- Email: [email protected]
P-836 Permanent Pleurx catheters for recurrent malignant pleural effusion
Posters/Supportive and palliative care/Oncology nursing Results: Forty patients were enrolled between 3;2002 and 9;2004 but 11 died before the 3 month appointment Age, gender, performance status and pnor chemotherapy were balanced Table 1 summar~ed the mm0mum% change in cellular immunity of patients in CHM and placebo arm Statistically significant increase in cellular immunity was observed in T-heipars call and T helper/suppressor cell ratio (83 4% vs -20 8%(p 0 028): ,51 6% vs 10 8%(p 0 04). respectively) Changes in cytokines level were similar between the two arms with the escaption of IL~ (5,5 ,5% vs -44 6%. p 0 045) Conclusions: CHM induces immun~modulation in patients with advanced NSCLC but its clinical implication remains to be investigated.
~ 3 3 ~ Nurelng research - Identifying the areas of priority for nursing research within lung cancer care S. Moore I . D. Borthwiek 2, L. Dadlson 2. 1. FJtzpatnsk 2, G. Walton 2, N Browne ~ 1Guy's & St Thomas' NHS Foundation Trust, London, United
t~ng¢om: 2National Lung Cancer Forum ;or Nurses, U/~ 3/~ng's C~lege School ot Nursmg & M/¢vvTfe~ London, UK Very little nursing research has been conducted within lung cancer care Most of the published research seems to have been conducted by nurse researchers working within academic cantTes rather than by nurses working within clihical prance At the nursing research workshop at the 2004 Bdtish Thoracic Oncology Group Meeting. a stTategy was proposed to increase the research activity of nurse specialists wortdng with patients with lung canear The first part of this strategy was for lung cancer nurse specialists to identify their priority areas for research. This poster will present the ~dings from a Delphi type survey oftbe Members of the National Lung Cancer Forum for Nurses in the UK. This survey was undertaken in two stages: A questionnaire was sent to all members of the Forum asking them to identify important areas for nursing research in lung cancer care. Analys~s of the questionnaires identified 8 main research areas. - A second questionnaire was sent to all members of the Forum asldng them to reek the 8. research areas in order of importance and suggest possible research questions The findings of this survey will be presented A StTategy of how the findings may be used to generate nursing research studies will also be discussed
Supportive and palliative care/Oncology nursing Wednesday, 6 July 2005
[P•
10:00-17:00
Different palliative therapy In patients with lung cancer and syndrome vsna cave superior
L NaAomJ-Obradovi. D Jovanovib. D Madb. M VelJnovJb Institute for
Pulmonary Diseases and TB, Be/grada, Serbia
Background: This study evaluated different poss~blllitJes of palliative therapy Jn patientsCots) with lung caneer(LC) and syndroma vena cave superior (SVCS). Methods: In Institute for Pulmonary Diseases and TB Jn Belgrade. during 2004 year. 6064 pts were hospJtaly b'eated, among them there were 1984 (31.1%) pts with LC. and 62 (3.3%) had LC and SVCS. We made retrospective analysis of 48. pts who were treated for SVCS at the moment of diagnosis of LC Results: We analyzed 48. pts (male 29 60 4%. female 1 9 3 g 6%: mean age 51 year) who were treated for SVCS at the moment of diagnosis of LC (SCLC: 30 62 5% pts: NSCLC: 1£~33 3% pts and without pathohistology confirmation 2 4 2 % pts)Chemotherapy was applied in 13 (27 1%) pts. radiotherapy in 12(25 0%) pts. combined chemotherapy and racletherapy in 17 (35 4%) pts and 6 (12 5%) pts were tTeated only with dif~rent medical palliative therapy There were not pts w~h LC and SVCS who had stent implacament in vena cava supenor because by reason of limited health care condition in our environment. Folowing palliative therapy was applied in all pts with LC and SVCS:glucocortJco~ds in 42 (97.5%) pts. ciuretios in 45 (93.7%) pts. nor-. oploJds analgetios in 30 (62.5%) pts. oploJds in 9 (16.6%) pts. oxygenotherapy in 10 (20.8%) pts. anticoagulants in 4 (8.3%) pts. antJdepreswe in 12 (25%) pts. Among pts who received glucocort]coJds, the most frequent was methyl prednisolone (26 61 g% pts) then prednisone ( 1 ~ 3 8 1% pts) Conclusions: In limited social and health care condition palliation of SVCS in LC is based on diuretics and glucocorticoids Combination of glucocorticoids. diuretics and analgetics is useful in home care concitions
~ 3 5 ~ Perrnanent Pleurx catheters for recurrent malignant pleural effusion A Olilve. G Nelissen. N van Zandwijk. P Beas. S Burgers Netherlands
Cancer Institute, Amsterdam, Na~her/anda
Background: Malignant pleural effusion, frequently complicating oncologJcal diagnoses Js a major reason for hosp~tal=ation. Standard care consists of
$33g
chest tube drainage and pleurodosJs. Unfortunately patients with sJgnlfK:ant effusion or a trapped lung cannot be effectively palliated and are not considered candidates for pleurodesis Tunneled catheters for long-term pleural drainage (Pleura. Denver Biomaterials) have been intToducad for palliation and initial reports have shown a high rate of symptomatic relief and a low complication rate Here we report the resuits of a prospective evaluation of the Pleurx system Results: From July 2003 until Januad 2005 34 patients (g mammary cancer. 4 lung cancer, and other less frequent malignancies), all with recurrent malignant pleural effusion after a standard pleuroddsJs attempt received oral explanation and written information on the Pleurx procedure. In 19 of them a catheter was be4ng introduced. The main reason withholcing the drain was rapid tumor progression and/or clinical deterioration. A satisfactory balliative effect was obtained in 12 patients (63%). Drainage time ranged from several days to 9 months. In 3 patients long term drainage eventually resulted in stopping the effusion and in these case the removal of the Pleurx was possible Three patients developed senous infectious complications In two cases this was the result of non-sterile handling oftbe drain in one case a neglected info~on of the sldn port caused empyema Conclusion: The Pleurx system effectively palliated recurrent pleural effusions in a majority of patients Attention should be paid to patient selection (avoid this procedure in patients in preterminal condition) and the prevention of infectious complications.
~-~1
Epcetln beta (NeoRecormorP) prevents anaemia and Improves quality of life In lung cancer patients receiving platinum-based chemotherapy
A Ordbr~ez~. M Gonzalez-Baron I . J De CastToI . D Isla 2. A Sanchez 3. A An'ivi 4 . J Manzano 5 1Hospital La Paz, Mad#d, S~aln, 2Hospital
CJlnico UnJversitario de Zaregoza, Zaregoza, Spain, ~Hospital Provincial de Castal;6n, Castallon, Spain, 4Hospital San Uatzer, Pa;ma de Mallorca, Spain, ~Hospital T#as i Pujot, Barcelona, Spain
Background Epoetin beta has been shown to prevent anaemia and improve quality of life (QoL) in solid tumour patients receiving platinum (Pt)~ased chemotherapy (CT) in a large-scale study (Ord6r3ez at al 2004) This abstTact presents data on a sub~]reup analysis of patients with lung cancer Methods: Patients with small~,ll lung cancer (SCLC) or non-SCLC (NSCLC). receiving Pt~ased CT were enrolled in this ppen4abel, slngl~arm, multicontre study If baseiJne haemoglobin (Hb) levels were ~<13g/dl (men) or ~<12g/dl (women). or fell to these levels after 1 or more CT cycles. Patients received eqoetin beta -30.000 IU/week (450 IUikg/woek). dlvJdeq Into 3 doses until 4 weeks after the last CT cycle. After 4 weeks, the epoetin dose was doubled JfHb decreased by >1 g/dl. Treatment efficacy was measured by response rate (Hb increase of >1 g]dl) and QoL (visual analogue scale). Adverse events were recorded Results: A total of 102 patients (SCLC 36 3%: NSCLC 63 7%) were evaluated. the majority (gg 0%) of whom had a baseline ECOG status of 0-2 (68 6% ECOG status 1) Hb response was shown in 59 8% of patients, with a further 30 4% maintaining baseline Hb ±1 g/dl Overall QoL improved significantly in patients with a Hb response (p < 0 01) and was maintained in non-responders Co 0 78.1). despite tTeah'nent with Pt-besed CT In responders, mean Hb level increased from 11.0 g/dl at baseline to 13.0 g/dl during epcotJn beta b-eatment. Mean duration of b'eatment was 71.6 days. Performance status (baseline vs final) was maintained Jn batients responding to epeatJn beta Co= 0.852). but significantly deteriorated Jn nor. responders (p <0.01). No patients with lung cancer had any adverse events with epoetin beta. COrlCluslons: Epoetin beta 30 O00 IU weekly Is highly effective In preventing anaemia in lung cancer patients receiving Pt~esed CT. In addition. improvement in Hb with epoetin beta translates into an improvement in g e l for patients
~7]
Lung cancer and the tam,y: Couples' management strategies In facing terrnlnal Illness
C PJccoI S ThJdwell1'2. H Ezer I ~McGi;I University, Montreal, Canada,
2SMBD Jewsh Genera/Hospital, Montrea/, Canada
Background: Lung cancer is the leading cause of cancer death in North America for both men end women with 85% of cases linked directly to cigarette smoking In addition, the majority of cases (85%) are diagnosed in the advanced stage (stage 3 or 4) with a median survival of 6 g months The devastating psychological impact of this disease on patients and their families has been dearly demonstrated in the literature (e g Fnesen. Papist. & Hunter. 2002: Zabera. Bdntzenhofeszoc. Curbow. Hooker. & Piantadosl. 2001) However. there is a scarolty of research that describes the experlenee of this clsease from a family perspect~e. The purpose of this qualitative study was to explore the espenenca of Jncivlduals dJagnesed with advanced lung cancer and their spouses/partners. More specifically, this project aimed to understand a) how patients and spouses
~ 3 3 ~ Nurelng research - Identifying the areas of priority for nursing research within lung cancer care S. Moore I . D. Borthwiek 2, L. Dadlson 2. 1. FJtzpatnsk 2, G. Walton 2, N Browne ~ 1Guy's & St Thomas' NHS Foundation Trust, London, United
t~ng¢om: 2National Lung Cancer Forum ;or Nurses, U/~ 3/~ng's C~lege School ot Nursmg & M/¢vvTfe~ London, UK Very little nursing research has been conducted within lung cancer care Most of the published research seems to have been conducted by nurse researchers working within academic cantTes rather than by nurses working within clihical prance At the nursing research workshop at the 2004 Bdtish Thoracic Oncology Group Meeting. a stTategy was proposed to increase the research activity of nurse specialists wortdng with patients with lung canear The first part of this strategy was for lung cancer nurse specialists to identify their priority areas for research. This poster will present the ~dings from a Delphi type survey oftbe Members of the National Lung Cancer Forum for Nurses in the UK. This survey was undertaken in two stages: A questionnaire was sent to all members of the Forum asking them to identify important areas for nursing research in lung cancer care. Analys~s of the questionnaires identified 8 main research areas. - A second questionnaire was sent to all members of the Forum asldng them to reek the 8. research areas in order of importance and suggest possible research questions The findings of this survey will be presented A StTategy of how the findings may be used to generate nursing research studies will also be discussed
Supportive and palliative care/Oncology nursing Wednesday, 6 July 2005
[P•
10:00-17:00
Different palliative therapy In patients with lung cancer and syndrome vsna cave superior
L NaAomJ-Obradovi. D Jovanovib. D Madb. M VelJnovJb Institute for
Pulmonary Diseases and TB, Be/grada, Serbia
Background: This study evaluated different poss~blllitJes of palliative therapy Jn patientsCots) with lung caneer(LC) and syndroma vena cave superior (SVCS). Methods: In Institute for Pulmonary Diseases and TB Jn Belgrade. during 2004 year. 6064 pts were hospJtaly b'eated, among them there were 1984 (31.1%) pts with LC. and 62 (3.3%) had LC and SVCS. We made retrospective analysis of 48. pts who were treated for SVCS at the moment of diagnosis of LC Results: We analyzed 48. pts (male 29 60 4%. female 1 9 3 g 6%: mean age 51 year) who were treated for SVCS at the moment of diagnosis of LC (SCLC: 30 62 5% pts: NSCLC: 1£~33 3% pts and without pathohistology confirmation 2 4 2 % pts)Chemotherapy was applied in 13 (27 1%) pts. radiotherapy in 12(25 0%) pts. combined chemotherapy and racletherapy in 17 (35 4%) pts and 6 (12 5%) pts were tTeated only with dif~rent medical palliative therapy There were not pts w~h LC and SVCS who had stent implacament in vena cava supenor because by reason of limited health care condition in our environment. Folowing palliative therapy was applied in all pts with LC and SVCS:glucocortJco~ds in 42 (97.5%) pts. ciuretios in 45 (93.7%) pts. nor-. oploJds analgetios in 30 (62.5%) pts. oploJds in 9 (16.6%) pts. oxygenotherapy in 10 (20.8%) pts. anticoagulants in 4 (8.3%) pts. antJdepreswe in 12 (25%) pts. Among pts who received glucocort]coJds, the most frequent was methyl prednisolone (26 61 g% pts) then prednisone ( 1 ~ 3 8 1% pts) Conclusions: In limited social and health care condition palliation of SVCS in LC is based on diuretics and glucocorticoids Combination of glucocorticoids. diuretics and analgetics is useful in home care concitions
~ 3 5 ~ Perrnanent Pleurx catheters for recurrent malignant pleural effusion A Olilve. G Nelissen. N van Zandwijk. P Beas. S Burgers Netherlands
Cancer Institute, Amsterdam, Na~her/anda
Background: Malignant pleural effusion, frequently complicating oncologJcal diagnoses Js a major reason for hosp~tal=ation. Standard care consists of
$33g
chest tube drainage and pleurodosJs. Unfortunately patients with sJgnlfK:ant effusion or a trapped lung cannot be effectively palliated and are not considered candidates for pleurodesis Tunneled catheters for long-term pleural drainage (Pleura. Denver Biomaterials) have been intToducad for palliation and initial reports have shown a high rate of symptomatic relief and a low complication rate Here we report the resuits of a prospective evaluation of the Pleurx system Results: From July 2003 until Januad 2005 34 patients (g mammary cancer. 4 lung cancer, and other less frequent malignancies), all with recurrent malignant pleural effusion after a standard pleuroddsJs attempt received oral explanation and written information on the Pleurx procedure. In 19 of them a catheter was be4ng introduced. The main reason withholcing the drain was rapid tumor progression and/or clinical deterioration. A satisfactory balliative effect was obtained in 12 patients (63%). Drainage time ranged from several days to 9 months. In 3 patients long term drainage eventually resulted in stopping the effusion and in these case the removal of the Pleurx was possible Three patients developed senous infectious complications In two cases this was the result of non-sterile handling oftbe drain in one case a neglected info~on of the sldn port caused empyema Conclusion: The Pleurx system effectively palliated recurrent pleural effusions in a majority of patients Attention should be paid to patient selection (avoid this procedure in patients in preterminal condition) and the prevention of infectious complications.
~-~1
Epcetln beta (NeoRecormorP) prevents anaemia and Improves quality of life In lung cancer patients receiving platinum-based chemotherapy
A Ordbr~ez~. M Gonzalez-Baron I . J De CastToI . D Isla 2. A Sanchez 3. A An'ivi 4 . J Manzano 5 1Hospital La Paz, Mad#d, S~aln, 2Hospital
CJlnico UnJversitario de Zaregoza, Zaregoza, Spain, ~Hospital Provincial de Castal;6n, Castallon, Spain, 4Hospital San Uatzer, Pa;ma de Mallorca, Spain, ~Hospital T#as i Pujot, Barcelona, Spain
Background Epoetin beta has been shown to prevent anaemia and improve quality of life (QoL) in solid tumour patients receiving platinum (Pt)~ased chemotherapy (CT) in a large-scale study (Ord6r3ez at al 2004) This abstTact presents data on a sub~]reup analysis of patients with lung cancer Methods: Patients with small~,ll lung cancer (SCLC) or non-SCLC (NSCLC). receiving Pt~ased CT were enrolled in this ppen4abel, slngl~arm, multicontre study If baseiJne haemoglobin (Hb) levels were ~<13g/dl (men) or ~<12g/dl (women). or fell to these levels after 1 or more CT cycles. Patients received eqoetin beta -30.000 IU/week (450 IUikg/woek). dlvJdeq Into 3 doses until 4 weeks after the last CT cycle. After 4 weeks, the epoetin dose was doubled JfHb decreased by >1 g/dl. Treatment efficacy was measured by response rate (Hb increase of >1 g]dl) and QoL (visual analogue scale). Adverse events were recorded Results: A total of 102 patients (SCLC 36 3%: NSCLC 63 7%) were evaluated. the majority (gg 0%) of whom had a baseline ECOG status of 0-2 (68 6% ECOG status 1) Hb response was shown in 59 8% of patients, with a further 30 4% maintaining baseline Hb ±1 g/dl Overall QoL improved significantly in patients with a Hb response (p < 0 01) and was maintained in non-responders Co 0 78.1). despite tTeah'nent with Pt-besed CT In responders, mean Hb level increased from 11.0 g/dl at baseline to 13.0 g/dl during epcotJn beta b-eatment. Mean duration of b'eatment was 71.6 days. Performance status (baseline vs final) was maintained Jn batients responding to epeatJn beta Co= 0.852). but significantly deteriorated Jn nor. responders (p <0.01). No patients with lung cancer had any adverse events with epoetin beta. COrlCluslons: Epoetin beta 30 O00 IU weekly Is highly effective In preventing anaemia in lung cancer patients receiving Pt~esed CT. In addition. improvement in Hb with epoetin beta translates into an improvement in g e l for patients
~7]
Lung cancer and the tam,y: Couples' management strategies In facing terrnlnal Illness
C PJccoI S ThJdwell1'2. H Ezer I ~McGi;I University, Montreal, Canada,
2SMBD Jewsh Genera/Hospital, Montrea/, Canada
Background: Lung cancer is the leading cause of cancer death in North America for both men end women with 85% of cases linked directly to cigarette smoking In addition, the majority of cases (85%) are diagnosed in the advanced stage (stage 3 or 4) with a median survival of 6 g months The devastating psychological impact of this disease on patients and their families has been dearly demonstrated in the literature (e g Fnesen. Papist. & Hunter. 2002: Zabera. Bdntzenhofeszoc. Curbow. Hooker. & Piantadosl. 2001) However. there is a scarolty of research that describes the experlenee of this clsease from a family perspect~e. The purpose of this qualitative study was to explore the espenenca of Jncivlduals dJagnesed with advanced lung cancer and their spouses/partners. More specifically, this project aimed to understand a) how patients and spouses