scores in the combination group and the compression group were significantly lower than those in the control group, and the total HADS score in the combination group was lower than that in the compression group (P < 0.001).</p><p><strong>Conclusion: </strong>Both intervention methods can effectively reduce the incidence of CIPN in breast cancer patients undergoing chemotherapy, improve their sleep quality, and alleviate negative emotions. Moreover, the combination group outperforms the compression group, and this mechanism may be related to multi-pathway regulation involving metabolism, nerve function, and psychological factors.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 11","pages":"936"},"PeriodicalIF":3.0,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275975","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":"Physical activity and sedentary behavior in patients during acute recovery from hematopoietic stem cell transplantation.","authors":"Lauren P Waldman, Daniel A Schaefer, Michelle Guo, Manfred N Mate-Kole, Emma P Keane, Isabella S Larizza, Annabella C Boardman, Lisa M Gudenkauf, Hermioni L Amonoo","doi":"10.1007/s00520-025-09937-1","DOIUrl":"https://doi.org/10.1007/s00520-025-09937-1","url":null,"abstract":"<p><strong>Purpose: </strong>Hematopoietic stem cell transplantation (HSCT) recipients experience symptoms that can impact physical functioning. Little research has examined physical activity levels during acute recovery following HSCT. The present study aimed to examine physical activity during acute recovery post-HSCT and to identify demographic and clinical characteristics associated with physical activity during acute recovery post-HSCT.</p><p><strong>Methods: </strong>We conducted a secondary analysis of cross-sectional data from HSCT-recipients at approximately + 100 days post-HSCT. Participants completed a demographic questionnaire; study staff collected clinical information from the health record. Physical activity was measured using accelerometry (i.e., ActiGraph wGT3X-BT). We used univariate analyses to examine the relationship between demographic and clinical factors and physical activity.</p><p><strong>Results: </strong>The present study included 63 participants (mean age = 61, 50.8% female, 92.1% White). Most participants completed college (68.3%) and earned a household yearly income > $75,000 (66.7%). On average, participants spent 13 min per day participating in moderate-to-vigorous physical activity with a total of 81 min weekly. Daily step count was 3679, and weekly average was 23,094. Participants with a college education or higher and yearly income > $75,000 engaged in more physical activity.</p><p><strong>Conclusion: </strong>HSCT recipients in acute recovery do not meet American Cancer Society recommended levels of physical activity. Those with fewer years of education and with lower income were at greater risk of low physical activity. Study findings identify potentially vulnerable cohorts of HSCT survivors at risk for low physical activity and indicate that future interventions to increase physical activity are warranted.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 11","pages":"934"},"PeriodicalIF":3.0,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275978","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":"The trajectory of cancer-related fatigue throughout lung cancer treatment and its association with physical activity.","authors":"Francesca Van Hulle, Eva Arents, Kirsten Quadflieg, Sarah Haesevoets, Fien Hermans, Maarten Criel, David Ruttens, Eric Derom, Marc Daenen, Martijn A Spruit, Veerle Surmont, Dieter Stevens, Chris Burtin, Heleen Demeyer","doi":"10.1007/s00520-025-09956-y","DOIUrl":"https://doi.org/10.1007/s00520-025-09956-y","url":null,"abstract":"<p><strong>Background: </strong>Cancer-related fatigue (CRF) is a debilitating symptom in patients with lung cancer and is often more severe than in other cancer populations. This study investigated the impact of different cancer treatments on CRF trajectories and the role of physical activity (PA) during treatment.</p><p><strong>Methods: </strong>Patients with non-small cell lung cancer (NSCLC) were included. CRF was assessed at diagnosis, during treatment, and 12 weeks after treatment initiation using the Multidimensional Fatigue Inventory (MFI-20). ΔMFI-20 (T_followup - T_diagnosis) was compared across treatments (surgery, surgery and (neo-)adjuvant treatment, and non-surgical treatment). PA was measured with an Actigraph GT3X (for 1 week during hospitalization after surgery and/or halfway through (neo-)adjuvant treatment), capturing daily step count and minutes of moderate to vigorous PA (MVPA). ΔMFI-20 between the three groups and the association with PA during treatment were examined using multivariable general linear models.</p><p><strong>Results: </strong>Sixty-two patients (66 ± 8 years, 66% male) were included. CRF increased significantly more in patients receiving surgery and (neo-)adjuvant treatment (n = 12) compared to surgery alone (n = 29) (ΔMFI-20, 16 ± 17 vs. 0.3 ± 13; p < 0.05). The increase in CRF in non-surgically treated patients (n = 21) (ΔMFI-20, 6 ± 19) was not statistically different (p = 0.41) from those receiving surgery. Patients performed 3695 ± 2288 steps/day and 11 ± 14 min of MVPA/day during treatment. Patients engaging in higher levels of PA during treatment (> 5000 steps/day or > 10 min of MVPA/day) tended to have lower CRF increases compared to most inactive patients (< 3000 steps/day) (ΔMFI-20, 6.4 ± 4.9; p = 0.06).</p><p><strong>Conclusions: </strong>Patients with lung cancer experience significant increases in CRF throughout treatment, particularly those receiving (neo-)adjuvant treatment and surgery. PA levels during treatment were very low and tended to be related to lower fatigue increases. These findings highlight the importance of measuring CRF and the potential for exploring PA interventions to manage CRF.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 11","pages":"926"},"PeriodicalIF":3.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275986","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":"Methadone for intractable cancer pain associated with pelvic floor lesions: a retrospective analysis of 36 cases.","authors":"Tetsumi Sato, Shigeki Ono, Taiichi Kawamura, Akira Fukutomi, Tetsu Sato, Yoshiko Kamo, Shota Hagiya, Tomomi Suzuki, Rei Tanaka","doi":"10.1007/s00520-025-09932-6","DOIUrl":"https://doi.org/10.1007/s00520-025-09932-6","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to examine the efficacy and safety of methadone for refractory cancer pain caused by pelvic floor lesions.</p><p><strong>Methods: </strong>Between April 2016 and September 2023, we retrospectively investigated all cases in which methadone was administered by our Palliative Care Team for refractory cancer pain due to pelvic floor lesions, based on the electronic medical records.</p><p><strong>Results: </strong>The extracted cases totaled 36 (21 females), and the age was 55.1 ± 15.1 years. The primary sites of malignancy were rectum, colon, and uterine cervix, each of which accounted for nine cases, and others in nine. The causes of refractory pain included pelvic tumors in 36, sacral metastasis/infiltration in 7, and others in 11 (with some overlaps). The prior opioid dosage (oral morphine equivalent) (median, (IQR)) was 168.0 (95.3, 352.5) mg/day. The starting, maximum, and final doses of methadone were 20.0 (10.0, 20.0), 20.0 (13.8, 40.0), and 20.0 (10.0, 37.5) mg/day, respectively, with a treatment duration of 28.0 (16.0, 97.5) days. The pain intensity in NRS on the day before (before) and 7 days after (after) the introduction of methadone was 6.0 (5.0, 8.0) and 4.0 (2.0, 5.0), respectively (p < 0.001). The numbers of rescue medications before and after the introduction of methadone were 4.0 (3.0, 5.0) and 3.0 (1.0, 4.0) times/day, respectively (p = 0.0015). Side effects that led to the discontinuation of methadone included nausea and dizziness in one case.</p><p><strong>Conclusion: </strong>Methadone is suggested to be an effective and safe treatment option for refractory cancer pain due to pelvic floor lesions.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 11","pages":"928"},"PeriodicalIF":3.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275925","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}