Objectives: The SiFEBI trial demonstrated that a post-operative Multicatheter Interstitial Brachytherapy (MIB) appears feasible and with acceptable toxicity in older adults aged 70 years and older presenting with low-risk breast cancer. The aim of the present ancillary study was to analyze the quality of life and Comprehensive Geriatric Assessment (CGA) domains within 6 months in older adults receiving Accelerated Partial Breast Irradiation (APBI) using a single fraction of MIB.
Materials And Methods: From 11/2012 to 09/2014, 37 patients were included and 26 were evaluable. Patients (pts) aged 70 years and older with a Balducci score of 1 or 2 and presenting with low-risk breast cancer were prospectively enrolled in this phase I/II trial (NCT01727011). After lumpectomy, intra-operative catheter implantation was performed for post-operative APBI after pathological findings. Quality of life (QoL) evaluation and CGA were scheduled at baseline and 1, 3, and 6 months after APBI. Autonomy decline was defined as a 1-point decrease in Activities of Daily Living (ADL).
Results: Mean age was 77 years. Within the first 6 months of follow-up, no autonomy decline was observed in ADL, 3 patients had an autonomy decline in Instrumental Activities of Daily Living (IADL) and 2 patients had a slower gait speed but no changes in cognitive function, nutritional status, and depression screening. Global QoL was quite similar at baseline compared to 1, 3, and 6 months. No differences were observed for functional items.
Conclusion: APBI based on a single fraction of MIB in older adults with low-risk breast cancer appears to be feasible with a minimal loss of autonomy regarding IADL, no loss of autonomy in ADL, an acceptable decrease in other CGA domains, and with no impact on global quality of life.
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http://dx.doi.org/10.1016/j.jgo.2021.04.009 | DOI Listing |
JAMA Dermatol
January 2025
Department of Dermatology, University of Pennsylvania, Philadelphia.
Importance: Cutaneous chronic graft-vs-host disease (GVHD) is independently associated with morbidity and mortality after allogeneic hematopoietic cell transplant. However, the health-related quality-of-life (HRQOL) domains that are most important to patients are poorly understood.
Objective: To perform a concept elicitation study to define HRQOL in cutaneous chronic GVHD from the patient perspective and to compare experiences of patients with epidermal vs sclerotic disease.
JAMA Netw Open
January 2025
Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
Importance: Spousal involvement in diabetes care is recommended theoretically, but effectiveness in clinical settings and among diverse populations is unclear.
Objective: To test the effect of a couple-based intervention among Chinese older patients with type 2 diabetes and their spouses.
Design, Setting, And Participants: This multicenter randomized clinical trial comprised 2 arms: a couple-based intervention arm and an individual-based control.
JAMA Netw Open
January 2025
Medical Oncology, The Ottawa Hospital Cancer Centre, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada.
Importance: Evolving breast cancer treatments have led to improved outcomes but carry a substantial financial burden. The association of treatment costs with the cost-effectiveness of screening mammography is unknown.
Objective: To determine the cost-effectiveness of population-based breast cancer screening in the context of current treatment standards.
Psychol Serv
January 2025
Center for Health Equity Research and Promotion, Department of Veterans Affairs Pittsburgh Healthcare System.
Chronic insomnia is one of the most common health problems among veterans and can significantly impact health, function, and quality of life. Brief behavioral treatment for insomnia (BBTI), an adaptation of cognitive behavioral therapy for insomnia (CBT-I), was developed to help increase access to care outside of specialty settings. However, training providers alone is rarely sufficient, and implementation strategies are needed for successful uptake, adoption, and sustainable delivery of care.
View Article and Find Full Text PDFAdv Ther
January 2025
CSL Vifor, Glattbrugg, Switzerland.
Introduction: Chronic kidney disease-associated pruritus (CKD-aP) is a common, yet underdiagnosed condition among patients on hemodialysis. Considering the lack of established treatment pathways, we sought to evaluate the use of antidepressant, systemic antihistamines, or gabapentinoid medications among patients with CKD-aP in the year following pruritus assessment.
Methods: We included 6209 patients on hemodialysis in the analysis.
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