Objective To evaluate the effectiveness of prosthetic revision using custom-made long stem prosthesis and allograft-prosthesis composite (APC) for aseptic loosening after bone tumor resection. Methods Between January 2002 and June 2008, 14 patients with aseptic loosening after bone tumor resection were treated. There were 8 males and 6 females,aged 21-70 years (mean, 43.9 years). The locations were distal femur (8 cases), proximal femur (2 cases), and proximal tibia (4 cases). Pain of the affected l imb occurred after 6-31 years of prosthesis replacement and worsened when bearing and walking; 6 patients had shortened l imb. The functional results were assessed quantitatively according to the functional rating system of the Musculoskeletal Tumor Society (MSTS). The MSTS score was 16.36 ± 1.50 before revision. The X-ray films showed obvious prosthetic loosening and subsidence. The average time of symptom was 4.5 years (range, 3-9 years). In 7 patients having severe bone loss (the decrease of the thickness of cortical bone was more than 50%) and the prosthetic subsidence was more than 2 cm, the revision operation with the APC was performed; in 7 patients having less bone loss (the decrease of the thickness of cortical bone was less than 50%), the custom-made long stem prosthesis was performed. Results All wound healed by first intention. Two patients had temporary peroneal nerve paralysis and recovered after 3 months. All the patients were followed up 3.6 years on average (range, 2 years and 2 months-7 years) after revision. After revision, pain was rel ieved and the range of joint was improved. The MSTS score was 23.43 ± 2.56 at 12 months after revision showing significant difference when compared with the preoperative score (t=8.910, P=0.024). The X-ray films showed that lucency space l ine around stem cement in 2 patients at 12 months, and no prosthesis loosening and infection occurred. Conclusion The prosthetic revision after l imb salvage surgery with prosthesis for bone tumors was acceptable. The good functional results can be achieved by the revision with the APC or the custom-made long stem prosthesis according to the bone loss.
ObjectiveTo analyze the clinical effect of sodium chlorophyllin in the treatment of geriatric oncology-related anemia and its significance. MethodsWe retrospectively analyzed the clinical data of elderly cancer patients with similar treatment background between December 2011 and February 2013, and the patients were divided into sodium chlorophyllin treatment group and no special treatment group. Then, parallel comparative study was carried out for anemia-related indexes and scores of quality of life. ResultsHemoglobin, red blood cells and quality of life of sodium chlorophyllin treatment group were improved after treatment, and these indexes were also better than those in the no special treatment group (P<0.05). ConclusionSodium chlorophyllin can ameliorate anemia in elderly patients with oncology-related anemia, which is worthy of being popularized.
ObjectiveTo investigate the application status of survival analysis in studies published in Chinese oncology journals, and assess their reporting quality and summarize the existing problems, so as to promote the application of survival analysis and reporting quality. MethodsStudies that used survival analysis were collected from 1 492 studies published in Chinese Journal of Oncology, Chinese Journal of Clinical Oncology, Chinese Journal of Radiation Oncology and Chinese Journal of Cancer Prevention and Treatment in 2013. The application status of survival analysis of included studies was analysed and their reporting quality was evaluated. ResultsA total of 242 survival analysis studies were included. Among them, the utilization rates of Kaplan-Meier method, life table method, log-rank test, Breslow test and Cox proportional hazards model were 91.74%, 3.72%, 78.51%, 0.41% and 46.28%, respectively. 112 studies did multivariate analysis through Cox proportional hazards model. A total of 396 end points and 10 different types of survival time were reported. Overall survival (OS) was reported in 233 studies (92.15%). Survival terms were defined to 158 end points (39.90%) of 103 studies (42.56%). The follow-up rates were mentioned in 155 studies (64.05%), of which 4 studies were under 80% and the lowest was 75.25%, 55 studies were 100%. The main problems of survival analysis studies published in Chinese journals were as follows:None of the studies which used Cox proportional hazards model reported the proportional hazards assumption. None of the studies used the method of parametric survival analysis. 130 studies (53.72%) did not use the method of multiple factor analysis. 139 studies (57.44%) did not define the survival terms. Only 11 of 100 studies which reported loss to follow-up had stated how to treat it in the analysis. None of the studies reported the methods of calculating sample size. None of the studies reported the censoring proportion. ConclusionThe methods of survival analysis are used in a low rate in studies published in Chinese oncology journals, and the overall reporting quality of survival analyses is poor. So the reporting guideline of survival analysis should be developed and the authors should be encouraged to cooperate with professional statisticians, in order to improve the design, analysis and reporting quality of survival analysis studies.
ObjectiveTo explore the feasibility and significance of self-training system for oncology nurses by observing the effect of the training in primary hospitals. MethodsFrom January 2013 to January 2015, a cohort of nurses from a primary oncology hospital were trained based on the practical needs of oncologists, nurses and patients.The training system included nursing measures for chemotherapy drug extravasation and other adverse reactions, tumor emergency, peripherally inserted central catheter catheterization, cancer patients' psychological state, rehabilitation of cancer patients and cancer pain.Training and assessment were conducted using a method of combination of theory and practice. ResultsA total of 240 nurses were trained.The theory score before and after training was respectively 72.28±2.56 and 84.85±4.17;the practice score was respectively 63.39±1.42 and 72.68±2.63.There were significant differences between the pre-training and post-training results of theory and practice scores (P < 0.05).The adverse nursing events rate three months before training was 22.1%, and was 8.8% three months after training, and the difference was significant (P < 0.05).The satisfaction rate increased from 59% one month before training to 84% one month after training. ConclusionThe self-training system in primary tumor hospitals can improve the level of nursing care for oncology nurses and is worthy of promotion.
ObjectiveTo investigate the estimated prevalence of depression and its associated factors among inpatients in the Department of Oncology in general hospitals. MethodsOn October 29th, 2013, we surveyed all hospitalized patients from the Department of Oncology in West China Hospital, Sichuan University. The questionnaire on patients’ demographic characteristics and the Patient Health Questionnaire-9 (PHQ-9) were combined to form one questionnaire to investigate the incidence of depression in hospitalized patients in general hospitals and its influencing factors. ResultsWe gave out 546 questionnaires and retrieved 528 with a retrieval rate of 96.6%. Seven questionnaires had 15 or more empty items and were deleted. The final number of valid questionnaires was 521, with a validity rate of 95.4%. The estimated prevalence of depression among inpatients from the Department of Oncology was 32.8% (171/521). Risk factors for depression in patients in the Department of Oncology included female gender [OR=1.550, 95%CI (1.034, 2.325), P=0.034] illiterate and primary school education [OR=2.534, 95%CI (1.329, 4.832), P=0.005] and annual household income lower than 10 000 RMB [OR=1.850, 95%CI (1.056, 3.243), P=0.032]. A total of 135 patients had suicidal risks, among whom 90 (52.6%) had depression, and Spearman correlation analysis showed that suicidal risk was moderately and positively correlated with PHQ-9 scores (r=0.558, P<0.001). ConclusionsThe estimated total prevalence of depression is high in hospitalized patients in the Department of Oncology, especially in female, low educational level and low family income patients. We must pay more attention to the mental health of cancer patients, evaluate depression and suicidal tendency carefully and provide psychological service timely.
Objective To discuss the effect of Balint groups on promoting mental health of oncology nurses through developing Balint group activities. Methods From December 2015 to December 2016, a series of Balint group activities were carried out among 63 oncology nurses in West China Hospital of Sichuan University. Huaxi Emotion Index was used to investigate the psychological status in the nurses before and after the activities of Balint groups, and then the data was analyzed statistically. Result Except the scores of nurses aged over 41 and nurses above the primary and secondary level (P>0.05), all other scores had significant differences (P<0.05). Conclusions Balint group activities can significantly relieve oncology nurses’ negative emotions such as anxiety, tension and depression, alleviate body discomfort symptoms and improve interpersonal relationships. Huaxi Emotion Index is easy to understand, which helps rapid clinical assessment and nurses’ psychological problems screening. It is suitable for popularization and application clinically.
Diffuse large B-cell lymphoma is highly heterogeneous and is diagnosed according to the 2016 World Health Organization Classification of Tumours of Haematopoietic and Lymphoid Tissues. The decision of treatment should be upon age, International Prognostic Index score and the tolerability of chemotherapy. High-dose chemotherapy and autologous stem cell transplantation is the standard care for relapsed, chemotherapy sensitive patients. Clinical trials are recommended in specific conditions.
ObjectivesTo systematically review the efficacy of problem-based learning (PBL) model in clinical oncology teaching.MethodsPubMed, EMbase, CNKI, WanFang Data, CBM databases were electronically searched to collect randomized controlled trials (RCTs) of PBL model used in clinical oncology teaching in China from January, 2000 to March, 2019. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 and Stata 12.0 software.ResultsA total of 29 RCTs involving 2 238 subjects were included. The results of meta-analysis showed that: PBL model in clinical oncology teaching was superior to traditional lecture-based learning (LBL) model on the total score (MD=6.50, 95%CI 4.44 to 8.55, P<0.000 01), theoretical knowledge score (MD=4.58, 95%CI 3.38 to 5.78, P<0.000 01), case analysis score (MD=4.26, 95%CI 3.38 to 5.78, P<0.000 01), skill operation score (MD=6.10, 95%CI 4.77 to 7.43, P<0.000 01), overall course satisfaction (RR=1.74, 95%CI 1.34 to 2.27, P<0.000 01), increased learning interest (RR=1.52, 95%CI 1.28 to 1.81, P<0.000 1), improved teamwork cooperation (RR=1.67, 95%CI 1.39 to 2.01, P=0.002), and improved self-study ability (RR=1.51, 95%CI 1.20 to 1.90, P<0.000 1), the differences were statistically significant.ConclusionsCurrent evidence shows that the PBL model can improve clinical teaching effect of oncology and learning satisfaction. Due to limited quality and quantity of the included studies accumulated, more high quality studies are required to verify above conclusion.
To enhance the quality and transparency of oncology real-world evidence studies, the European Society for Medical Oncology (ESMO) has developed the first specific reporting guidelines for oncology RWE studies in peer-reviewed journals ‘the ESMO Guidance for Reporting Oncology Real-World Evidence (GROW)’. To facilitate readers understanding and application of these reporting standards, this article introduces and interprets the development process and main content of the ESMO-GROW checklist.