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2.
Anticancer Res ; 39(6): 3159-3165, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31177162

RESUMO

BACKGROUND: Patients with sarcoma are particularly vulnerable to psychosocial distress. The aim of this study was to collect preliminary data on the prevalence of psychosocial distress in such patients during follow-up care and identify risk factors associated with higher psycho-oncological stress levels. PATIENTS AND METHODS: The study retrospectively enrolled 202 patients with bone or soft-tissue sarcomas who underwent routine psychosocial distress screening during their follow-up care. All patients were screened using an electronic cancer-specific questionnaire. RESULTS: Females and patients who underwent radiotherapy were more distressed. Psychosocial distress levels were markedly higher in the early postoperative phase, but approximately one-third of patients showed high psychosocial distress levels even more than 2 years postoperatively. CONCLUSION: The results underscore the importance of routine psychosocial distress screenings in patients with sarcoma, which should be performed throughout the follow-up period.


Assuntos
Assistência ao Convalescente/psicologia , Neoplasias Ósseas/terapia , Saúde Mental , Osteossarcoma/terapia , Sarcoma/terapia , Neoplasias de Tecidos Moles/terapia , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Inquéritos e Questionários , Adaptação Psicológica , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/psicologia , Efeitos Psicossociais da Doença , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Osteossarcoma/diagnóstico , Osteossarcoma/psicologia , Valor Preditivo dos Testes , Dados Preliminares , Prevalência , Estudos Retrospectivos , Fatores de Risco , Sarcoma/diagnóstico , Sarcoma/psicologia , Neoplasias de Tecidos Moles/diagnóstico , Neoplasias de Tecidos Moles/psicologia , Estresse Psicológico/diagnóstico , Fatores de Tempo , Adulto Jovem
3.
Braz J Psychiatry ; 41(6): 540-545, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31116262

RESUMO

OBJECTIVES: To evaluate the effects of mindfulness-based stress reduction (MBSR) combined with music therapy (MT) on clinical symptoms in patients with osteosarcoma. METHODS: Patients diagnosed with osteosarcoma were assessed for eligibility. A total of 101 patients were ultimately randomized into the intervention and control groups. Both groups received routine care. Eight sessions of MBSR and MT psychotherapy were conducted in the intervention group, while the control group received no psychological intervention. Patients were assessed regarding pain, anxiety, and sleep quality at two distinct stages: before and after the intervention. RESULTS: There were no significant differences in sociodemographic and clinical parameters between the intervention and control groups at baseline. The intervention program significantly alleviated psychological and physiological complications in patients with osteosarcoma. Specifically, the study revealed that 8 weeks of the combined MBSR/MT intervention effectively reduced pain and anxiety scores and improved the quality of sleep in patients. CONCLUSION: MBSR combined with MT significantly alleviated clinical symptoms, and could be considered a new, effective psychotherapeutic intervention for patients with osteosarcoma.


Assuntos
Ansiedade/prevenção & controle , Neoplasias Ósseas/psicologia , Atenção Plena/métodos , Musicoterapia/métodos , Osteossarcoma/psicologia , Dor/prevenção & controle , Sono/fisiologia , Adolescente , Adulto , Neoplasias Ósseas/fisiopatologia , Criança , Feminino , Humanos , Masculino , Osteossarcoma/fisiopatologia , Dor/psicologia , Medição da Dor , Qualidade de Vida/psicologia , Estresse Psicológico/prevenção & controle , Estresse Psicológico/psicologia , Inquéritos e Questionários , Escala de Ansiedade Frente a Teste , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
4.
J Glob Oncol ; 4: 1-11, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30241221

RESUMO

PURPOSE: Health-related quality of life (HRQOL) improves throughout treatment of patients with nonmetastatic osteosarcoma. We compared HRQOL for patients in the United States and Chile treated on an international trial (OS99) with polychemotherapy and surgery, and we assessed the relationships among HRQOL measures, event-free survival (EFS), and overall survival (OS). MATERIALS AND METHODS: Patients with newly diagnosed, localized osteosarcoma and their parents completed three HRQOL instruments (PedsQL v.4, PedsQL Cancer v.3, and Symptom Distress Scale [SDS]). Data were collected at four time points throughout therapy. Repeated measures models were used to investigate the effect of treatment site on instrument scores. The log-rank test examined the impact of treatment site on survival outcomes, and Cox proportional hazards regression models evaluated baseline HRQOL measures as predictors of EFS and OS. RESULTS: Of 71 eligible patients, 66 (93%) participated in the HRQOL studies in the United States (n = 44) and Chile (n = 22). The median age was 13.4 years (range, 5 to 23 years). Clinical characteristics were similar between treatment sites. US patients reported better scores for physical ( P = .030), emotional ( P = .027), and school functioning ( P < .001). Chilean patients reported poorer scores for worry ( P < .001) and nausea ( P = .007). Patient and parent nausea scores were similar between patients treated in the United States and Chile by the end of therapy. Differences in symptom distress were not observed between the countries. Neither HRQOL measures nor treatment site were associated with EFS or OS. CONCLUSION: Although significant differences in HRQOL were observed between countries, outcomes were similar, and HRQOL measures were not associated with prognosis.


Assuntos
Neoplasias Ósseas , Osteossarcoma , Adolescente , Adulto , Neoplasias Ósseas/mortalidade , Neoplasias Ósseas/psicologia , Neoplasias Ósseas/terapia , Criança , Pré-Escolar , Chile , Feminino , Recursos em Saúde , Humanos , Masculino , Osteossarcoma/mortalidade , Osteossarcoma/psicologia , Osteossarcoma/terapia , Qualidade de Vida , Resultado do Tratamento , Estados Unidos , Adulto Jovem
5.
J Plast Reconstr Aesthet Surg ; 71(12): 1730-1739, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30236876

RESUMO

BACKGROUND: Sacrectomy is a rare and demanding surgical procedure that results in major soft tissue defects and spinopelvic discontinuity. No consensus is available on the optimal reconstruction algorithm. Therefore, the present study evaluated the results of sacrectomy reconstruction and its impact on patients' quality of life (QOL). METHODS: A retrospective chart review was conducted for 21 patients who underwent sacrectomy for a primary bone tumour. Patients were divided into groups based on the timing of reconstruction as follows: no reconstruction, immediate reconstruction or delayed reconstruction. QOL was measured using the EQ-5D instrument before and after surgery in patients treated in the intensive care unit. RESULTS: The mean patient age was 57 (range 22-81) years. The most common reconstruction was gluteal muscle flap (n = 9) and gluteal fasciocutaneous flap (n = 4). Four patients required free-tissue transfer, three latissimus dorsi flaps and one vascular fibula bone transfer. No free flap losses were noted. The need for unplanned re-operations did not differ between groups (p = 0.397), and no significant differences were found for pre- and post-operative QOL or any of its dimensions. DISCUSSION: Free flap surgery is reliable for reconstructing the largest sacrectomy defects. Even in the most complex cases, surgery can be safely staged, and final reconstruction can be carried out within 1 week of resection surgery without increasing peri­operative complications. Sacrectomy does not have an immoderate effect on the measured QOL.


Assuntos
Condrossarcoma/cirurgia , Cordoma/cirurgia , Osteossarcoma/cirurgia , Sacro/cirurgia , Neoplasias da Coluna Vertebral/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Condrossarcoma/psicologia , Cordoma/psicologia , Feminino , Fíbula/transplante , Retalhos de Tecido Biológico , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/transplante , Osteossarcoma/psicologia , Qualidade de Vida , Estudos Retrospectivos , Neoplasias da Coluna Vertebral/psicologia , Resultado do Tratamento , Adulto Jovem
6.
Integr Cancer Ther ; 17(3): 928-940, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29900751

RESUMO

BACKGROUND: Pediatric cancer patients experience different psychological processes during hospitalization that may regulate the immune response and affect recovery and response to cancer treatment. In this study, we aimed to examine the feasibility of longitudinal testing of psychophysiological parameters of stress and fatigue in pediatric osteosarcoma patients hospitalized for chemotherapy submitted to clown intervention; and to investigate whether changes in the levels of biomarkers are associated with psychological stress and fatigue levels in these patients after the clown intervention. METHODS: A pretest-posttest quasi-experimental pilot study was conducted at the pediatric oncology inpatient unit in a comprehensive cancer care center in Brazil including children and adolescents with osteosarcoma hospitalized for chemotherapy. Eight saliva samples were collected, comprising 4 at baseline (pre-intervention) and 4 after the clown intervention (+1, +4, +9, and +13 hours post-awakening). Salivary cortisol, α-amylase (sAA), cytokines, and matrix metalloproteinase-9 (MMP-9) levels were determined using high-sensitivity enzyme-linked immunosorbent assay (ELISA) kits. Stress and fatigue were measured by Child Stress Scale-ESI and PedsQL Multidimensional Fatigue Scale respectively. Bivariate association analysis between stress and fatigue scores and biomarker levels were investigated using nonparametric statistics. Effect sizes were calculated for each outcome variable. RESULTS: Six pediatric osteosarcoma patients were enrolled with no missing data. No significant effects sizes were observed for psychophysiological outcomes. Effect sizes ranged from 0.54 (cortisol) to 0 (interleukin-1ß [IL-1ß]). Decreasing overall trends were observed for cortisol levels for all 6 pediatric osteosarcoma patients over time. In addition, a similar pattern of tumor necrosis factor-α (TNF-α) levels over time was found for all 6 patients. Patients with metastatic osteosarcoma showed a linear trend for a decrease in MMP-9 levels between 1 and 9 hours after the clown intervention and restoration to basal levels after 13 hours. CONCLUSIONS: The results of this pilot study suggest that it is feasible longitudinally measure psychophysiological outcomes in the pediatric osteosarcoma inpatients for chemotherapy. Clown intervention merits further study as a way to reduce stress as well as fatigue, since that the stress and cytokines measurements are feasible based on our work.


Assuntos
Biomarcadores , Neoplasias Ósseas , Fadiga/diagnóstico , Felicidade , Osteossarcoma , Terapia Recreacional/métodos , Estresse Psicológico/diagnóstico , Adolescente , Afeto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biomarcadores/análise , Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/psicologia , Neoplasias Ósseas/terapia , Criança , Fadiga/etiologia , Fadiga/psicologia , Fadiga/terapia , Feminino , Humanos , Masculino , Osteossarcoma/diagnóstico , Osteossarcoma/psicologia , Osteossarcoma/terapia , Projetos Piloto , Autorrelato , Estresse Psicológico/etiologia , Estresse Psicológico/prevenção & controle , Estresse Psicológico/psicologia
7.
Musculoskelet Surg ; 102(2): 147-151, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29030830

RESUMO

PURPOSE: This study aimed to evaluate the psychometric properties of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) in Iranian osteosarcoma patients and apply this to compare the functional level, quality of life, symptoms and financial burden of the patients who underwent amputation and limb-salvage operations. METHODS: This study was conducted at the main referral orthopedic centers in the southwest of Iran from 2006 to 2016. After complete review of medical records, 48 patients were invited to attend the outpatient clinic and participate in the study via initial telephone interview. All data were entered in the Statistical Package for the Social Sciences version 15.0, and p values <0.05 were considered statistically significant. RESULTS: In total, 48 patients with extremities osteosarcoma completed the study. Of these, 31 had been treated with limb-salvage operation and 17 had undergone amputation. In functioning subscale, all the mean score of items, except social function, were higher in the limb salvage group than the amputee group. The mean scores (SD) of global health and quality of life were 64.5(13.2) and 61.2± 12.4 in the limb salvage and amputee groups, respectively. In the financial impact subscale, the mean score (SD) in the limb salvage group was 68.8± (29.7) compared to 74.5(25.0) in the amputee group. CONCLUSION: Results support the responsiveness of the EORTC QLQ-C30 for Iranian osteosarcoma patients. Applying this questionnaire revealed similar functional outcome, quality of life, symptoms and financial burden between amputation and limb-salvage groups.


Assuntos
Amputação , Neoplasias Ósseas/cirurgia , Salvamento de Membro/métodos , Osteossarcoma/cirurgia , Sobreviventes/psicologia , Adulto , Amputação/economia , Amputação/psicologia , Imagem Corporal , Neoplasias Ósseas/economia , Neoplasias Ósseas/psicologia , Estudos Transversais , Extremidades , Feminino , Humanos , Renda , Irã (Geográfico) , Salvamento de Membro/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Osteossarcoma/economia , Osteossarcoma/psicologia , Satisfação do Paciente , Complicações Pós-Operatórias/economia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/psicologia , Psicometria , Qualidade de Vida , Recuperação de Função Fisiológica , Estudos Retrospectivos , Apoio Social , Inquéritos e Questionários , Resultado do Tratamento , Adulto Jovem
8.
Artigo em Inglês | MEDLINE | ID: mdl-28657211

RESUMO

It remains unclear if quality of life (QoL) improvements could be expected in young patients after malignant bone tumour surgery after 2 years. To assess the course of QoL over time during a long-term follow-up, malignant bone tumour survivors of a previous short-term study were included. Assessments were done at least 5 years after surgery. QoL was measured with Short-form (SF)-36, TNO-AZL Questionnaire for Adult's Quality of Life (TAAQOL) and Bone tumour (Bt)-DUX. QoL throughout the follow-up was analysed by linear mixed model analysis. From the original cohort of 44 patients; 20 patients were included for this study, 10 males; mean age at surgery 15.1 years and mean follow-up 7.2 years. Twenty-one patients of the initial cohort (47%) deceased. Fifteen patients (75%) underwent limb-salvage and five (25%) ablative surgery. QoL improved significantly during follow-up at Physical Component Summary Scale scale of the SF-36 and TAAQOL and all subscales of the Bt-DUX (p < .01). No significant differences were found between current evaluations and previous evaluations at 2 years after surgery (p = .41-.98). Significant advantages after limb-salvage were seen at the PCS scale of the SF-36 (MD 13.7, p = .05) and the cosmetic scale of the Bt-DUX (MD 17.7, p = .04).


Assuntos
Neoplasias Ósseas/cirurgia , Articulação do Joelho/cirurgia , Osteossarcoma/cirurgia , Qualidade de Vida , Adolescente , Neoplasias Ósseas/psicologia , Feminino , Seguimentos , Humanos , Assistência de Longa Duração , Masculino , Osteossarcoma/psicologia , Terapia de Salvação/métodos , Adulto Jovem
9.
In Vivo ; 31(3): 443-450, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28438877

RESUMO

BACKGROUND: Psychosocial distress can be frequently observed in patients with sarcoma, depicting a relevant clinical problem. However, prospective data collection on psychosocial distress in patients with rare tumors is often time-consuming. In this context, social media such as Facebook can serve as a potential platform to expand research. The aim of this study was to assess the feasibility of psychosocial distress screening in patients with osteosarcoma and Ewing's sarcoma via social media. MATERIALS AND METHODS: For this study an online questionnaire including general information and self-assessment distress measurement tools for patients and parents was created. The link to the questionnaire was then posted on the main page of the two largest disease-specific Facebook communities on osteosarcoma and Ewing's sarcoma. RESULTS: Within 2 months, 28 patients and 58 parents of patients were enrolled. All patients with osteosarcoma and Ewing's sarcoma, as well as the majority of parental caregivers of such patients, showed relevant psychosocial distress levels. CONCLUSION: Crowdsourcing via disease-specific patient communities on Facebook is feasible and provides great potential for acquisition of medical data of rare diseases.


Assuntos
Cuidadores/psicologia , Transtornos Mentais/psicologia , Sarcoma/psicologia , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Sistemas On-Line , Osteossarcoma/psicologia , Sarcoma de Ewing/psicologia , Mídias Sociais , Inquéritos e Questionários , Adulto Jovem
10.
Pain ; 157(6): 1239-47, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27186713

RESUMO

Recent studies have suggested that in humans and animals with significant skeletal pain, changes in the mechanical hypersensitivity of the skin can be detected. However, whether measuring changes in skin hypersensitivity can be a reliable surrogate for measuring skeletal pain itself remains unclear. To explore this question, we generated skeletal pain by injecting and confining GFP-transfected NCTC 2472 osteosarcoma cells unilaterally to the femur of C3H male mice. Beginning at day 7 post-tumor injection, animals were administered vehicle, an antibody to the P2X3 receptor (anti-P2X3) or anti-NGF antibody. Pain and analgesic efficacy were then measured on days 21, 28, and 35 post-tumor injection using a battery of skeletal pain-related behaviors and von Frey assessment of mechanical hypersensitivity on the plantar surface of the hind paw. Animals with bone cancer pain treated with anti-P2X3 showed a reduction in skin hypersensitivity but no attenuation of skeletal pain behaviors, whereas animals with bone cancer pain treated with anti-NGF showed a reduction in both skin hypersensitivity and skeletal pain behaviors. These results suggest that although bone cancer can induce significant skeletal pain-related behaviors and hypersensitivity of the skin, relief of hypersensitivity of the skin is not always accompanied by attenuation of skeletal pain. Understanding the relationship between skeletal and skin pain may provide insight into how pain is processed and integrated and help define the preclinical measures of skeletal pain that are predictive end points for clinical trials.


Assuntos
Comportamento Animal/fisiologia , Neoplasias Ósseas/fisiopatologia , Dor do Câncer/fisiopatologia , Osteossarcoma/fisiopatologia , Pele/fisiopatologia , Animais , Neoplasias Ósseas/psicologia , Dor do Câncer/psicologia , Linhagem Celular Tumoral , Modelos Animais de Doenças , Hiperalgesia/fisiopatologia , Hiperalgesia/psicologia , Masculino , Camundongos , Camundongos Endogâmicos C3H , Transplante de Neoplasias , Osteossarcoma/psicologia
12.
J Surg Oncol ; 113(2): 229-34, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26714610

RESUMO

BACKGROUND AND OBJECTIVES: Among several long-term effects, people treated for cancer may experience an altered appearance. Our study aims to identify how visible body changes following surgical treatment affect the life and identity of primary bone sarcoma survivors 3-10 years after diagnosis. A qualitative, phenomenological, and hermeneutic design was applied. METHODS: Sarcoma survivors (n = 18) who were previously treated at Norwegian Radium Hospital, Oslo University Hospital, participated in the study. In-depth and semi-structured interviews were conducted and analyzed using inductive thematic analysis. RESULTS: The main finding of this study concerned how altered appearance after bone cancer treatment in the hip/pelvis or lower extremities affected the participants' self-esteem. Half of the participants expressed concerns about their visible differences, particularly those with functional impairment. They felt that it is important to hide the bodily signs of changes to appear as normal as possible, as well as attractive and healthy. They describe, with specific examples, how these changes influence their self-realization, especially their social life. CONCLUSIONS: Healthcare providers who guide bone sarcoma survivors during follow-up should develop a comprehensive understanding of what it means to cope with a changed and challenging body.


Assuntos
Imagem Corporal , Neoplasias Ósseas/cirurgia , Osteossarcoma/cirurgia , Qualidade de Vida , Sobreviventes , Adaptação Psicológica , Adulto , Neoplasias Ósseas/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteossarcoma/psicologia , Pesquisa Qualitativa , Autoimagem , Autorrelato , Sobreviventes/psicologia , Sobreviventes/estatística & dados numéricos
13.
Anticancer Res ; 35(11): 6081-90, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26504033

RESUMO

BACKGROUND: Our study aimed to explore how survivors of osteosarcoma of the lower extremity experience physical and psychosocial late effects several years after undergoing arduous treatment. A qualitative, phenomenological and hermeneutic approach was applied. MATERIALS AND METHODS: Osteosarcoma survivors (n=8) previously treated at the Norwegian Radium Hospital, Oslo University Hospital, participated in the study. In-depth and semi-structured interviews were conducted. The interviews were analyzed using inductive thematic analysis. RESULTS: Three to ten years after diagnosis, the majority of participants had experienced both negative and positive consequences following treatment. Changes in activity and exclusion from participation in different areas were the most challenging consequences. Several of their experiences are similar to those described by people with disabilities. CONCLUSION: It is important to understand osteosarcoma survivors' own experiences in order to assist those who struggle to reorient in life and to construct a new identity for themselves.


Assuntos
Neoplasias Ósseas/psicologia , Osteossarcoma/psicologia , Pesquisa Qualitativa , Qualidade de Vida , Sobreviventes/psicologia , Adolescente , Adulto , Neoplasias Ósseas/terapia , Terapia Combinada , Feminino , Seguimentos , Humanos , Infertilidade , Relações Interpessoais , Masculino , Pessoa de Meia-Idade , Osteossarcoma/terapia , Prognóstico , Autoimagem , Suécia , Adulto Jovem
14.
BMC Musculoskelet Disord ; 15: 453, 2014 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-25539904

RESUMO

BACKGROUND: We tried to compare the functional and psychosocial outcomes after various reconstruction methods according to tumor location following resection of osteosarcoma in distal femur. METHODS: We retrospectively reviewed 51 patients who underwent limb-salvage surgery of osteosarcoma in distal femur in our institution, 30 males and 21 females with an average age of 21 years (range 13-51 years). We classified osteosarcoma in distal femur into 3 types, and organized affected limb reconstruction methods after wide resection. MSTS and QOL scores were used to analyze the functional and psychological outcomes. RESULTS: After a mean follow-up of 43 months (12-225 months), there is no difference on functional results and QOL scores among three reconstruction groups (p > 0.05) and among three types groups (p > 0.05). No difference could be noticed on tumor-free survival and total survival among three reconstruction groups (p > 0.05) and three type groups (p > 0.05). In ≤2-year, better functional scores could be found in prosthesis group, rather than the other two inactivated-bone groups (p < 0.05). CONCLUSIONS: Biological reconstruction with alcohol-inactivated autograft replantation could avoid prosthesis related complications and achieved comparable results with prosthesis following resection of osteosarcoma in distal femur. Different reconstruction options could be chosen according to tumor location, such as the distance to Insall line.


Assuntos
Neoplasias Femorais/diagnóstico , Neoplasias Femorais/cirurgia , Salvamento de Membro/métodos , Osteossarcoma/diagnóstico , Osteossarcoma/cirurgia , Qualidade de Vida , Adolescente , Adulto , Feminino , Neoplasias Femorais/psicologia , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Osteossarcoma/psicologia , Qualidade de Vida/psicologia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
15.
Rev Invest Clin ; 66(2): 121-8, 2014.
Artigo em Espanhol | MEDLINE | ID: mdl-24960321

RESUMO

INTRODUCTION. Previously, amputation was the only treatment option for patients with malignant bone tumors. Due to technological, medical and surgical advances, the number of survivors and years of survival has been increasing, and thus, the interest in evaluating the impact of this disease on quality of life. OBJECTIVE. To evaluate the health related quality of life reported by patients with bone tumors undergoing different treatments (no surgery/amputation/salvage). MATERIAL AND METHODS. Patients (n = 85) with bone tumors over the age of 18, both sexes, from the Instituto Nacional de Rehabilitación of Mexico City were included, divided into three groups according to type of treatment. The study design was cross-sectional, descriptive of a nonrandom sample. Quality of life was assessed with the Inventory of Quality of Life and Health (InCaViSa). Data were analyzed using descriptive statistics, comparisons between patients with different treatments were evaluated with multivariate analysis of covariance and Sidak post hoc tests. RESULTS. Statistically significant differences were detected in six of the twelve areas of quality of life that are assessed by the scale: physical functioning, isolation, body perception, treatment attitude leisure time and daily life. Health related quality of life in the study group is best for those patients who received amputation compared with the other treatments, while patients limb salvage procedures are those with greater impairment.


Assuntos
Neoplasias Ósseas/terapia , Qualidade de Vida , Adolescente , Adulto , Idoso , Amputação , Neoplasias Ósseas/psicologia , Estudos Transversais , Feminino , Tumor de Células Gigantes do Osso/psicologia , Tumor de Células Gigantes do Osso/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Osteossarcoma/psicologia , Osteossarcoma/terapia , Terapia de Salvação , Sarcoma/psicologia , Sarcoma/terapia , Adulto Jovem
16.
Eur J Oncol Nurs ; 18(3): 267-72, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24656419

RESUMO

PURPOSE: Adolescents experience physical and psychosocial changes as part of their normal development. It can be hypothesized that they have lower scores on Quality of Life (QoL) and self-perception when additional changes occur due to cancer treatment. The purpose of our study was to assess self-perception and QoL of adolescents during or up to three months after adjuvant treatment for a primary malignant bone tumour. METHODS: Ten adolescent patients (median age of 15 years) were included. Every patient was matched with two healthy peers. Participants completed the dutch version of the Self Perception Profile of Adolescents (SPPA) to measure self-perception and the KIDSCREEN-52 questionnaire for QoL. For both instruments, normative data were available. RESULTS: Adolescents with a bone tumour had consistently lower scores on QoL as compared to healthy peers. Significantly on domains: physical well-being (P < 0.002), autonomy (P = 0.02), social support (P = 0.04) and school environment (P = 0.02). Scores on self-perception in this group were similar in both the study and control group. CONCLUSIONS: Adolescents with a primary malignant bone tumour during or up to three months after adjuvant treatment had lower scores on QoL (KIDSCREEN-52), significantly on domains of physical well-being and social functioning. Unlike most other quality of life instruments, the KIDSCREEN-52 contains different areas of social functioning and has shown to be a useful instrument in our patient group. Scores on self-perception in this group were similar in both study and control group.


Assuntos
Neoplasias Ósseas/psicologia , Neoplasias Ósseas/terapia , Osteossarcoma/psicologia , Osteossarcoma/terapia , Qualidade de Vida , Autoimagem , Adolescente , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Masculino , Países Baixos
17.
Clin Orthop Relat Res ; 471(12): 4020-6, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23917993

RESUMO

BACKGROUND: The Musculoskeletal Tumor Society (MSTS) rating scale is an English-language instrument used worldwide to assess functional evaluation of patients with musculoskeletal cancer. Despite its use in several studies in English-speaking countries, its validity for assessing patients in other languages is unknown. The translation and validation of widely used scales can facilitate the comparison across international patient samples. OBJECTIVES/PURPOSES: The objectives of this study were (1) to translate and culturally adapt the MSTS rating scale for functional evaluation in patients with lower extremity bone sarcomas to Brazilian Portuguese; (2) analyze its factor structure; and (3) test the reliability and (4) validity of this instrument. METHOD: The MSTS rating scale for lower limbs was translated from English into Brazilian Portuguese. Translations were synthesized, translated back into English, and reviewed by a multidisciplinary committee for further implementation. The questionnaire was administered to 67 patients treated for malignant lower extremity bone tumors who were submitted to limb salvage surgery or amputation. They also completed a Brazilian version of the Toronto Extremity Salvage Score (TESS). Psychometric properties were analyzed including factor structure analysis, internal consistency, interobserver reliability, test-retest reliability, and construct validity (by comparing the adapted MSTS with TESS and discriminant validity). RESULTS: The MSTS rating scale for lower limbs was translated and culturally adapted to Brazilian Portuguese. The MSTS-BR proved to be adequate with only one latent dimension. The scale was also found to be reliable in a population that speaks Brazilian Portuguese showing good internal consistency (Cronbach's alpha = 0.84) and reliability (test-retest reliability and interobserver agreement of 0.92 and 0.98, respectively). Validity of the Brazilian MSTS rating scale was proved by moderate with TESS and good discriminant validity. CONCLUSIONS: The Brazilian version of the MSTS rating scale was translated and validated. It is a reliable tool to assess functional outcome in patients with lower extremity bone sarcomas. It can be used for functional evaluation of Brazilian patients and crosscultural comparisons.


Assuntos
Neoplasias Ósseas/diagnóstico , Extremidade Inferior/cirurgia , Osteossarcoma/diagnóstico , Adolescente , Adulto , Neoplasias Ósseas/psicologia , Neoplasias Ósseas/cirurgia , Brasil , Avaliação da Deficiência , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteossarcoma/psicologia , Osteossarcoma/cirurgia , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários , Traduções
18.
J Pediatr Hematol Oncol ; 35(4): 271-5, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23612378

RESUMO

BACKGROUND: This study has been performed to examine the currently used doses of folinic acid (FA) and to determine the importance of the dose of FA in preventing subtle neurotoxicity. Thirty osteosarcoma patients were an appropriate population studied as they have no intrinsic neurological involvement. The neuropsychological and psychosocial status was tested in 2 groups of patients treated with similar protocols containing repeated doses of high-dose methotrexate, but different doses of FA. The patients received 300 to 600 mg/m or 120 to 250 mg/m FA in their protocols. METHODS: Eighteen tests or subtests of neuropsychological assessment were tested. RESULTS: Eleven of 18 tests were significant at the P=0.025 level favoring the group treated with high dose of FA. There were no clear results in the psychosocial measures with only a single measure of self-esteem (understanding) being significantly higher (P=0.024) in the group treated with high dose of FA, other measures had no statistical significance. CONCLUSIONS: A correlation between a higher dose of FA after high-dose methotrexate and a better neuropsychological status was clearly shown. The doses of FA used in the low FA group, 120 to 250 mg/m, were similar to those used by several groups treating children with leukemia; some have used even lower doses and report gross neurotoxicity.


Assuntos
Neoplasias Ósseas/tratamento farmacológico , Leucovorina/administração & dosagem , Metotrexato/efeitos adversos , Síndromes Neurotóxicas/prevenção & controle , Síndromes Neurotóxicas/psicologia , Osteossarcoma/tratamento farmacológico , Adolescente , Adulto , Antimetabólitos Antineoplásicos/administração & dosagem , Antimetabólitos Antineoplásicos/efeitos adversos , Neoplasias Ósseas/psicologia , Relação Dose-Resposta a Droga , Feminino , Humanos , Masculino , Metotrexato/administração & dosagem , Testes Neuropsicológicos , Síndromes Neurotóxicas/etiologia , Osteossarcoma/psicologia , Adulto Jovem
19.
J Surg Oncol ; 107(4): 353-9, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22806913

RESUMO

PURPOSE: To translate the Dutch DUX questionnaire for lower extremity bone tumor patients (Bt-DUX), a disease-specific quality of life (QoL) instrument, into the English (UK) language and preliminary validate the English version in patients who were treated for lower-extremity bone tumors. METHODS: Adaptation and translation process included forward translation, back-translation, and a review of the back-translation by an expert committee. Internal consistency and validity of the translated questionnaire were examined in a sample of adolescents treated for lower extremity osteosarcoma in the United Kingdom. Assessments included the Bt-DUX, the Toronto Extremity Salvage Score (TESS), the Short Form (SF)-36, and the TNO-AZL Questionnaire for Adult's Quality of Life (TAAQOL). RESULTS: Seventeen patients (7 ♂ and 10 ♀), median age 19.9 (range: 16-25) years completed the questionnaires. Mean Bt-DUX score was 38.8 (range: 23-78), with Cronbach's α being 0.95 domain-total correlations ranged between 0.84 and 0.93 (P < 0.01). Spearman's correlation coefficients between the Bt-DUX total and domain scores and corresponding TAAQOL and SF-36 scores were overall moderate to good and reaching statistical significance in a most cases. CONCLUSION: Preliminary evidence suggests that the English Bt-DUX translation is a valid disease-specific instrument for evaluating QoL of adolescents with lower extremity bone cancer.


Assuntos
Neoplasias Ósseas , Extremidade Inferior , Procedimentos Ortopédicos , Osteossarcoma , Qualidade de Vida , Inquéritos e Questionários , Atividades Cotidianas , Adolescente , Adulto , Amputação , Neoplasias Ósseas/psicologia , Neoplasias Ósseas/cirurgia , Feminino , Nível de Saúde , Humanos , Linguagem , Extremidade Inferior/patologia , Masculino , Países Baixos , Procedimentos Ortopédicos/métodos , Osteossarcoma/psicologia , Osteossarcoma/cirurgia , Implantação de Prótese , Psicometria , Inquéritos e Questionários/normas , Tradução , Traduções , Transplante Autólogo , Reino Unido
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