Current Opinion in Supportive and Palliative Care最新文献_第2页

Palliative radiotherapy for the hemostasis of bleeding tumors: an overview of the most recent literature.

IF 1.9 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2025-03-01 Epub Date: 2025-01-30 DOI: 10.1097/SPC.0000000000000741

Manuel Guhlich, Pieter Verschuren, Eva Oldenburger

{"title":"Palliative radiotherapy for the hemostasis of bleeding tumors: an overview of the most recent literature.","authors":"Manuel Guhlich, Pieter Verschuren, Eva Oldenburger","doi":"10.1097/SPC.0000000000000741","DOIUrl":"10.1097/SPC.0000000000000741","url":null,"abstract":"Purpose of review: Palliative radiotherapy is frequently applied for various indications, with hemostasis being a quite common one. However, while bleeding can occur at different sites and arise from various primary tumor types, clear guidelines for administering hemostatic radiotherapy are lacking. Additionally, most available data on hemostatic radiotherapy are retrospective, and often studies do not focus on hemostasis specifically. This review provides an overview of the most recent data on hemostatic radiotherapy to identify any research trends and focus areas for this specific topic.Recent findings: This review confirms the value of radiation for tumor bleeding. Unfortunately, research in hemostatic radiotherapy predominantly continues to focus on retrospective analyses of treated patients. However, at least two prospective trials specifically investigating hemostasis have been published recently, both conducted in low-income countries.Summary: Radiotherapy is an effective and well-tolerated treatment for bleeding tumors. As the incidence of advanced cancer rises in low- and middle-income countries, where resources are limited, further research should focus on hypofractionated regimens. Additionally, there is a need for comprehensive descriptions of contouring and treatment planning to optimize outcomes in these settings.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":"19 1","pages":"33-40"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143071262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Palliative radiation therapy for locally advanced breast cancer. 局部晚期乳腺癌的姑息放射治疗。

IF 1.9 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2025-03-01 Epub Date: 2024-12-12 DOI: 10.1097/SPC.0000000000000739

Stephen L B Ciocon, Cecília F P M Sousa, Gustavo N Marta, Jennifer Y Y Kwan

{"title":"Palliative radiation therapy for locally advanced breast cancer.","authors":"Stephen L B Ciocon, Cecília F P M Sousa, Gustavo N Marta, Jennifer Y Y Kwan","doi":"10.1097/SPC.0000000000000739","DOIUrl":"10.1097/SPC.0000000000000739","url":null,"abstract":"Purpose of review: Globally, breast cancer is the most commonly diagnosed cancer in women. Locally advanced breast cancers (LABCs) may necessitate palliative radiation therapy (RT) due to the severity of the patients' symptoms, inoperability, or other reasons precluding curative-intent treatment such as poor performance status and patient comorbidities. This review aims to discuss current evidence on palliative RT in LABC.Recent findings: Advanced targeted RT techniques have led to improvements in local control with reduced treatment-related toxicities. Emerging short-course palliative RT prescriptions offer feasible options that avoid delay in systemic therapy. Additionally, recent studies also highlight approaches for integrating palliative RT with systemic therapies.Summary: Palliative RT plays a vital role in managing symptoms and enhancing quality of life for LABC patients. However, there is currently no consensus on the optimal prescriptions for palliative RT in these patients. Standardized reporting of palliative RT studies is needed for robust comparison of efficacy and toxicity between various treatment regimens. Furthermore, future research on the optimal integration of RT with novel systemic agents is needed.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":" ","pages":"41-50"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Advancing care for older adults with cancer: addressing key challenges and emerging insights.

IF 1.9 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2025-03-01 Epub Date: 2025-01-30 DOI: 10.1097/SPC.0000000000000748

Schroder Sattar

引用次数: 0

Medication management: supportive care medications in older adults with cancer.

IF 1.9 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2025-03-01 Epub Date: 2025-01-30 DOI: 10.1097/SPC.0000000000000742

Darren J Walsh, Chloé Herledan

引用次数: 0

Blood-based biomarkers of frailty in older patients with cancer.

IF 1.9 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2025-03-01 Epub Date: 2025-01-30 DOI: 10.1097/SPC.0000000000000747

Baran Akagunduz, Yakup Ergün, Dig dem Dog An Akagündüz, Nergis Akbas, Dilara Akagündüz, Aziz Karaog Lu, Pinar Soysal

{"title":"Blood-based biomarkers of frailty in older patients with cancer.","authors":"Baran Akagunduz, Yakup Ergün, Dig dem Dog An Akagündüz, Nergis Akbas, Dilara Akagündüz, Aziz Karaog Lu, Pinar Soysal","doi":"10.1097/SPC.0000000000000747","DOIUrl":"10.1097/SPC.0000000000000747","url":null,"abstract":"Purpose of review: This review aims to evaluate the current evidence on blood-based biomarkers for frailty detection in older cancer patients. It explores the potential of various biomarkers, including inflammatory markers and microRNAs (miRNAs), to serve as indicators of frailty and examines the limitations of existing studies. The review also highlights the need for further research to validate these biomarkers and improve their clinical applicability.Recent findings: Recent studies have examined blood biomarkers associated with frailty in older cancer patients. Findings suggest that elevated granulocyte levels and lower macrophage-derived stem cells and regulatory T cells are linked to frailty. Inflammatory biomarkers such as interleukin-6 and specific miRNAs, as well as higher neutrophil-to-lymphocyte ratios, have also been identified as potential indicators of frailty. While these biomarkers show promise, no single marker has proven sufficient, and combining them may improve frailty detection. Further research is needed to validate their clinical usefulness in this population.Summary: Blood-based biomarkers show potential for detecting frailty in older patients with cancer, but further research is needed, particularly beyond an inflammatory focus and with more robust study designs.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":"19 1","pages":"25-32"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143071249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Assessment of the benefits of bone modifying agents in the management of advanced breast, prostate, and lung cancers.

IF 1.9 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2025-02-14 DOI: 10.1097/SPC.0000000000000749

Jennifer Leigh, Shing Fung Lee, Ali Fawaz, Jason Jia, Christopher F Theriau, Jessica Rodrigues, Janet Brown, Terry L Ng

{"title":"Assessment of the benefits of bone modifying agents in the management of advanced breast, prostate, and lung cancers.","authors":"Jennifer Leigh, Shing Fung Lee, Ali Fawaz, Jason Jia, Christopher F Theriau, Jessica Rodrigues, Janet Brown, Terry L Ng","doi":"10.1097/SPC.0000000000000749","DOIUrl":"https://doi.org/10.1097/SPC.0000000000000749","url":null,"abstract":"Purpose of review: Skeletal metastases occur in approximately 80% of advanced breast, 70% of advanced prostate, and 30% of lung cancers, and place patients at increased risk of skeletal related events (SRE). Bone modifying agents (BMAs) have been shown to prevent or delay SRE development. Our objective was to summarize the role of these agents in the management of these three cancers.Recent findings: Total 52 studies met our inclusion criteria. These highlighted the benefit of BMAs in reducing SREs in metastatic breast and castrate resistant prostate cancer (mCRPC), with less clear impact on reducing SRE in lung cancer, or on improving progression-free and overall survival due to significant heterogeneity in trial design and outcomes. Benefits in SRE reduction occurred with bisphosphonates and denosumab, however when compared, denosumab was superior. Denosumab however is not more cost effective, and multiple trials support potential de-escalation to either 12 weekly dosing or other reduced duration.Summary: There is a large body of evidence to support the role of BMAs in reducing SREs in metastatic breast and mCRPC. Impact on survival outcomes is heterogeneous, and future large database trials would be helpful in identifying which subgroups of patients truly have survival benefit from BMAs.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Early palliative care and its impact on end of life care. 早期姑息关怀及其对生命末期关怀的影响。

IF 1.9 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2024-12-01 Epub Date: 2024-10-30 DOI: 10.1097/SPC.0000000000000729

Dan Monnery, Joanne Droney

{"title":"Early palliative care and its impact on end of life care.","authors":"Dan Monnery, Joanne Droney","doi":"10.1097/SPC.0000000000000729","DOIUrl":"10.1097/SPC.0000000000000729","url":null,"abstract":"Purpose of review: The impacts of early palliative care for patients with advanced cancer are well described. This has led to endorsement of early palliative care, alongside cancer treatment, by leading cancer organisations. The aim of this review is to consider how best to adopt and integrate the learning from studies of early palliative care into an effective, sustainable service that is offered as part of routine cancer care.Recent findings: 'Timely', 'targeted' and 'precision' approaches have been proposed to ensure that limited palliative care resources are available to those who are most likely to benefit. Triage and referral based on individual patients' needs has been shown to be both efficient and effective. Standardised referral criteria and the use of tools to assess complexity may support equitable service development. A specialist multidisciplinary approach is a common factor underpinning successful integration between palliative care and oncology but does not negate the importance patient-centred considerations such as advance care planning, which can be facilitated by non-specialist teams.Summary: The challenge is no longer whether early palliative care should be provided, but how. Evidence-based strategies about how best to implement early palliative care are needed to inform appropriate resourcing, funding, and delivery.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":" ","pages":"230-234"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142330503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

How to evaluate exertional breathlessness using normative reference equations in research. 如何在研究中使用常模参考方程评估用力呼吸困难。

IF 1.9 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2024-12-01 Epub Date: 2024-10-30 DOI: 10.1097/SPC.0000000000000721

Magnus Ekström, Hayley Lewthwaite, Dennis Jensen

{"title":"How to evaluate exertional breathlessness using normative reference equations in research.","authors":"Magnus Ekström, Hayley Lewthwaite, Dennis Jensen","doi":"10.1097/SPC.0000000000000721","DOIUrl":"https://doi.org/10.1097/SPC.0000000000000721","url":null,"abstract":"Purpose of review: Breathlessness is a common, distressing and limiting symptom in people with advanced disease, but is challenging to assess as the symptom intensity depends on the level of exertion (symptom stimulus) during the assessment. This review outlines how to use recently developed normative reference equations to evaluate breathlessness responses, accounting for level of exertion, for valid assessment in symptom research.Recent findings: Published normative reference equations are freely available to predict the breathlessness intensity response (on a 0-10 Borg scale) among healthy people after a 6-minute walking test (6MWT) or an incremental cycle cardiopulmonary exercise test (iCPET). The predicted normal values account for individual characteristics (including age, sex, height, and body mass) and level of exertion (walk distance for 6MWT; power output, oxygen uptake, or minute ventilation at any point during the iCPET). The equations can be used to (1) construct a matched healthy control dataset for a study; (2) determine how abnormal an individual's exertional breathlessness is compared with healthy controls; (3) identify abnormal exertional breathlessness (rating > upper limit of normal); and (4) validly compare exertional breathlessness levels across individuals and groups.Summary: Methods for standardized and valid assessment of exertional breathlessness have emerged for improved symptoms research.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":"18 4","pages":"191-198"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bridging the care gap: radiation therapy in elderly and frail cancer patients. 缩小护理差距：年老体弱癌症患者的放射治疗。

IF 1.9 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2024-12-01 Epub Date: 2024-10-30 DOI: 10.1097/SPC.0000000000000727

Caroline Hircock, Shing Fung Lee, Srinivas Raman, Elizabeth Chuk, Adrian W Chan, Edward Chow, Henry C Y Wong

{"title":"Bridging the care gap: radiation therapy in elderly and frail cancer patients.","authors":"Caroline Hircock, Shing Fung Lee, Srinivas Raman, Elizabeth Chuk, Adrian W Chan, Edward Chow, Henry C Y Wong","doi":"10.1097/SPC.0000000000000727","DOIUrl":"10.1097/SPC.0000000000000727","url":null,"abstract":"Purpose of review: This review aims to address the gap in radiation therapy (RT) care for elderly cancer patients. It will discuss the barriers to implementing effective RT in elderly and frail patients with a focus on breast cancer and metastatic settings.Recent findings: Recent studies indicate that SBRT provides better pain control for bone metastases compared to cEBRT, but elderly patients are underrepresented in these trials. Evidence on the effectiveness of geriatric assessment tools in predicting RT tolerance and toxicity is mixed, with some studies showing a correlation while others do not. Comprehensive geriatric assessments, though promising, are often impractical due to time and resource constraints.Summary: There is a critical need for more inclusive research to better understand the risks and benefits of RT in elderly patients. Developing streamlined geriatric assessment tools and integrating them into clinical practice can enhance treatment personalization. Future studies should prioritize elderly populations to generate robust data, thereby improving RT outcomes and quality of life for this growing patient group.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":" ","pages":"276-281"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Role of caregivers being trained in assisting in end of life care - Latin American perspective. 接受培训的护理人员在协助临终关怀中的作用--拉丁美洲视角。

IF 1.9 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2024-12-01 Epub Date: 2024-10-30 DOI: 10.1097/SPC.0000000000000730

Esther de Vries, José A Calvache, Sandra M Hernández Zambrano

{"title":"Role of caregivers being trained in assisting in end of life care - Latin American perspective.","authors":"Esther de Vries, José A Calvache, Sandra M Hernández Zambrano","doi":"10.1097/SPC.0000000000000730","DOIUrl":"10.1097/SPC.0000000000000730","url":null,"abstract":"Purpose of review: Palliative care in Latin America is evolving, but training for informal caregivers remains underexplored. This review summarizes recent interventions to educate or train caregivers in end-of-life care.Recent findings: The literature search identified three interventions published by 2023, two with reception evaluations, all with small sample sizes and no control groups. Needs of caregivers have been more frequently described and include training on aspects of the disease, nursing skills, how to handle patients´ and own emotions; help in navigating the complex healthcare systems in Latin America; help in conversations about the end of life and dying, still taboos in the region; help in finding additional caregivers or other types of support to make the caregiving role sustainable over time for the caregiver. Interventions mainly focused on emotional support and identifying additional caregivers without guilt; two included nursing skills training.Summary: There are very few formal interventions described and evaluated to assist caregivers in end-of-life care in Latin America described in the literature. This illustrates the rather invisible but very important role of these important stakeholders in the care for patients. Multidimensional interventions should be developed and evaluated to support caregivers.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":" ","pages":"243-248"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0