scholarly journals Can cognitive behavioral therapy (CBT) intervention in patients diagnosed with stage 3/4 gastric cancer increase patients’ acceptance of palliative care earlier in the cancer continuum?

2020 ◽  
Vol 3 ◽  
Author(s):  
Rhea Sharma ◽  
Joseph McCollom
Keyword(s):  
Gastric Cancer ◽  
Palliative Care ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Behavioral Therapy ◽  
Cancer Prognosis ◽  
Control Group ◽  
Gastric Cancer Patients ◽  
Positive Outlook ◽  
Patients Acceptance

Background and Hypothesis: Palliative care, though designed improve quality of life in patients diagnosed with a grave illness, is widely stigmatized as an “end of life” service. Cancer diagnosis has been known to cause mental stress on patients; the added stigmatization of palliative care with death is a barrier to care, especially in gastric cancer patients whose delay in treatment can result in poor cancer prognosis and outcomes. Cognitive Behavior Therapy (CBT) intervention is promising is an ideal intervention in this case, yet, understudied in palliative oncology. Successful CBT intervention can combat guilt, denial and stigma, leading to more positive outlook on life and palliative care. We hypothesize that CBT intervention will increase stage 3/4 gastric cancer patients’ acceptance to start palliative care early in their cancer treatment by decreasing associated stigma.     Experimental Design and Results: Study will be an interventional, unblinded, randomized clinical trial with an experimental and control group. A CBT video intervention will be used, preceded and followed by a pre-/post session questionnaire generated from IU’s RedCap. Full intervention will have 4 sessions, with experimental groups divided into those receiving <2, 3 or full 4 sessions. All individuals age 18+ with a recent stage 3/4 gastric cancer diagnosis, who have the ability to provide consent/comprehend the CBT video will be illegible to participate in the study. A spearman’s correlation will be used to test significance of CBT. A negative trend is predicted between CBT intervention and palliative care stigma; as the number of CBT sessions increase, palliative care stigma should decrease accordingly.    Potential Impact: CBT’s effectiveness in alleviating stigma faced by patients with advanced gastric cancer can suggest more psychosocial training for physicians to move away from disease centered approach to one that implements ways that eradicate social barriers to care.   

CLINICAL SIGNIFICANCE OF SERUM CAVEOLIN-1 LEVELS IN GASTRIC CANCER PATIENTS

2018 ◽  
Vol 40 (4) ◽  
pp. 323-327 ◽  
Author(s):  
F Tas ◽  
S Karabulut ◽  
K Erturk ◽  
D Duranyildiz
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Histological Grade ◽  
Clinical Importance ◽  
Disease Stage ◽  
Control Group ◽  
Tissue Samples ◽  
Caveolin 1 ◽  
Study Results ◽  
Gastric Cancer Patients

Aim: Caveolin-1 plays a significant role in the pathogenesis of various carcinomas and its expression affects the survival of cancer patients. However, the molecular function of caveolin-1 and its possible clinical importance has remained uncertain in gastric cancer. No clinical trial has examined serum caveolin-1 levels in gastric cancer patients so far, instead all available results were provided from studies conducted on tissue samples. In the current study, we analyzed the soluble serum caveolin-1 levels in gastric cancer patients, and specified its associations with the clinical factors and prognosis. Material and Methods: Sixty-three patients with pathologically confirmed gastric cancer were enrolled into the trial. Serum caveolin-1 concentrations were detected by ELISA method. Thirty healthy subjects were also included in the study. Results: The median age of patients was 62 years, ranging from 28 to 82 years. The serum caveolin-1 levels in gastric cancer patients were significantly higher than those in control group (p < 0.001). The common clinical parameters including patient age, sex, lesion localization, histopathology, histological grade, disease stage, and various serum tumor markers (e.g. LDH, CEA, and CA 19.9) were not found to be associated with serum caveolin-1 levels (p > 0.05). Similarly, no correlation existed between serum caveolin-1 concentration and chemotherapy responsiveness (p = 0.93). Furthermore, serum caveolin-1 level was not found to have a prognostic role (p = 0.16). Conclusion: Even though it is neither predictive nor prognostic, serum caveolin-1 level may be a valuable diagnostic indicator in patients with gastric cancer. Key

PILGRIM: Phase III clinical trial in evaluating the role of hyperthermic intraperitoneal chemotherapy for locally advanced gastric cancer patients after radical gastrectomy with D2 lymphadenectomy(HIPEC-01).

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 4538-4538
Author(s):  
Shu-zhong Cui ◽  
Han Liang ◽  
Yong Li ◽  
Yanbing Zhou ◽  
Kaixiong Tao ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Locally Advanced ◽  
Control Group ◽  
Radical Gastrectomy ◽  
Node Dissection ◽  
D2 Lymph Node Dissection ◽  
Locally Advanced Gastric Cancer ◽  
Gastric Cancer Patients

4538 Background: Gastric cancer remains the 3rd leading cancer related death worldwide due to early disease recurrence. We hypothesize that hyperthermic intraperitoneal chemotherapy (HIPEC) may effectively prevent local regional recurrence for locally advanced gastric cancer patients who received curative intent surgery. Methods: Pathology proven gastric cancer patients with clinical T3/T4NxM0 disease are eligible for the study and will be randomized to either control group, who will receive standard radical gastrectomy and D2 lymph node dissection or HIPEC group, who will receive the same surgery and HIPEC with paclitaxel x 2 within the first week after surgery. All patients will receive either XELOX or SOX adjuvant chemotherapy. The primary end point is overall survival. Results: 648 patients from 16 high volume gastric medical centers were enrolled between May, 2015 and March, 2019. 331 and 317 patients were randomized to control and HIPEC groups respectively. The median follow-up time is 12.1 months. The common grade 3/4 toxicities ( > 5%) in control and HIPEC groups are anemia 6% vs. 4.1%, intraabdominal infection 5.4% vs. 3.8%, pneumonia 9.7% vs. 9.8%, fever 10.6% vs. 11.4% and hypoalbunemia 15.1% vs. 16.7% respectively. All three perioperative death (within 30 days after surgery) occurred in control group. One patient died from duodenum stump leak which led to multiple organ failure. One patient died from anastomotic led to intraabdominal infection and shock. The 3rd death was suicide caused by severe depression. At the time of this report, the number of event has not reached for final efficacy analysis. Conclusions: It is safe to administer HIPEC to patients received radical gastrectomy with D2 lymph node dissection within one week of surgery. The primary analysis will be expected in one year. Clinical trial information: NCT02356276 .

scholarly journals Effect of Combining Early Chemotherapy with Zhipu Liujunzi Decoction under the Concept of Strengthening and Consolidating Body Resistance for Gastric Cancer Patients and Nursing Strategy

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Min Wang ◽  
Shujuan Wang ◽  
Qiang Su ◽  
Tian Ma
Keyword(s):  
Gastric Cancer ◽  
Immune Function ◽  
Cancer Patients ◽  
Remission Rate ◽  
Effective Rate ◽  
Control Group ◽  
Nursing Satisfaction ◽  
Body Resistance ◽  
Gastric Cancer Patients ◽  
Experimental Group

Objective. To explore the clinical efficacy of combining early chemotherapy with Zhipu Liujunzi decoction under the concept of strengthening and consolidating body resistance for gastric cancer patients and nursing strategy. Methods. The clinical data of 100 patients undergoing radical gastrectomy in our hospital from July 2019 to July 2020 were selected for the retrospective analysis, and the patients were divided into the control group and experimental group according to different treatment methods, with 50 cases in each group. Early chemotherapy after surgery was given to patients in the control group, and on the basis of the aforesaid treatment and under the concept of strengthening and consolidating body resistance, patients in the experimental group took Zhipu Liujunzi decoction and received the nursing strategy, so as to compare their effective rate, adverse reaction rate (ARR), immune function indicators, KPS scores, and nursing satisfaction scores. Results. After treatment, the experimental group obtained significantly higher objective remission rate (ORR) and disease control rate (DCR) ( P < 0.05 ), lower carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) levels ( P < 0.001 ), higher immune parameters levels ( P < 0.001 ), higher KPS scores and lower TCM symptom scores ( P < 0.001 ), lower PSQI scores, SAS scores, and SDS scores ( P < 0.001 ) and higher nursing satisfaction scores ( P < 0.001 ), and lower total accidence rate of toxic side effects ( P < 0.05 ) than the control group. Conclusion. Under the concept of strengthening and consolidating body resistance, combining early chemotherapy with Zhipu Liujunzi decoction is a reliable method for improving the immune function and quality of life for gastric cancer patients with higher safety. Such a strategy greatly reduces the tumor marker levels in patients. Further research will be conducive to establishing a better solution for gastric cancer patients.

SOLUBLE FORMS OF PD-1 AND PD-L1 IN BLOOD PLASMA OF GASTRIC CANCER PATIENTS AND THEIR ASSOCIATIONS WITH CLINICAL AND MORPHOLOGICAL CHARACTERISTICS OF THE DISEASE

2020 ◽  
Vol 65 (6) ◽  
pp. 347-352 ◽  
Author(s):  
E. S. Gershtein ◽  
N. A. Ognerubov ◽  
V. L. Chang ◽  
V. V. Delektorskaya ◽  
E. A. Korotkova ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Blood Plasma ◽  
Cancer Patients ◽  
Cell Cancer ◽  
Morphological Characteristics ◽  
Control Group ◽  
Tnm System ◽  
Healthy Donors ◽  
Gastric Cancer Patients ◽  
In Blood Plasma

Results of comparative ELISA investigation of pretreatment sPD-1 and sPD-L1 content in blood plasma of 100 gastric cancer patients at various disease stages aged 25 to 81 years are presented. Control group included 60 practically healthy donors aged 18 - 68 years. Plasma sPD-L1 concentrations did not differ between gastric cancer patients and control group, and sPD-1 levels were statistically significantly lower in patients than in healthy donors (p<0.0001). Positive correlation (R=0.38; p=0.003) was revealed between plasma sPD-1 and sPD-L1 levels in control group and negative (R= -0.26; p=0,009) - in gastric cancer patients. ROC curve revealed the best sPD-1 cut-off level (< 21 pg/ml) with 77% sensitivity and 63.3% specificity, which is not sufficient for its application as diagnostic marker. Statistically significant increase of plasma sPD-L1 from stage I to stage IIIC (R=0.50; p=0.000011) was found. Analysis of associations between the evaluated markers’ levels and indices of gastric cancer expansion according to TNM system revealed statistically significant positive associations of plasma sPD-L1 levels with T (tumor invasion depth) and N (number of affected lymph nodes) indices: R=0.33; p=0.00093, and R=0.27; p=0.0099 respectively. sPD-L1 level was significantly increased in patients with low differentiated adenocarcinoma and cricoid-cell cancer as compared to highly differentiated adenocarcinoma (p=0.02 and p=0.004 respectively); in patients with cricoid-cell cancer it was also higher than in those with moderately differentiated adenocarcinoma (p=0.043) and undifferentiated cancer (p=0.049). Plasma sPD-1 level did not depend on disease stage, TNM system indices and tumor histological structure. Thus, soluble ligand sPD-L1, but not its receptor sPD-1, plasma level is increased in patients with unfavorable clinical and morphological characteristics, may be regarded as potentially valuable prognostic factor for gastric cancer patients’ survival, and probably as a predictor of anti - PD-1/PD-L1 treatment efficiency.

The effect of CTLA-4 and CD28 gene variants and circulating protein levels in patients with gastric cancer

2017 ◽  
Vol 42 (5) ◽  
Author(s):  
Soykan Arikan ◽  
Alper Gümüş ◽  
Özlem Küçükhüseyin ◽  
Cihan Coşkun ◽  
Saime Turan ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Control Group ◽  
Protein Levels ◽  
Cancer Group ◽  
Pcr Rflp ◽  
Gastric Cancer Patients ◽  
Turkish Patients ◽  
Circulating Levels ◽  
Gastric Cancer Group

AbstractObjective:Gastric cancer is one of the most common malignancies worldwide. The risk factors for gastric cancer include environmental and genetic factors. Inflammation and the immune system are known to contribute to the development of the gastric cancer. We examined the influence of critical polymorphisms of CTLA-4 and CD28 genes and circulating protein levels on the etiology of gastric cancer.Methods:Genotyping of SNPs was performed in 55 gastric cancer patients and 105 healthy individuals using the PCR-RFLP method, and circulating levels of sCTLA-4 and sCD28 were measured.Results:There were no significant differences in the genotype and allele distributions of the evaluated SNPs [CTLA-4-318 C>T (rs5742909), CTLA-4+49 A>G (rs231775), CD28 C>T (rs3116496)] between gastric cancer patients and controls (p=0.36, p=0.78, and p=0.80, respectively). The circulating levels of sCTLA-4 and sCD28 were significantly different between the gastric cancer group and the control group (p<0.001 and p<0.001, respectively).Conclusion:The present results suggest that the CTLA-4 and CD28 gene polymorphisms that were evaluated do not play an important role in Turkish patients with gastric cancer. However, sCTLA4 and sCD28 levels were higher in cancer patients and may be useful as an auxiliary parameter in the diagnosis and monitoring of gastric cancer.

scholarly journals Increasing serum level of transforming growth factor beta 2 (TGF-β) in patients with colorectal and gastric cancer in Iraq

2013 ◽  
Vol 7 (1) ◽  
pp. 72-79
Author(s):  
Ahmed Rushdi Abdullah ◽  
Shaimaa Yousif Abdulfattah ◽  
Farah Thamer Abdullah ◽  
Ali Talib Abid ◽  
Hussam Bassim Salah
Keyword(s):  
Colorectal Cancer ◽  
Gastric Cancer ◽  
Serum Level ◽  
Cancer Patients ◽  
Transforming Growth Factor Beta ◽  
Transforming Growth Factor ◽  
Control Group ◽  
Healthy Control ◽  
Growth Factor Beta ◽  
Gastric Cancer Patients

Gastrointestinal cancers (GITs) are worldwide problem particularly in highly developed countries. In Iraq, gastric cancer(GC) is the 9th most common cancer while colorectal cancers (CRC) is considered as the 7th most common cancer among all cancer patients in both males and females. The Objective of this study was to estimate the serum level of transforming growth factor beta 2 (TGF-β) in Iraqi patients who are complying from gastric and colorectal cancers. Fifty four serum samples were collected starting from the 1st of March till the mid of May of 2011 to investigate the TGF-β serum level by using ELISA technique. Thirty eight samples were gastric (H.pylori +ve) and colorectal cancer patients (GC=17, CRC=21) while the other 16 samples considered as a healthy control group. The results showed that TGF-β serum levels of both GIT tumors were increased significantly (p<0.05) compared to the healthy control group. In conclusion, the presented study showed elevated serum level of TGF-β in Gastric cancer patients which could point out to use this elevation as a biomarker for tumor prognosis; while in colorectal cancer it may evade the immune system cancer killing mechanisms. We recommend further studies concerning the correlation between serum level of TGF-β in Gastric cancer patients with staging and grading, and more immunological techniques can be implied to know the exact immunological evading mechanism of colorectal cancer cells.

scholarly journals Effects of perioperative ERAS pathway management VS traditional management on clinical outcomes in laparoscopic-assisted radical resection of distal gastric cancer The GISSG18-01 Randomized Clinical Trial

2020 ◽  
Author(s):  
Yulong Tian ◽  
Shougen Cao ◽  
Leping Li ◽  
Qingsi He ◽  
Lijian Xia ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Clinical Trial ◽  
Cancer Patients ◽  
Radical Resection ◽  
Control Group ◽  
Short Term ◽  
Traditional Management ◽  
Gastric Cancer Patients ◽  
Laparoscopic Assisted ◽  
Experimental Group

Abstract Background: As well known, the incidence of gastric cancer in East Asian countries is much higher than the international average. Therefore, improving the prognosis of patients and establishing effective clinical pathways are important topics for the prevention and treatment of gastric cancer. At present, the enhanced recovery after surgery (ERAS) pathway is widely used in the field of gastric surgery. Many RCT studies have proven that the ERAS regimen can not improve the short-term clinical outcomes of gastric cancer patients. However, a prospective study on the effect of the ERAS pathway on the prognosis of gastric cancer patients has not been reported. This trial aims to confirm whether ERAS pathway can improve disease-free survival (DFS) and overall survival (OS) in patients undergoing laparoscopic-assisted radical resection for distal gastric cancer.Methods/design: This study is a prospective, multicenter, randomized controlled trial (RCT). This experiment will include randomly divided groups, the experimental group and the control group, according to a proportion of 1:1. The perioperative period of the experimental group will be managed according to the ERAS pathway, and the control group will be managed according to the traditional management mode. An estimated 400 patients will be enrolled. The main endpoint is to compare the 3-year OS and PFS between the two groups.Discussion: This RCT should demonstrate whether ERAS pathway is superior to traditional treatment on inflammatory indexes, short-term clinical outcome and survival for laparoscopic assisted radical resection of distal gastric cancer.Our data can provide evidence that the ERAS pathway improves survival in patients with gastric cancer.Trial registration: Chinese Clinical Trial Registry, CHiCTR1900022438. Registered on 11 April 2019

scholarly journals OncoVee™-MiniPDX-Guided Anticancer Treatment for Gastric Cancer Patients With Synchronous Liver Metastases: A Retrospective Cohort Analysis

2022 ◽  
Vol 11 ◽  
Author(s):  
Yutong Ge ◽  
Xin Zhang ◽  
Wei Liang ◽  
Cuiju Tang ◽  
Dongying Gu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Retrospective Cohort ◽  
Response Rate ◽  
Cohort Analysis ◽  
Control Group ◽  
Observation Group ◽  
Retrospective Cohort Analysis ◽  
Gastric Cancer Patients ◽  
And Control

BackgroundIt is estimated that 35% of gastric cancer patients appear with synchronous distant metastases—the vast majority of patients presenting with metastatic hepatic disease. How to choose the most appropriate drugs or regimens is crucial to improve the prognosis of patients. We conducted this retrospective cohort analysis to evaluate the efficacy of OncoVee™-MiniPDX-guided treatment for these patients.MethodsGastric cancer patients with liver metastases (GCLM) were enrolled. Patients were divided into MiniPDX and control group according to their wishes. In the observation group, the OncoVee™-MiniPDX model was conducted to screen the most sensitive drug or regimens to determine the clinical administration. Meanwhile, patients were treated with regular medications in the control group according to the guidelines without the MiniPDX model. The primary endpoint was overall survival (OS), and the secondary outcomes included objective response rate (ORR), disease control rate (DCR), and progression-free survival (PFS).ResultsA total of 68 patients with GCLM were included, with the observation and control groups of 21 and 47 patients, respectively. The baseline characteristics of patients were balanced between these two groups. MiniPDX drug sensitivity tests were associated with the increased use of targeted drugs when compared with the control group (33.3 vs. 0%, p=0.032). Median OS was estimated to be 9.4 (95% CI, 7.9–11.2) months and 7.9 (95% CI, 7.2–8.7) months in the observation and control group, respectively. Both univariate (control group vs. MiniPDX group: HR=2.586, 95% CI= 1.362–4.908, p=0.004) and multivariate regression analyses (Control group vs. MiniPDX group: adjusted HR (aHR)=4.288, 95% CI= 1.452–12.671, p=0.008) showed the superiority of the observation group on OS. Similarly, MiniPDX-based regiments significantly improve the PFS of these cases (median PFS 6.7 months vs. 4.2 months, aHR=2.773, 95% CI=1.532–3.983, p=0.029). ORR and DCR were also improved in MiniPDX group comparing with control group (ORR, 57.14 vs. 25.53%, p=0.029; DCR: 85.71 vs. 68.08%, p=0.035).ConclusionOncoVee™-MiniPDX model, which was used to select drugs to guide antitumor treatment, was promising to prolong survival and improve the response rate of patients with GCLM. Further well-designed studies are needed to confirm the clinical benefits of MiniPDX.

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