{"title":"癌症合并单侧胸腔积液患者呼吸困难的体位治疗:一项试点试验。","authors":"Jun Kako, Yoshinobu Matsuda, Tomoo Ikari, Kozue Suzuki, Ryo Tachikawa, Yoshihisa Matsumoto, Satoru Miwa, Masanori Mori, Tetsu Kobayashi, Hajime Fujimoto, Atsushi Tomaru, Hitoshi Sumitani, Akira Inoue, Rintaro Koike, Shota Kobayashi, Shunsuke Oyamada, Keisuke Ariyoshi, Takashi Yamaguchi","doi":"10.1177/10966218251377535","DOIUrl":null,"url":null,"abstract":"<p><p><b><i>Background:</i></b> Dyspnea is common in advanced cancer, especially with unilateral pleural effusion. Lateral positioning is widely used, but evidence of effectiveness is limited. <b><i>Objectives:</i></b> To assess the feasibility and short-term effects of affected-side-down (PLEUR-DOWN) versus affected-side-up (PLEUR-UP) positioning for dyspnea relief. <b><i>Design:</i></b> Multicenter randomized crossover pilot trial. <b><i>Setting/Subjects:</i></b> Ten patients with cancer with dyspnea were enrolled at seven hospitals in Japan. <b><i>Methods:</i></b> Patients (numerical rating scale [NRS] ≥ 3) were randomized to two sequences. Each position was maintained for five minutes within a washout period. The primary outcome was feasibility, assessed by completion, absence of carryover/period effects, and adherence. Secondary outcomes included NRS changes, patient preference, and safety. <b><i>Results:</i></b> All patients completed the trial. No significant carryover (<i>p</i> = 0.57) or period effects (<i>p</i> = 0.25) were found. Mean NRS difference favored PLEUR-DOWN (-0.9; <i>p</i> = 0.34). Half preferred PLEUR-DOWN. No adverse events occurred. <b><i>Conclusions:</i></b> The trial confirmed feasibility and supports further research.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1000,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Body Positioning for Dyspnea in Patients with Cancer with Unilateral Pleural Effusion: A Pilot Trial.\",\"authors\":\"Jun Kako, Yoshinobu Matsuda, Tomoo Ikari, Kozue Suzuki, Ryo Tachikawa, Yoshihisa Matsumoto, Satoru Miwa, Masanori Mori, Tetsu Kobayashi, Hajime Fujimoto, Atsushi Tomaru, Hitoshi Sumitani, Akira Inoue, Rintaro Koike, Shota Kobayashi, Shunsuke Oyamada, Keisuke Ariyoshi, Takashi Yamaguchi\",\"doi\":\"10.1177/10966218251377535\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b><i>Background:</i></b> Dyspnea is common in advanced cancer, especially with unilateral pleural effusion. Lateral positioning is widely used, but evidence of effectiveness is limited. <b><i>Objectives:</i></b> To assess the feasibility and short-term effects of affected-side-down (PLEUR-DOWN) versus affected-side-up (PLEUR-UP) positioning for dyspnea relief. <b><i>Design:</i></b> Multicenter randomized crossover pilot trial. <b><i>Setting/Subjects:</i></b> Ten patients with cancer with dyspnea were enrolled at seven hospitals in Japan. <b><i>Methods:</i></b> Patients (numerical rating scale [NRS] ≥ 3) were randomized to two sequences. Each position was maintained for five minutes within a washout period. The primary outcome was feasibility, assessed by completion, absence of carryover/period effects, and adherence. Secondary outcomes included NRS changes, patient preference, and safety. <b><i>Results:</i></b> All patients completed the trial. No significant carryover (<i>p</i> = 0.57) or period effects (<i>p</i> = 0.25) were found. Mean NRS difference favored PLEUR-DOWN (-0.9; <i>p</i> = 0.34). Half preferred PLEUR-DOWN. No adverse events occurred. <b><i>Conclusions:</i></b> The trial confirmed feasibility and supports further research.</p>\",\"PeriodicalId\":16656,\"journal\":{\"name\":\"Journal of palliative medicine\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-09-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of palliative medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/10966218251377535\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of palliative medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/10966218251377535","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
摘要
背景:呼吸困难在晚期癌症中很常见,尤其是单侧胸腔积液。侧卧位被广泛使用,但有效性的证据有限。目的:评估患侧朝下(PLEUR-DOWN)与患侧朝上(PLEUR-UP)体位缓解呼吸困难的可行性和短期效果。设计:多中心随机交叉试验。背景/对象:10例癌症伴呼吸困难患者来自日本7家医院。方法:将数值评定量表[NRS]≥3分的患者随机分为两组。每个体位在冲洗期间保持5分钟。主要结局是可行性,通过完成度、无结转/期效应和依从性来评估。次要结局包括NRS变化、患者偏好和安全性。结果:所有患者均完成试验。未发现显著的结转效应(p = 0.57)或周期效应(p = 0.25)。平均NRS差异有利于PLEUR-DOWN (-0.9; p = 0.34)。一半的人喜欢pleurdown。无不良事件发生。结论:本试验证实了可行性,为进一步研究提供了依据。
Body Positioning for Dyspnea in Patients with Cancer with Unilateral Pleural Effusion: A Pilot Trial.
Background: Dyspnea is common in advanced cancer, especially with unilateral pleural effusion. Lateral positioning is widely used, but evidence of effectiveness is limited. Objectives: To assess the feasibility and short-term effects of affected-side-down (PLEUR-DOWN) versus affected-side-up (PLEUR-UP) positioning for dyspnea relief. Design: Multicenter randomized crossover pilot trial. Setting/Subjects: Ten patients with cancer with dyspnea were enrolled at seven hospitals in Japan. Methods: Patients (numerical rating scale [NRS] ≥ 3) were randomized to two sequences. Each position was maintained for five minutes within a washout period. The primary outcome was feasibility, assessed by completion, absence of carryover/period effects, and adherence. Secondary outcomes included NRS changes, patient preference, and safety. Results: All patients completed the trial. No significant carryover (p = 0.57) or period effects (p = 0.25) were found. Mean NRS difference favored PLEUR-DOWN (-0.9; p = 0.34). Half preferred PLEUR-DOWN. No adverse events occurred. Conclusions: The trial confirmed feasibility and supports further research.
期刊介绍:
Journal of Palliative Medicine is the premier peer-reviewed journal covering medical, psychosocial, policy, and legal issues in end-of-life care and relief of suffering for patients with intractable pain. The Journal presents essential information for professionals in hospice/palliative medicine, focusing on improving quality of life for patients and their families, and the latest developments in drug and non-drug treatments.
The companion biweekly eNewsletter, Briefings in Palliative Medicine, delivers the latest breaking news and information to keep clinicians and health care providers continuously updated.