RESUMO
PURPOSE: Patients with advanced pancreatic and biliary tract cancer (aPBC) frequently suffer from high symptom burden. Exercise can reduce treatment side effects and improve patient-related outcomes (PROMs). However, evidence from prospective studies regarding feasibility and efficacy in advanced settings are sparse. The primary aim of this prospective, randomized-controlled study was to evaluate the feasibility and effects of exercise (ET) in patients with aPBC. METHODS: Patients with aPBC beyond first-line therapy were randomized according to the minimization procedure with stratification by gender, age, and loss of body weight in the past six months. The intervention group (IG) completed 3 training units/week for 8 weeks (1x supervised strength sessions, 2x individualized home-based sessions). Control group (CG) received recommendations on physical activity during cancer. RESULTS: 41 patients (stage IV pancreatic or biliary tract cancer) were included no adverse events related to exercise occurred during the trial. Physical function increased significantly in IG in 5 out of 7 physical domains. Comparison of IG and CG at 8 weeks (t2) showed significant differences in favour of IG in leg press (p=0.001), bench press (p=0.011), sit-to-stand (p=0.001) and crunch (0.006). Constipation revealed a significant difference in favour of IG at t2 (p=0.033). Quality of life stabilized/increased in IG during the study period compared to a decrease in CG. Throughout/Over the 8 weeks, fatigue notably reduced in the IG (p=0.028). CONCLUSION: Exercise is safe and feasible in patients with aPBC undergoing further line therapy. Significant improvements in physical functioning and increased quality of life were achieved. German Clinical Trials Register ID: DRKS00021179; Registration date 15.05.2020.
Assuntos
Neoplasias do Sistema Biliar , Terapia por Exercício , Neoplasias Pancreáticas , Qualidade de Vida , Humanos , Neoplasias do Sistema Biliar/tratamento farmacológico , Neoplasias do Sistema Biliar/terapia , Masculino , Feminino , Neoplasias Pancreáticas/tratamento farmacológico , Idoso , Pessoa de Meia-Idade , Estudos Prospectivos , Terapia por Exercício/métodos , Estudos de ViabilidadeRESUMO
BACKGROUND: Tebentafusp has recently been approved for the treatment of metastatic uveal melanoma (mUM) after proving to have survival benefits in a first-line setting. PATIENTS AND METHODS: This retrospective, multicenter study analyzed the outcomes and safety of tebentafusp therapy in 78 patients with mUM. RESULTS: Patients treated with tebentafusp had a median PFS of 3 months (95% CI 2.7 to 3.3) and a median OS of 22 months (95% CI 10.6 to 33.4). In contrast to a published Phase 3 study, our cohort had a higher rate of patients with elevated LDH (65.4% vs. 35.7%) and included patients with prior systemic and local ablative therapies. In patients treated with tebentafusp following ICI, there was a trend for a longer median OS (28 months, 95% CI 26.9 to 29.1) compared to the inverse treatment sequence (24 months, 95% CI 13.0 to 35.0, p = 0.257). The most common treatment-related adverse events were cytokine release syndrome in 71.2% and skin toxicity in 53.8% of patients. Tumor lysis syndrome occurred in one patient. CONCLUSIONS: Data from this real-life cohort showed a median PFS/OS similar to published Phase 3 trial data. Treatment with ICI followed by tebentafusp may result in longer PFS/OS compared to the inverse treatment sequence.
Assuntos
Competência Clínica , Satisfação no Emprego , Programas Nacionais de Saúde , Jornais como Assunto , Papel do Profissional de Enfermagem , Opinião Pública , Salários e Benefícios , Adolescente , Escolha da Profissão , Feminino , Alemanha , Humanos , Masculino , Recursos Humanos de Enfermagem/educação , Recursos Humanos de Enfermagem/psicologia , Recursos Humanos de Enfermagem/provisão & distribuição , Adulto JovemAssuntos
Serviços de Saúde da Criança/organização & administração , Criança Abandonada/estatística & dados numéricos , Cuidados no Lar de Adoção/organização & administração , Infecções por HIV/mortalidade , Criança , Proteção da Criança , Pré-Escolar , Países em Desenvolvimento , Feminino , Humanos , Incidência , Lactente , Masculino , Formulação de Políticas , Política Pública , Medição de Risco , Organização Mundial da SaúdeAssuntos
Direitos Civis/legislação & jurisprudência , Esportes/legislação & jurisprudência , Estudantes/legislação & jurisprudência , Detecção do Abuso de Substâncias/legislação & jurisprudência , Adolescente , Criança , Humanos , Serviços de Enfermagem Escolar/legislação & jurisprudência , Estados UnidosAssuntos
Estupro/legislação & jurisprudência , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , África do SulAssuntos
Depressão Pós-Parto/prevenção & controle , Infanticídio/legislação & jurisprudência , Defesa por Insanidade , Serviços de Saúde Mental/legislação & jurisprudência , Proteção da Criança , Pré-Escolar , Depressão Pós-Parto/epidemiologia , Depressão Pós-Parto/etiologia , Feminino , Humanos , Recém-Nascido , Infanticídio/prevenção & controle , Saúde Mental , Serviços de Saúde Mental/normas , Texas , Saúde da MulherRESUMO
OBJECTIVES: To review privacy issues of medical information and current legal guidelines. DATA SOURCES: Government regulations and reports. CONCLUSIONS: Patients must have trust and confidence that the health care system will safeguard their health information and that it will not be used to discriminate against them through insurance or employment. IMPLICATIONS FOR NURSING PRACTICE: Health care professionals must be sensitive to the privacy needs of patients during the collection and storage of data, the access to information, and the sharing of patient information.