Yue Feng

A longitudinal study of symptom cluster latent profiles in ovarian cancer patients undergoing chemotherapy

AbstractBackgroundThis study aimed to identify distinct patterns within the symptom cluster of fatigue, pain, and sleep disturbance among ovarian cancer patients receiving chemotherapy, to determine the factors predicting these patterns and their impact on quality of life.MethodsThe longitudinal study collected data from 151 ovarian cancer patients at three time points: before chemotherapy (T0), after the first chemotherapy cycle (T1), and following the completion of four cycles of chemotherapy (T2). Latent profile analysis and latent transition analysis were used to identify symptom patterns and evaluate changes in symptom patterns. A bias‐adjusted three‐step approach was utilized to examine predictor variables and distal outcomes associated with latent class membership.ResultsThree symptom patterns emerged: “All Low,” “Moderate” (T0)/“Low pain and high sleep disturbance” (T1 and T2), and “All High.” Patients with lower educational attainment and higher levels of anxiety and depression were found to be at an elevated risk of belonging to the “All High” class. All quality‐of‐life domains showed significant differences among the three subgroups, following an “All Low” > “All High” pattern (p < 0.05). Membership in three classes remained relatively stable over time, with probabilities of 0.749 staying within their groups from T0 to T2.ConclusionsThis study underscores the existence of a diverse and heterogeneous experience within the symptom cluster of fatigue, pain, and sleep disturbance among ovarian cancer patients. Importantly, these patterns were stable throughout chemotherapy. Recognizing and understanding these patterns can inform the development of targeted interventions to alleviate the burden of symptom clusters in this population.

Efficacy and safety of cisplatin combined with paclitaxel concurrent radiotherapy in patients with locally advanced cervical squamous cell carcinoma

This study aimed to compare outcomes and adverse events of patients with locally advanced cervical cancer (LACC) undergoing concurrent chemoradiotherapy (CCRT) with cisplatin single-agent chemotherapy vs. CCRT with cisplatin combined with paclitaxel dual-agent therapy. The primary outcomes are overall survival (OS), progression-free survival (PFS), local recurrence (LR), distant metastasis (DM) and the occurrence of adverse events. This retrospective cohort study included patients with FIGO 2009 stage IB1-IVA cervical squamous cell carcinoma undergoing radical CCRT. Patients were divided into groups A and B, treatment outcomes were compared between the two groups after 1:1 proportional propensity score matching. Medical records of 1,203 patients were reviewed and 572 patients were finally included for propensity score matching. After propensity score matching, 121 pairs of patients were selected for analysis. The OS, PFS, LR and DM rates were 78.5% and 83.5% (p=0.417), 73.3% and 78.5% (p=0.312), 6.6% and 2.5% (p=0.123), 19% and 15.7% (p=0.497) for groups A and B, respectively. Further subgroup analysis according to stage and lymph node metastatic status showed no difference in survival between the two groups. The incidence of grade 3-4 acute haematological toxicities was different between the two groups (p<0.05). Cisplatin combined with paclitaxel CCRT couldn't improve the survival rates of patients with LACC. However, the hematological toxicity of combination chemotherapy is more severe but controllable. Cisplatin single-agent therapy remains the first choice for CCRT. Further prospective studies are indicated to provide evidence for the efficacy of cisplatin plus paclitaxel in dual-agent concurrent therapy.

Efficacy and Safety Analysis of Recombinant Human Endostatin (Endostar) Combined With Chemoradiotherapy for Locally Advanced Cervical Cancer: A 2-Center Retrospective Study

Background This study aims to assess the efficacy and safety of Endostar in the management of locally advanced cervical cancer. Methods This retrospective, 2-center study enrolled 41 patients with locally advanced cervical cancer between June 2017 and December 2020. The patients were subjected to a combination of Endostar and chemoradiotherapy until they experienced disease progression or an unacceptable level of toxicity. The patients in the Endostar combined chemoradiotherapy (E + CRT) and CRT groups were matched 1:1 based on clinical features, including age, disease stage, and pathological type. The therapeutic efficacy and safety outcomes were compared between the 2 groups. Results Early treatment response: the CR rates in E + CRT and CRT groups were 48.8% and 26.8%, respectively ( χ2 = 4.20, P &lt; .05). The ORR and DCR were not significantly different between the 2 groups. Long-term efficacy: there was no significant difference in the 1-year and 2-year PFS rates and OS rates between 2 groups. However, in patients with stage IIB, subgroup analyses revealed a significant difference in PFS between the 2 groups ( P &lt; .05). Prognostic factors: stage, Eastern Cooperative Oncology Group (ECOG) score, and tumor size were independent predictive factors for PFS, while ECOG score and tumor size were those of OS in patients with locally advanced cervical cancer. Safety: The incidence of grade III-IV myelosuppression was significantly lower in E + CRT group than in CRT group ( P &lt; .05). Conclusions The combination of Endostar and concurrent CRT exhibited greater efficacy in treating locally advanced cervical cancer with no severe adverse reactions, when compared to simple CRT. It is expected that this approach will evolve into a new treatment alternative for patients with locally advanced cervical cancer.

Translation and validation of the Chinese version of EORTC QLQ-SWB32 assessing the spiritual wellbeing of women with gynecological cancer

Background This study aimed to translate the internationally developed and validated European Organization for Research and Treatment of Cancer measure of spiritual wellbeing (EORTC QLQ-SWB32) into Chinese, validate the translation with women with gynecological cancer, and examine associations between demographic variables and the scales of the measure. Methods The study followed EORTC translation guidelines. After pilot testing with sixteen gynecological cancer patients, we validated the final measure with another 200 patients. We analyzed reliability using Cronbach’s alpha coefficients. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and exploratory graphic analysis (EGA) were used to analyze the construct validity. A multiple linear regression model analyzed the relationship of the factors to spiritual well-being. Results Cronbach’s alpha coefficients showed good reliability, ranging from 0.885 to 0.907 in each dimension. The EFA (KMO = 0.876, χ2 = 2865.036, df = 231, P &lt; 0.001) and EGA produced a four-dimension structure. CFA fit statistics indicated adequate fit to a four-dimension solution (χ2/df = 2.178, RMESA = 0.077, GFI = 0.973, SRMR = 0.057, CFI = 0.915, TLI = 0.902), which matched the dimensions and constituent items from the original measure. Regression analysis indicated that higher education levels correlated with higher scores on the Relationships with Others (RO) and Existential (EX) scales; unemployment with lower Relationship with Self (RS) scores, and lower incomes with lower EX scores; patients with religious beliefs scored higher on Relationship with God (RG). Conclusions The Chinese EORTC QLQ-SWB32 exhibits good reliability and validity among gynecological cancer patients, with dimensions aligning with those found in the original validation. This approved, validated instrument is now available for Chinese medical staff to use to assess the spiritual wellbeing of Chinese cancer patients and help improve understanding of the relevance of spiritual wellbeing to people from Chinese cultural backgrounds.