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Cognitive function changes and associated factors in patients receiving chemotherapy
abstracts
Annals of Oncology
CN79
Cognitive function changes and associated factors in patients receiving chemotherapy
E. Dil1, G. Bagcivan2 1 Medical Oncology, Istanbul Sultan Abdulhamid Han Egitim ve Arastirma Hastanesi, Istanbul, Turkey, 2School of Nursing, Koc University, Istanbul, Turkey
CN80
M. Bosch-Damas1, M. Rodriguez-Reyes2, M. Cervera-Carbonell1, N. Borras-Maixenchs1, E. Carcelero-San Martın2, G. Riu-Viladoms2, M. Valverde-Bosch1, G. Gutierrez-Garcia1 1 ICMHO, Hospital Clınic Barcelona, Barcelona, Spain, 2Pharmacy, Hospital Clınic Barcelona, Barcelona, Spain Background: The oral, fixed-combination NEPA containing netupitant and palonosetron target crucial pathways involved in both acute and delayed chemotherapy-induced nausea and vomiting (CINV) in patients with highly emetogenic chemotherapy.Hematopoietic stem cell transplantation (HSCT) is associated with infectious complications, especially bloodstream infections (BSI). The risk factors associated with BSI include presence of indwelling vascular catheters. NEPA eliminates accessing intravenous catheters leading to a decreased risk of infection in HSCT recipients.There is a paucity of studies about the management of CINV during preparative regimens for HSCT. The aim of this study was to assess the safety of NEPA during and after HSCT conditioning. Methods: Patients with chronic myeloid leukemia, multiple myeloma, myelodysplastic syndrome, and acute myeloid leukemia who received an allogeneic HSCT between 2017 and 2018 were retrospective studied. Conditioning regimen consisted of fludarabine and busulfan. Graft versus host disease prophylaxis was done with high-dose cyclophosphamide on days þ3 to þ 4 post-HSCT. Patients received a single capsule of NEPA prior to conditioning regimen and before cyclophosphamide, both with oral dexamethasone on days 1-3 . Safety was assessed by evaluation of adverse events and use of rescue medications (baclofen for hiccups and lactitol, macrogol and sennosides for constipation). Results: Six patients were included: 4/6were male and median age was 50 years (IQR: 46-53 years). Two patients reported hiccups needing baclofen and 6 required rescue medications for constipation. Five out of six patients presented neutropenic enterocolitis on day þ7, oral intake was stopped in 4 of them, total parenteral nutrition was started in 3 cases, 3 patients required extra antibiotic coverage, and 4 received analgesic therapy. All patients improved with conservative measures. Conclusions: In this real-world observational study, the incidence of neutropenic enterocolitis was considerably higher than previous reports in HSCT recipients. It may be associated with NEPA administration but future studies will be needed to confirm this relationship. Legal entity responsible for the study: Hospital Clınic Barcelona. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
Prevention of dental complications in patients with multiple myeloma (MM) receiving bisphosphonates treatment
C.L. Puigmarti, N. Santos, S. Mostacedo, Y. Gonzalez Haematology, Catalan Institute of Oncology (ICO)-Hospital Universitari Josep Trueta, Girona, Spain Background: Thanks to the new therapeutic strategies, the patients with MM live longer, but with complex chronic disease and with a diversity of supportive treatments that are increasingly complex. The bisphosphonates are important part of these therapeutic options for them. The aim of this study is to describe four clinical cases presenting dental complications and to define the prevention actions they needed. Methods: A series of cases study. Sample 4 cases with MM patients in treatment with bisphosphonates attended by Functional Unit during 6 months in 2018. Variables recruited were dental complications, nurses’ activities, clinical implications and type of treatment received. Results: From October-2018 to March-2019, a total of 32 patients with MM have been received intravenous bisphosphonates treatment. Four of them (12.5%) have presented dental complications that are following: Two patients (# 68 years old and $ 68) have needed a 6 months of bisphosphonates interruption to have a dental extraction One patient (# 51 years) has delayed 15 days his autologous stem cell transplantation due to dental extraction with infection One patient (# 69 years) has delayed one month his autologous stem cell because of a dental fistula that needed surgical intervention Preventive nurses’ measures included: dental assessment prior to bisphosphonate initiation so that any invasive dental procedures could be completed prior to initiation the therapy. It is crucial to include prevention in the health system to avoid increasing financial toxicity for patients & families. Conclusions: All the patients with dental complications affected and delayed the planned treatment. A preventive approach with oral care before and during treatment with bisphosphonates can minimize the occurrence of complications associated with treatment and avoid interruptions since extractions are contraindicated and endodontic treatment should be performed under conditions that ensure no trauma to bone tissue. Nurses should be aware that MM patient treatment depends not only on antimyeloma treatments but, also on supportive measures to improve their quality of life and avoid complications. Legal entity responsible for the study: Cesca Llopis. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
Volume 30 | Supplement 5 | October 2019
Safety profile of oral netupitant/palonosetron in hematopoietic stem cell transplantation recipients
CN82
Symptomatic and toxicity management of cancer patients using a telephone support model led by the oncology nurse
G. Sim o1, C. Royo2, E. Mahia2, E. Baille´s2, S. Echevarria2, A. Berenguer2, S. Albiol2 Oncology Department, Hospital Nostra Senyora de Meritxell, Escaldes-Engordany, Andorra, 2Oncology, Hospital Nostra Senyora de Meritxell, Escaldes-Engordany, Andorra
1
Background: Most cancer patients are treated and followed up on an outpatient basis. A nursing led model of telephone care attention for cancer patients can be useful to improve the symptomatic control and the toxicity of the treatment. This model is being implemented in our hospital belonging to the Andorran Health Care Service. The specific aims of this study is to assess a nursing led model of telephone care attention for cancer patients in the course of treatment. Methods: A descriptive prospective design has been used to analyze the telephone calls of cancer patients in treatment between outpatient appointments and the resolution capacity of oncology nurses. Telephone calls have been collected from October 2018 to March 2019 in a database. The variables analyzed using this database were: age, sex, type of tumor, type of treatment (oral or intravenous chemotherapy or immunotherapy), call reason and nursing resolution. Results: 49 telephone calls and 52 call reasons have been registered of 45 patients. On average, the patients were 58.1 (6 9.4) years old and 53% of them were male. Patients with colon and breast cancer were the most frequent, representing 20% and 16% respectively. 47% of patients were receiving intravenous chemotherapy, 36% oral chemotherapy and 18% immunotherapy. The call reasons were: 33% related to disease symptoms, 24 % related to toxicity, and 21 % related to treatment information and general issues. The most frequent reason for consultation was pain (23%) and the second was diarrhea (15%). Of the total telephone calls received, 92% were resolved by the nurse compared to 8% who required attention by a physician (p < 0.001). Conclusions: Oncology nurse led model of telephone support for patients with cancer who attend outpatient treatment can improve symptomatic and toxicity management, reducing medical appointments and admissions to the Emergency Service. Legal entity responsible for the study: Hospital Nostra Senyora de Meritxell. Funding: Has not received any funding. Disclosure: G. Simo: Full / Part-time employment: Hospıtal Nostra Senyora de Meritxell. C. Royo: Full / Part-time employment: Hospıtal Nostra Senyora de Meritxell. E. Mahia: Full / Part-time employment: Hospıtal Nostra Senyora de Meritxell. E. Baille´s: Full / Part-time employment: Hospıtal Nostra Senyora de Meritxell. S. Echevarria: Full / Part-time employment: Hospıtal Nostra Senyora de Meritxell. A. Berenguer: Full / Part-time employment: Hospıtal Nostra Senyora de Meritxell. S. Albiol: Full / Part-time employment: Hospıtal Nostra Senyora de Meritxell.
doi:10.1093/annonc/mdz276 | v839
Downloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_5/mdz276.011/5576406 by guest on 26 October 2019
Background: Despite the accumulation of knowledge on the cognitive side-effects of chemotherapy, the actual incidence of this impairment is still a subject of research. Estimates of affected patients vary from 17% to 78% across studies.In recent years, growing attention is being paid to the potential adverse effects of chemotherapy on brain and cognitive function. Despite the accumulation of knowledge on the cognitive side-effects of chemotherapy, the actual incidence of this impairment is still a subject of research. Estimates of affected patients vary from 17% to 78% across studies. The aim of the study is to evaluate cognitive function changes experienced by cancer patients who receive chemotherapy and associated factors. Methods: This is a descriptive study. The data collection phase of the study is ongoing and the results obtained from 47 patients who received chemotherapy have been reported here. The results of the large group will be presented at the congress. Data collection was started on March 2019 and will be continuing until September 2019. This study was conducted in a Research and Training Hospital in Istanbul/Turkey. Data _ were collected by using the Patient Information form and Functional Assessment of Chronic Illness Therapy- Cognitive Function (FACIT-Cog) and The European Organization for Research and Treatment of Cancer quality of life questionnaire (EORTC QLQ-C30). Mann-Whitney U test, Kruskal-Wallis test, and Spearman Correlation analysis were used to evaluate the data. Results: There was statistically significant and positive relationship between FACITCog “perceived cognitive impairments” subscale and EORTC-30 cognitive (r ¼ 0,755; p 0,001), emotional (r ¼ 0,505; p ¼ 0,001) and social (r ¼ 0,504; p ¼ 0,001) functioning subscales. There was statistically significant and positive relationship between FACIT-Cog “comments from others on cognitive function” and EORTC-30 emotional (r ¼ 0,491; p ¼ 0,001), cognitive (r ¼ 0,539; p 0,001), and social (r ¼ 0,588; p 0,001) functioning subscales. FACIT-Cog scores was not significantly differ by patients’ characteristics (p > 0,005). Conclusions: Cognitive function should be assessed and considered during the care of cancer patients. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
CN81
Annals of Oncology
CN79
Cognitive function changes and associated factors in patients receiving chemotherapy
E. Dil1, G. Bagcivan2 1 Medical Oncology, Istanbul Sultan Abdulhamid Han Egitim ve Arastirma Hastanesi, Istanbul, Turkey, 2School of Nursing, Koc University, Istanbul, Turkey
CN80
M. Bosch-Damas1, M. Rodriguez-Reyes2, M. Cervera-Carbonell1, N. Borras-Maixenchs1, E. Carcelero-San Martın2, G. Riu-Viladoms2, M. Valverde-Bosch1, G. Gutierrez-Garcia1 1 ICMHO, Hospital Clınic Barcelona, Barcelona, Spain, 2Pharmacy, Hospital Clınic Barcelona, Barcelona, Spain Background: The oral, fixed-combination NEPA containing netupitant and palonosetron target crucial pathways involved in both acute and delayed chemotherapy-induced nausea and vomiting (CINV) in patients with highly emetogenic chemotherapy.Hematopoietic stem cell transplantation (HSCT) is associated with infectious complications, especially bloodstream infections (BSI). The risk factors associated with BSI include presence of indwelling vascular catheters. NEPA eliminates accessing intravenous catheters leading to a decreased risk of infection in HSCT recipients.There is a paucity of studies about the management of CINV during preparative regimens for HSCT. The aim of this study was to assess the safety of NEPA during and after HSCT conditioning. Methods: Patients with chronic myeloid leukemia, multiple myeloma, myelodysplastic syndrome, and acute myeloid leukemia who received an allogeneic HSCT between 2017 and 2018 were retrospective studied. Conditioning regimen consisted of fludarabine and busulfan. Graft versus host disease prophylaxis was done with high-dose cyclophosphamide on days þ3 to þ 4 post-HSCT. Patients received a single capsule of NEPA prior to conditioning regimen and before cyclophosphamide, both with oral dexamethasone on days 1-3 . Safety was assessed by evaluation of adverse events and use of rescue medications (baclofen for hiccups and lactitol, macrogol and sennosides for constipation). Results: Six patients were included: 4/6were male and median age was 50 years (IQR: 46-53 years). Two patients reported hiccups needing baclofen and 6 required rescue medications for constipation. Five out of six patients presented neutropenic enterocolitis on day þ7, oral intake was stopped in 4 of them, total parenteral nutrition was started in 3 cases, 3 patients required extra antibiotic coverage, and 4 received analgesic therapy. All patients improved with conservative measures. Conclusions: In this real-world observational study, the incidence of neutropenic enterocolitis was considerably higher than previous reports in HSCT recipients. It may be associated with NEPA administration but future studies will be needed to confirm this relationship. Legal entity responsible for the study: Hospital Clınic Barcelona. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
Prevention of dental complications in patients with multiple myeloma (MM) receiving bisphosphonates treatment
C.L. Puigmarti, N. Santos, S. Mostacedo, Y. Gonzalez Haematology, Catalan Institute of Oncology (ICO)-Hospital Universitari Josep Trueta, Girona, Spain Background: Thanks to the new therapeutic strategies, the patients with MM live longer, but with complex chronic disease and with a diversity of supportive treatments that are increasingly complex. The bisphosphonates are important part of these therapeutic options for them. The aim of this study is to describe four clinical cases presenting dental complications and to define the prevention actions they needed. Methods: A series of cases study. Sample 4 cases with MM patients in treatment with bisphosphonates attended by Functional Unit during 6 months in 2018. Variables recruited were dental complications, nurses’ activities, clinical implications and type of treatment received. Results: From October-2018 to March-2019, a total of 32 patients with MM have been received intravenous bisphosphonates treatment. Four of them (12.5%) have presented dental complications that are following: Two patients (# 68 years old and $ 68) have needed a 6 months of bisphosphonates interruption to have a dental extraction One patient (# 51 years) has delayed 15 days his autologous stem cell transplantation due to dental extraction with infection One patient (# 69 years) has delayed one month his autologous stem cell because of a dental fistula that needed surgical intervention Preventive nurses’ measures included: dental assessment prior to bisphosphonate initiation so that any invasive dental procedures could be completed prior to initiation the therapy. It is crucial to include prevention in the health system to avoid increasing financial toxicity for patients & families. Conclusions: All the patients with dental complications affected and delayed the planned treatment. A preventive approach with oral care before and during treatment with bisphosphonates can minimize the occurrence of complications associated with treatment and avoid interruptions since extractions are contraindicated and endodontic treatment should be performed under conditions that ensure no trauma to bone tissue. Nurses should be aware that MM patient treatment depends not only on antimyeloma treatments but, also on supportive measures to improve their quality of life and avoid complications. Legal entity responsible for the study: Cesca Llopis. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
Volume 30 | Supplement 5 | October 2019
Safety profile of oral netupitant/palonosetron in hematopoietic stem cell transplantation recipients
CN82
Symptomatic and toxicity management of cancer patients using a telephone support model led by the oncology nurse
G. Sim o1, C. Royo2, E. Mahia2, E. Baille´s2, S. Echevarria2, A. Berenguer2, S. Albiol2 Oncology Department, Hospital Nostra Senyora de Meritxell, Escaldes-Engordany, Andorra, 2Oncology, Hospital Nostra Senyora de Meritxell, Escaldes-Engordany, Andorra
1
Background: Most cancer patients are treated and followed up on an outpatient basis. A nursing led model of telephone care attention for cancer patients can be useful to improve the symptomatic control and the toxicity of the treatment. This model is being implemented in our hospital belonging to the Andorran Health Care Service. The specific aims of this study is to assess a nursing led model of telephone care attention for cancer patients in the course of treatment. Methods: A descriptive prospective design has been used to analyze the telephone calls of cancer patients in treatment between outpatient appointments and the resolution capacity of oncology nurses. Telephone calls have been collected from October 2018 to March 2019 in a database. The variables analyzed using this database were: age, sex, type of tumor, type of treatment (oral or intravenous chemotherapy or immunotherapy), call reason and nursing resolution. Results: 49 telephone calls and 52 call reasons have been registered of 45 patients. On average, the patients were 58.1 (6 9.4) years old and 53% of them were male. Patients with colon and breast cancer were the most frequent, representing 20% and 16% respectively. 47% of patients were receiving intravenous chemotherapy, 36% oral chemotherapy and 18% immunotherapy. The call reasons were: 33% related to disease symptoms, 24 % related to toxicity, and 21 % related to treatment information and general issues. The most frequent reason for consultation was pain (23%) and the second was diarrhea (15%). Of the total telephone calls received, 92% were resolved by the nurse compared to 8% who required attention by a physician (p < 0.001). Conclusions: Oncology nurse led model of telephone support for patients with cancer who attend outpatient treatment can improve symptomatic and toxicity management, reducing medical appointments and admissions to the Emergency Service. Legal entity responsible for the study: Hospital Nostra Senyora de Meritxell. Funding: Has not received any funding. Disclosure: G. Simo: Full / Part-time employment: Hospıtal Nostra Senyora de Meritxell. C. Royo: Full / Part-time employment: Hospıtal Nostra Senyora de Meritxell. E. Mahia: Full / Part-time employment: Hospıtal Nostra Senyora de Meritxell. E. Baille´s: Full / Part-time employment: Hospıtal Nostra Senyora de Meritxell. S. Echevarria: Full / Part-time employment: Hospıtal Nostra Senyora de Meritxell. A. Berenguer: Full / Part-time employment: Hospıtal Nostra Senyora de Meritxell. S. Albiol: Full / Part-time employment: Hospıtal Nostra Senyora de Meritxell.
doi:10.1093/annonc/mdz276 | v839
Downloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_5/mdz276.011/5576406 by guest on 26 October 2019
Background: Despite the accumulation of knowledge on the cognitive side-effects of chemotherapy, the actual incidence of this impairment is still a subject of research. Estimates of affected patients vary from 17% to 78% across studies.In recent years, growing attention is being paid to the potential adverse effects of chemotherapy on brain and cognitive function. Despite the accumulation of knowledge on the cognitive side-effects of chemotherapy, the actual incidence of this impairment is still a subject of research. Estimates of affected patients vary from 17% to 78% across studies. The aim of the study is to evaluate cognitive function changes experienced by cancer patients who receive chemotherapy and associated factors. Methods: This is a descriptive study. The data collection phase of the study is ongoing and the results obtained from 47 patients who received chemotherapy have been reported here. The results of the large group will be presented at the congress. Data collection was started on March 2019 and will be continuing until September 2019. This study was conducted in a Research and Training Hospital in Istanbul/Turkey. Data _ were collected by using the Patient Information form and Functional Assessment of Chronic Illness Therapy- Cognitive Function (FACIT-Cog) and The European Organization for Research and Treatment of Cancer quality of life questionnaire (EORTC QLQ-C30). Mann-Whitney U test, Kruskal-Wallis test, and Spearman Correlation analysis were used to evaluate the data. Results: There was statistically significant and positive relationship between FACITCog “perceived cognitive impairments” subscale and EORTC-30 cognitive (r ¼ 0,755; p 0,001), emotional (r ¼ 0,505; p ¼ 0,001) and social (r ¼ 0,504; p ¼ 0,001) functioning subscales. There was statistically significant and positive relationship between FACIT-Cog “comments from others on cognitive function” and EORTC-30 emotional (r ¼ 0,491; p ¼ 0,001), cognitive (r ¼ 0,539; p 0,001), and social (r ¼ 0,588; p 0,001) functioning subscales. FACIT-Cog scores was not significantly differ by patients’ characteristics (p > 0,005). Conclusions: Cognitive function should be assessed and considered during the care of cancer patients. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
CN81