ObjectiveTo systematically review the global situation of off-label drug use in cancer patients. MethodsWe searched PubMed, EMbase, CNKI, CBM and VIP databases from their inception to October 2014, to collect studies on off-label drug use in cancer patients. The publication language was limited to English and Chinese. Combieg criteria was used for methodological quality assessment of included studies. A describe analysis was used to analyze the incidence and the proportion of different off-label used drugs. ResultsA total of 14 cross-sectional studies were included. Among them, 1 was from Switzerland, 1 was from Italy, 1 was from Australia, and the other 11 studies were from China. Seven included studies reported the investigated patients' number, containing 3 713 cancer patients and 13 238 prescriptions. The incidences of off-label drug were 2 844, accounting for 21.48%. There were similar rates of off-label prescriptions in Europe, Asia and Australia, but the average off-label prescriptions of European cancer patients were lower than Asia and Australia. The total rate of "unapproved dose", "unapproved indication", and "unapproved solvents" were more than 80% in off-label drug use. ConclusionThe average off-label prescriptions of European cancer patients are lower than Asian and Australian. "Unapproved dose", "unapproved indication" and "unapproved solvents" are the most common off-label prescription in off-label drug use.
Cancer is a disease that incidence rate, disability rate and mortality rate are high all over the world. It brings great physical and mental pain to patients. Cancer patients are in a life-threatening state of disease for a long time, which will produce fear of progression (FoP). FoP is a psychological state in which fear of disease may recur or progress. As early as the 1980s, foreign countries began the psychological research on the FoP of cancer patients. They found that this fear really exists in cancer patients and is affected by many factors. This paper reviews the concept of FoP and the related factors affecting FoP in cancer patients. The purpose is to provide reference for clinical early evaluation and reducing the FoP of cancer patients and formulating corresponding nursing measures.
ObjectiveTo systematically review the efficacy of different nucleosides (acids) in preventing hepatitis B virus reactivation after chemotherapy in cancer patients. MethodsThe Cochrane Library, PubMed, EMbase, Web of Science, CNKI, WanFang Data, and VIP databases were electronically searched to collect randomized controlled trials (RCTs) of different nucleosides (acids) to prevent HBV reactivation after chemotherapy in cancer patients from inception to June 7th, 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Network meta-analysis was then performed by using Stata 16.0 software. ResultsA total of 43 RCTs involving 3 269 patients were included. There were 7 interventions, namely entecavir (ETV), lamivudine (LAM), adefovir dipivoxil (ADV), telbivudine (LdT), tenofovir dipivoxil (TDF), lamivudine combined with entecavir (LAM+ETV), and lamivudine combined with adefovir dipivoxil (LAM+ADV). The results of network meta-analysis showed that the efficacy of reducing the reactivation rate of ETV, LAM, ADV, LdT, TDF, LAM+ETV, LAM+ADV were superior than the control group. The ETV, LAM and ADV were not as effective as LAM+ETV. The leading drug combinations were LAM+ETV (94.8%), LdT (81.5%) and LA+ADV (58.0%). ConclusionsCurrent evidence shows that LAM+ETV, LdT, and LA+ADV are more effective in preventing hepatitis B virus reactivation after chemotherapy in cancer patients. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusions.
ObjectiveTo evaluate the degree of psychological pain for cancer patients undergoing surgical treatment and analyze the contributory factors to provide the theoretical basis for psychological intervention for cancer patients with surgical treatment.MethodsThe clinical data of 455 cancer patients who received surgeries in our hospital from November 2020 to January 2021 were retrospectively analyzed, including 225 males and 230 females aged 53.80±13.50 years. By applying the method of convenient sampling, a cross-sectional survey was carried out by gathering the general information of the patients and evaluating their mental condition with the distress thermometer. The contributory factors were discussed by logistic regression analysis.ResultsThe score for the psychological pain of the patients was 4.11±2.49 points. The main factors contributing to the psychological pain were physical problems, emotional problems and family matters. The logistic regression analysis showed that the main factors related to the degree of psychological pain were cancer types (P=0.023), religious belief (P=0.046), number of niduses (P=0.016), respiratory status (P=0.004), medical expense (P=0.007), grief (P=0.001) and anxiety (P=0.040).ConclusionNearly half of the patients have been subjected to apparent psychological pain, and emotion and physical problems are the main factors. It is crucial to pay attention to the patients’ mental problems, seek convenient tools for psychological evaluation, and take actions to deal with the psychological problems and physical symptoms.
ObjectiveTo systematically review the incidence of financial toxicity among cancer patients in China. MethodsThe Cochrane Library, Web of Science, PubMed, Embase, CINAHL, CNKI, and WanFang databases were searched to collect studies on the prevalence of financial toxicity among cancer patients in China from January 2016 to April 2023. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. A meta-analysis was performed by using Stata 16.0 software. ResultsA total of 24 studies involving 8 799 participants were included. Meta-analysis results showed that the prevalence of financial toxicity among cancer patients was 67.4% (95%CI 60.9% to 74.0%) in China. The subgroup analysis showed that sex, educational level, type of medical insurance, cancer site and stage, the cut-off of the instrument, and region were all influential factors of financial toxicity among cancer patients. ConclusionCurrent evidence shows that high prevalence of financial toxicity among cancer patients. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo overview the systematic reviews of the efficacy of cancer patient decision aids (PDAs) for treatment decision-making. MethodsThe PubMed, Web of Science, Cochrane Library, Embase, CINAHL, JBI, CNKI, VIP, CBM and WanFang Data databases were electronically searched to collect the systematic reviews relevant to the objective from inception to September 2023. Literature screening, data extraction, methodological quality assessment of the included literature, and summary and grading of the evidence were carried out independently by two researchers, and duplication of original studies in the included systematic evaluations was investigated using the corrected covered area (CCA). ResultsA total of 17 systematic reviews were included, of which 13 (76.47%) were low- or very low-quality studies. A total of 64 pieces of evidence were included, of which only 26 (40.62%) were of moderate quality, and the original studies included in the included literature had a low degree of overlap (CCA=0.05). The results of meta-analysis showed that PDAs could increase decision-related knowledge, reduce decision conflict and regret in cancer patients' treatment decision (P<0.05). However, there was no significant difference in decision satisfaction, anxiety or depression (P>0.05). ConclusionPDAs can improve cancer patients' knowledge related to treatment decision, reduce decision conflicts and regrets, and have no significant negative effects on decision preparation, satisfaction, anxiety, and depression. However, the existing systematic reviews are of low quality and limited to a few cancer types.