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  • 1
    In: Breast Cancer Research and Treatment, Springer Science and Business Media LLC, Vol. 186, No. 3 ( 2021-04), p. 761-768
    Type of Medium: Online Resource
    ISSN: 0167-6806 , 1573-7217
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2004077-5
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  • 2
    In: Gynecologic Oncology, Elsevier BV, Vol. 124, No. 2 ( 2012-02), p. 216-220
    Type of Medium: Online Resource
    ISSN: 0090-8258
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2012
    detail.hit.zdb_id: 1467974-7
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  • 3
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2023
    In:  Breast Cancer Research and Treatment Vol. 197, No. 3 ( 2023-02), p. 535-545
    In: Breast Cancer Research and Treatment, Springer Science and Business Media LLC, Vol. 197, No. 3 ( 2023-02), p. 535-545
    Type of Medium: Online Resource
    ISSN: 0167-6806 , 1573-7217
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2004077-5
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  • 4
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2021
    In:  The Journal of Sexual Medicine Vol. 18, No. 10 ( 2021-10-01), p. 1768-1774
    In: The Journal of Sexual Medicine, Oxford University Press (OUP), Vol. 18, No. 10 ( 2021-10-01), p. 1768-1774
    Abstract: Tools for diagnosing sexual dysfunction and for tracking outcomes of interest include clinician interviews, physical exam, and patient self-report. Limited work has described relationships among these three sources of information regarding female sexual dysfunction and vulvovaginal health. Aim We describe correlations among data collected from clinician interviews, clinical gynecological examination, and patient self-report. Methods Data are from a single-site, single-arm, prospective trial in 100 postmenopausal patients with a history of breast or endometrial cancer who sought treatment for vulvovaginal symptoms. The trial collected a standardized clinical gynecologic exam, clinician-reported outcome (ClinRO) measures of vulvovaginal dryness and pain, and patient-reported outcome (PRO) measures of sexual function, including PROMIS Sexual Function and Satisfaction (SexFS) lubrication, vaginal discomfort, labial discomfort, and clitoral discomfort and Female Sexual Function Index (FSFI) lubrication and pain. We examined polyserial correlations between measures with bootstrapped 95% confidence intervals from the baseline and 12–14-week timepoints. RESULTS All of the relationships between the ClinRO variables and the PRO variables were in the expected direction (ie, positive), but the strength of the relationships varied substantially. At 12–14 weeks, there were medium-to-large correlations between ClinRO vaginal dryness and SexFS Lubrication (0.64), ClinRO vulvar dryness and SexFS Lubrication (0.46), ClinRO vulvar discomfort and SexFS Labial Discomfort (0.70), and ClinRO vulvar discomfort and SexFS Clitoral Discomfort (0.43). With one exception, the correlations between the exam variables and the corresponding PRO scores were small (range 0.01–0.27). Strengths & Limitations Our study included a comprehensive, standardized gynecologic exam designed specifically to evaluate sexual dysfunction as well as established PRO measures with significant evidence for validity. A limitation of our findings is that the sample size was relatively small, and our sample was restricted to women who received cancer treatments known to have dramatic effects on vulvovaginal tissue quality. CONCLUSION Patient- and clinician-reported vulvovaginal dryness and discomfort were moderately correlated with each other but not with clinical gynecologic exam findings. Understanding the relationships among these different types of data highlights the distinct contributions of each to understand vulvovaginal tissue quality and patient sexual function after cancer.
    Type of Medium: Online Resource
    ISSN: 1743-6109 , 1743-6095
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
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  • 5
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2021
    In:  Annals of Surgical Oncology Vol. 28, No. 1 ( 2021-01), p. 48-56
    In: Annals of Surgical Oncology, Springer Science and Business Media LLC, Vol. 28, No. 1 ( 2021-01), p. 48-56
    Type of Medium: Online Resource
    ISSN: 1068-9265 , 1534-4681
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2074021-9
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  • 6
    In: Blood, American Society of Hematology, Vol. 125, No. 9 ( 2015-02-26), p. 1403-1410
    Abstract: We conducted a phase-2 study in newly diagnosed PCNSL utilizing R-MPV and HDC with ASCT. Excellent disease control and OS (2-year PFS: 79%) were observed, with an acceptable toxicity profile and minimal neurotoxicity.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2015
    detail.hit.zdb_id: 1468538-3
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  • 7
    In: Clinical Cancer Research, American Association for Cancer Research (AACR), Vol. 20, No. 19 ( 2014-10-01), p. 5023-5031
    Abstract: Purpose: Bevacizumab is associated with decreased vascular permeability that allows for more aggressive radiotherapy schedules. We conducted a phase II trial in newly diagnosed glioblastoma utilizing a novel hypofractionated stereotactic radiotherapy (HFSRT) schedule combined with temozolomide and bevacizumab. Experimental Design: Patients with tumor volume ≤60 cc were treated with HFSRT (6 × 6 Gy to contrast enhancement and 6 × 4 Gy to FLAIR hyperintensity with dose painting) combined with concomitant/adjuvant temozolomide and bevacizumab at standard doses. Primary endpoint was 1-year overall survival (OS): promising = 70%; nonpromising = 50%; α = 0.1; β = 0.1. Results: Forty patients were enrolled (median age: 55 years; methylated MGMT promoter: 23%; unmethylated: 70%). The 1-year OS was 93% [95% confidence interval (CI), 84–100] and median OS was 19 months. The median PFS was 10 months, with no pseudo-progression observed. The objective response rate (ORR) was 57%. Analysis of The Cancer Genome Atlas glioblastoma transcriptional subclasses (Nanostring assay) suggested patients with a proneural phenotype (26%) fared worse (ORR = 14%, vs. 77% for other subclasses; P = 0.009). Dynamic susceptibility-contrast perfusion MRI showed marked decreases in relative cerebral blood volume over time (P & lt; 0.0001) but had no prognostic value, whereas higher baseline apparent diffusion coefficient (ADC) ratios and persistent hypermetabolism at the 6-month FDG-PET predicted poor OS (P = 0.05 and 0.0001, respectively). Quality-of-life (FACT-BR-4) and neuropsychological test scores were stable over time, although some domains displayed transient decreases following HFSRT. Conclusions: This aggressive radiotherapy schedule was safe and more convenient for patients, achieving an OS that is comparable with historical controls. Analysis of advanced neuroimaging parameters suggests ADC and FDG-PET as potentially useful biomarkers, whereas tissue correlatives uncovered the poor prognosis associated with the proneural signature in non–IDH-1–mutated glioblastoma. Clin Cancer Res; 20(19); 5023–31. ©2014 AACR.
    Type of Medium: Online Resource
    ISSN: 1078-0432 , 1557-3265
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2014
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    detail.hit.zdb_id: 2036787-9
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  • 8
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 82, No. 4_Supplement ( 2022-02-15), p. P4-08-01-P4-08-01
    Abstract: Introduction: Chronic musculoskeletal pain is common and debilitating among breast cancer survivors. Recently, the Personalized Electroacupuncture (EA) versus Auricular Acupuncture (AA) Comparative Effectiveness (PEACE) trial demonstrated that both acupuncture methods improved pain control better than usual care (UC) in cancer survivors. However, the comparative effectiveness between EA and AA among breast cancer survivors, specifically, for chronic musculoskeletal pain is unknown. Here, we report the results of breast cancer survivors enrolled in the PEACE trial. Methods: PEACE is a three-arm, parallel, single center randomized trial investigating the effectiveness of EA and AA versus UC for chronic musculoskeletal pain in 360 cancer survivors. Patients in both EA and AA received ten weekly treatments. Patients in UC could receive ten EA treatments after week 12. The primary endpoint was the change in mean Brief Pain Inventory (BPI) pain intensity from baseline to week 12; change from baseline to week 24 was a secondary endpoint. We analyzed the subset of trial participants with a primary diagnosis of breast cancer (46%). We conducted constrained linear mixed model analyses, which constrained all arms to have a common pre-randomization baseline mean. Model-based mean estimates at weeks 12 and 24 were compared between arms using model contrasts. Results: Among the 165 breast cancer survivors, mean (SD) age was 60.3 (11.0) years, 35.8% were non-white, and mean time since cancer diagnosis was 5.4 (6.5) years. Patients had been experiencing pain for 5.6 (7.3) years, with baseline mean pain severity of 5.35 (95% CI: 5.04, 5.66). 86.7% had a prior history of surgery, 43.0% chemotherapy, 64.8% radiotherapy, and 50.3% endocrine therapy. The common locations of pain were lower back (24.2%), knee/leg (23.6%), and shoulder/arm/elbow (13.9%). 107 (66.9%) patients were taking pain medication. At week 12, the BPI pain severity score was 2.69 (2.26. 3.13) in EA, 3.60 (3.17, 4.02) in AA, and 5.06 (4.47, 5.65) in UC. The change in mean BPI intensity score from baseline was -2.65 (-3.06, -2.25), -1.75 (-2.15, -1.35), and -0.29 (-0.86, 0.28) in EA, AA, and UC, respectively (Table 1). At week 24, the mean BPI pain severity was 2.84 (95% Confidence Interval [CI] : 2.40, 3.28) in EA and 3.67 (95% CI: 3.23, 4.10) in AA. EA reduced pain severity significantly more than AA at both week 12, (-0.90 [-1.45, -0.36], p =0.001) and week 24 (-0.82, [-1.38, -0.27] , p=0.004). Minimal toxicities were reported. Conclusions: While both EA and AA were associated with clinically meaningful and persistent reduction of pain among breast cancer survivors, EA was more effective than AA at reducing pain severity. Breast cancer survivors with chronic musculoskeletal pain may consider EA. Table 1.Changes in BPI Pain Intensity from BaselineBPI Pain IntensityUCEAAAEA vs AAChange from baselineChange from baselineDifference from UCChange from baselineDifference from UCDifference between EA and AAWeek 12Mean (95% CI)-0.29 (-0.86, 0.28)-2.65* (-3.06, -2.25)-2.37*(-3.05, -1.68)-1.75* (-2.15, -1.35)-1.46* (-2.14, -0.78)-0.90* (-1.45, -0.36)*p≤0.001 Citation Format: Wanqing Iris Zhi, Jun J Mao, Raymond E Baser, Susan Q Li, Vicotria S Blinder, Larry Norton, Andrew D Seidman, Mark E Robson, Ting Bao. Effectiveness of electroacupuncture versus auricular acupuncture in breast cancer survivors with chronic musculoskeletal pain: The PEACE randomized clinical trial [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-08-01.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2022
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    detail.hit.zdb_id: 1432-1
    detail.hit.zdb_id: 410466-3
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  • 9
    In: Translational Behavioral Medicine, Oxford University Press (OUP), Vol. 12, No. 8 ( 2022-08-17), p. 841-852
    Abstract: Caregivers of patients with glioblastoma multiforme (GBM) are at significant risk for existential distress. Such distress negatively impacts caregivers’ quality of life and capacity to serve in their role as healthcare proxies, and ultimately, contributes to poor bereavement outcomes. Our team developed Meaning-Centered Psychotherapy for Cancer Caregivers (MCP-C), the first targeted psychosocial intervention that directly addresses existential distress in caregivers. The purpose of this study was to evaluate the feasibility, acceptability, and preliminary effects of MCP-C among caregivers of patients with GBM via a mixed-method pilot trial. Caregivers were randomized to seven sessions of MCP-C or Enhanced Usual Care (EUC), which included distress screening and the provision of targeted referrals and completed quantitative assessments at baseline (T1), after completion of MCP-C (T2), and at 2-month follow-up (T3). A subset of participants engaged in semistructured interviews at T2. Of 60 caregivers randomized, 55 were evaluable for preliminary efficacy analysis. Constrained linear mixed models indicated the MCP-C arm had statistically significant improvement relative to the EUC arm in the primary outcome of personal meaning and multiple secondary outcomes, including benefit finding, depressive symptomatology, and spiritual wellbeing. MCP-C demonstrated preliminary efficacy in facilitating caregivers’ capacity to experience a sense of meaning and purpose despite the challenges and suffering associated with providing care to patients with GBM. Future studies are needed among more diverse samples of caregivers and should include the opportunity for concurrent patient enrollment to allow for a reciprocal and augmented experience of meaning among patient–caregiver dyads.
    Type of Medium: Online Resource
    ISSN: 1869-6716 , 1613-9860
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2586893-7
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  • 10
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 33, No. 20 ( 2015-07-10), p. 2246-2253
    Abstract: To examine bereavement mental health service use, barriers to use, and factors associated with use in parents bereaved by cancer. Patients and Methods A multicenter, cross-sectional study of 120 parents bereaved by cancer between 6 months and 6 years after their loss was performed. Parents completed self-report assessments of mental health service use and barriers, prolonged grief, depression, anxiety, attachment styles, and sense of meaning by phone, in person, or on their own. Results Forty-one percent of bereaved parents were currently using mental health services (talk therapy, psychotropic medication, and/or a support group), most commonly within the first 2 years after their loss. Talk therapy was the most frequently used service, although 36% of parents who discontinued therapy did so because it was not helpful. Forty percent of parents who wanted bereavement support reported they were not receiving services. The most common barriers to service use were that it was too painful to speak about the loss (64%) and too difficult to find help (60%). Factors associated with current mental health service use included more recent loss, prior mental health service use, subclinical/increased depression, insecure attachment styles, and a decreased sense of meaning. Minority parents were more likely to have unmet needs than nonminority parents. Conclusion Parents appear to need, want, and often access bereavement mental health services, which could be offered in oncology settings. However, barriers to service use must be addressed, particularly for those with more debilitating grief symptoms and for minorities. High treatment dropout rates suggest the importance of improving retention, training providers, and developing effective grief interventions.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
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    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2015
    detail.hit.zdb_id: 2005181-5
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