Exploring readiness for discharge, quality of discharge teaching, and fear of disease progression in lung cancer patients undergoing chemotherapy: A correlation analysis.

BACKGROUND: To explore the correlation between the current status of discharge preparation, quality of discharge teaching, and fear of disease progression among patients with lung cancer undergoing chemotherapy to provide a basis for improving patients' level of preparation. METHODS: In this cross-sectional study, convenience sampling was used to select 452 patients with lung cancer who received chemotherapy and were admitted to the Department of Medical Oncology of the Cancer Hospital, between February 2023 and April 2023. A general information questionnaire, discharge preparation scale, quality of discharge teaching scale, and fear of disease progression scale were used to conduct surveys 2 h before the patients were discharged. RESULTS: The score for discharge preparation among lung cancer patients with chemotherapy was 99.11 ± 14.79 and the item score was 8.26 ± 1.23. The score for quality of discharge teaching was 193.23 ± 37.69, and that for fear of disease progression was 25.47 ± 8.92. Multiple linear regression analysis showed that sex, marital status, treatment period, quality of discharge teaching, and fear of disease progression influenced discharge readiness among patients with lung cancer receiving chemotherapy. Pearson's correlation analysis showed that the total quality of the discharge guidance score was positively correlated with the discharge readiness score (r = 0.288, p < 0.001). In contrast, the total fear of disease progression score was negatively correlated with the discharge preparation score (r = -0.252, p < 0.001). CONCLUSION: Discharge readiness among patients with lung cancer receiving chemotherapy was relatively at the good level, and there was a significant correlation between readiness for discharge, discharge teaching and fear of disease progression in these patients. Therefore, it is necessary to provide effective discharge guidance and implement targeted intervention measures to further improve patient preparation, reduce the fear of disease progression, and promote patient ability of coping with the disease and overall satisfaction.

Refining penalty parameter selection in whole-body PET image reconstruction for lung cancer patients using the cross-validation log-likelihood method.

OBJECTIVE: Penalty parameters in penalized likelihood positron emission tomography (PET) reconstruction are typically determined empirically. The cross-validation log-likelihood (CVLL) method has been introduced to optimize these parameters by maximizing a CVLL function, which assesses the likelihood of reconstructed images using one subset of a list-mode dataset based on another subset. This study aims to validate the efficacy of the CVLL method in whole-body imaging for cancer patients using a conventional clinical PET scanner. APPROACH: Fifteen lung cancer patients were injected with 243.7±23.8 MBq of [18F]FDG and underwent a 22-minute PET scan on a Biograph mCT PET/CT scanner, starting at 60±5 minutes post-injection. The PET list-mode data were partitioned by subsampling without replacement, with 20 minutes used for image reconstruction using an in-house ordered subset expectation maximization algorithm and the remaining 2 minutes for cross-validation. Two penalty parameters, penalty strength ß and Fair penalty function parameter δ, were subjected to optimization. Whole-body images were reconstructed, and CVLL values were computed across various penalty parameter combinations. The optimal image corresponding to the maximum CVLL value was selected by a grid search for each patient. MAIN RESULTS: The δ value required to maximize the CVLL value was notably small (≤ 10-6 in this study). The influences of voxel size and scan duration on image optimization were investigated. A correlation analysis revealed a significant inverse relationship between optimal ß and scan count level, with a correlation coefficient of -0.68 (p-value = 3.5×10-5). The optimal images selected by the CVLL method were compared with those chosen by two radiologists based on their diagnostic preferences. Differences were observed in the selection of optimal images. SIGNIFICANCE: This study demonstrates the feasibility of incorporating the CVLL method into routine imaging protocols, potentially allowing for a wide range of combinations of injected radioactivity amounts and scan durations in modern PET imaging.

Identification of the Unique Clinical and Genetic Features of Chinese Lung Cancer Patients With EGFR Germline Mutations in a Large-Scale Retrospective Study.

BACKGROUND: Epidemiological surveys have suggested that lung cancer has inherited susceptibility and shows familial aggregation. However, the distribution and prevalence of epidermal growth factor receptor (EGFR) germline variants and their roles in lung cancer genetic predisposition in Chinese population remain to be elucidated. METHODS: In this study, EGFR germline and somatic variants were retrospectively reviewed from the next-generation sequencing results of 31,906 patients with lung cancer. Clinical information was also collected for patients with confirmed EGFR germline mutations. RESULTS: A total of 22 germline EGFR variants were identified in 64 patients with lung cancer, accounting for 0.2% of the total cases studied. Five patients were diagnosed as multiple primary carcinomas. Family history was documented in 31.3% (20/64) of patients, 55% of which were diagnosed as lung cancer. G863D was the most frequent EGFR germline mutation, followed by P848L, D1014N, and K757R. Somatic EGFR-sensitive mutations were identified in 51.6% of patients with germline EGFR mutations. The proportion of L858R mutation, exon 19 deletion, and rare sensitive mutation was 50%, 17.6%, and 32.4%, respectively. D1014N and T790M mutations were common in young patients. The family members of patients with P848L, R776H, V769M, and V774M mutations were more commonly diagnosed with cancers. A total of 19 patients were confirmed to have received EGFR tyrosine kinase inhibitors (TKIs), but the response to EGFR-TKIs differed among patients with different EGFR mutations. CONCLUSION: Chinese patients with lung cancer harbored unique and dispersive EGFR germline mutations and showed unique clinical and genetic characteristics, with varied response patterns to EGFR-TKI treatment.

Patients with lung cancer: Are electronic cigarettes harmful or useful?

E-cigarettes remain controversial because the scientific evidence of short term and long term effects on tolerance and the health value of a switch from tobacco to e-cigarettes is contested and controversial. Nevertheless the quality of e-cigarettes and e-liquids has improved. The main ingredients, propylene glycol, vegetable glycerine and nicotine are pharmaceutical-grade quality in most e-liquids. Flavors are almost all food grade. The high quality of ingredients has decreased the presence of impurities in e-liquids. The emissions of e-cigarettes do not contain solid particles or carbon monoxide. Nitrosamine content is at least one hundred times lower than in tobacco smoke. E-cigarette emissions in normal use do not contain any harmful constituents at significant levels except nicotine. UK public health authorities have stated that e-cigarette use is likely to be at least 95% less toxic than cigarette use. There are benefits from having a well-regulated legal market. In countries where e-liquid containing nicotine is not allowed, "do-it-yourself" liquids are common and have handling risks and may sometimes contain toxic impurities. Though e-cigarettes should never be assumed safe products for non-smokers, for smokers, the e-cigarette is at least 20 times less dangerous than the cigarette. Tobacco cessation specialists in countries where nicotine containing e-cigarettes are available increasingly provide counselling for e-cigarette use to stop smoking or to reduce smoking at the request of patients. Based on current knowledge, for patients with lung or other forms of cancer who would otherwise continue to smoke, e-cigarettes offer an alternative way to quit smoking while they undergo medical treatment.