European journal of cancer care
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Eur J Cancer Care (Engl) · Jan 2009
Randomized Controlled Trial Multicenter StudyLong-term glutamate supplementation failed to protect against peripheral neurotoxicity of paclitaxel.
Toxic peripheral neuropathy is still a significant limiting factor for chemotherapy with paclitaxel (PAC), although glutamate and its closely related amino acid glutamine were claimed to ameliorate PAC neurotoxicity. This pilot trial aimed to evaluate the role of glutamate supplementation for preventing PAC-induced peripheral neuropathy in a randomized, placebo-controlled, double-blinded clinical and electro-diagnostic study. Forty-three ovarian cancer patients were available for analysis following six cycles of the same PAC-containing regimen: 23 had been supplemented by glutamate all along the treatment period, at a daily dose of three times 500 mg (group G), and 20 had received a placebo (group P). ⋯ However, this difference reached statistical significance only with regard to reported pain sensation (P = 0.011). Also the frequency of abnormal electro-diagnostic findings showed similarity between the two groups (G: 7/23 = 30.4%; P: 6/20 = 30%). This pilot study leads to the conclusion that glutamate supplementation at the chosen regimen fails to protect against peripheral neurotoxicity of PAC.
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Eur J Cancer Care (Engl) · Jan 2008
Multicenter Study Comparative StudyOpioid use in dying patients in hospice and hospital, with and without specialist palliative care team involvement.
Newspapers claim that patients in hospices have their opioid doses increased to a point at which doctors know that they will die. However, research has produced conflicting results about whether hospice patients receive higher doses of opioids. ⋯ There was no statistically significant difference in the mean dose of opioids prescribed to and given to the different groups of cancer patients dying in different settings, indicating that the claims of the press are untrue. The cancer patients dying in hospital who were not on the HPCT records more commonly received Tramadol, which may indicate a reluctance of hospital doctors to move from weak opioids to strong opioids.
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Eur J Cancer Care (Engl) · Mar 2007
Multicenter StudySpecial considerations for haematology patients in relation to end-of-life care: Australian findings.
Recent hematology clinical guidelines recommend that palliative care specialists should have central roles in hemato-oncology teams. However, the available research evidence indicates there are presently significant obstacles to the integration of palliative care in hematology. ⋯ This article presents the list of special considerations from a nursing perspective, including issues associated with the high-tech nature of treatments, the speed of change to a terminal event, the need for blood products and possibility of catastrophic bleeds, the therapeutic optimism based on a myriad of treatment options and the clinical indices of the terminal trajectory. The nursing insights provide an important foundation for building a practical, patient-centred model for terminal care in hematology.
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Eur J Cancer Care (Engl) · Mar 2007
Multicenter Study Comparative StudyHospital stay frequency and duration of patients with advanced cancer diseases - differences between the most frequent tumour diagnoses: a secondary data analysis.
The differences in the number and duration of hospital stays of cancer patients in an advanced stage of disease were to be examined with regard to the most frequent cancer diagnoses. Therefore, routinely compiled data of the largest health insurance company in the State of Lower Saxony, Germany, were analysed. Patients with lung, colon, breast and prostate cancer were included, who died in the year of 2004. ⋯ The patient groups differed significantly both in the average number of cases and in the duration of hospital stays (Kruskal-Wallis test: P<0001), whereby patients with lung cancer underwent inpatient hospital treatment most frequently (3.3 times), and for the longest periods (35 days). This study shows that patients in an advanced stage of lung cancer are a particular important target group for reducing hospitalization at the end of life. They should receive special attention when structures of palliative care are extended.