11 research outputs found
Evidence-based management of chemotherapy-induced nausea and vomiting: a position statement from a European cancer nursing forum
Chemotherapy-induced nausea and vomiting (CINV) is a common, but now often overlooked side effect of cancer treatment, and one that can be largely prevented through the implementation of international evidence-based guidelines. The European CINV Forum, comprising nurses from France, Germany, Portugal, Spain and the UK, discussed the use of CINV preventive strategies in routine practice, and the factors that affect optimal delivery of antiemetic therapies. Based on these discussions, they developed a series of recommendations for optimal, evidence-based management of CINV. These state that all patients receiving chemotherapy should undergo full assessment of their risk of CINV and receive appropriate prophylactic treatment based on guidelines from the Multinational Association of Supportive Care in Cancer (MASCC) and the National Comprehensive Cancer Network (NCCN), which were both updated in 2011. Other recommendations, aimed at raising awareness of CINV and its management, include timely updates of relevant local practice guidelines and protocols, translation of the MASCC and NCCN guidelines into all European languages and their dissemination through accessible articles in nursing journals and newsletters and via nursing conferences and study days, improved training for nurses on CINV, collaboration between the European Oncology Nursing Society and national nursing organisations to promote consistent practice, the development of a CINV toolkit, information provision for patients, local audits of CINV management, and a survey of CINV management between and within European countries
Evidence-based management of chemotherapy-induced nausea and vomiting: a position statement from a European cancer nursing forum
Chemotherapy-induced nausea and vomiting (CINV) is a common, but now often overlooked side effect of cancer treatment, and one that can be largely prevented through the implementation of international evidence-based guidelines. The European CINV Forum, comprising nurses from France, Germany, Portugal, Spain and the UK, discussed the use of CINV preventive strategies in routine practice, and the factors that affect optimal delivery of antiemetic therapies. Based on these discussions, they developed a series of recommendations for optimal, evidence-based management of CINV. These state that all patients receiving chemotherapy should undergo full assessment of their risk of CINV and receive appropriate prophylactic treatment based on guidelines from the Multinational Association of Supportive Care in Cancer (MASCC) and the National Comprehensive Cancer Network (NCCN), which were both updated in 2011. Other recommendations, aimed at raising awareness of CINV and its management, include timely updates of relevant local practice guidelines and protocols, translation of the MASCC and NCCN guidelines into all European languages and their dissemination through accessible articles in nursing journals and newsletters and via nursing conferences and study days, improved training for nurses on CINV, collaboration between the European Oncology Nursing Society and national nursing organisations to promote consistent practice, the development of a CINV toolkit, information provision for patients, local audits of CINV management, and a survey of CINV management between and within European countries
Pain related to repeated invasive procedures in oncology: Improvement of management between 1998 and 2004
“Regards croisés 2009”: survey on perception of fatigue and chemotherapy-induced anemia conducted in cancer patients and health professionals, typologies and insights
≪Regards croisés 2009 ≫: survey about perception and management of fatigue and chemotherapy-induced anemia conducted among cancer patients and health professionals
« Regards croisés 2009 »: perception of cancer patients and health professionals about consequences of fatigue and chemotherapy-induced anemia on daily life
Traduction et republication de : « Traitement de la maladie thromboembolique veineuse associée au cancer chez les patients en soins palliatifs »
International audienceMany patients with cancer require palliative care at some stage and the vast majority of people followed in palliative care are cancer patients. Patients with cancer are at high risk of venous thromboembolism (VTE), and this is particularly true during the advanced palliative phase when mobility is limited or absent. Patients with cancer in palliative care are at higher bleeding risk compared to non-cancer patients. Decisions to treat VTE or withhold anticoagulation for these patients have proven to be difficult and depend largely on an individual clinician's judgment. For this reason, we have developed a consensus proposal for appropriate management of cancer-associated thromboembolism (CAT) in patients in palliative care, which is presented in this article. The proposal was informed by the recent scientific literature retrieved through a systematic literature review. In cancer patients in advanced palliative care, the benefit/risk ratio of anticoagulation seems unfavourable with a higher haemorrhagic risk than the benefit associated with prevention of CAT recurrence and, above all, in the absence of any benefit on quality of life. For this reason, we recommend that patients should be prescribed anticoagulants on a case-by-case basis. The choice of whether to treat, and with which type of treatment, should take into account anticipated life expectancy and patient preferences, as well as clinical factors such as the estimated bleeding risk, the type of VTE experienced and the time since the VTE event.De nombreux patients atteints de cancer ont besoin de soins palliatifs et la grande majorité des personnes suivies en soins palliatifs sont atteintes de cancer. Dans le contexte de cancer, le risque de maladie thromboembolique veineuse (MTEV) est élevé, d’autant plus pendant la phase palliative avancée, lorsque la mobilité est limitée ou inexistante. Par ailleurs, les patients atteints de cancer et recevant des soins palliatifs présentent un risque hémorragique plus élevé que les autres patients. Dans ce contexte, la décision de traiter la MTEV ou de suspendre l’anticoagulation s’avère difficile à prendre et dépend largement du jugement du clinicien. Nous présentons dans cet article une proposition de consensus pour la prise en charge de la thrombose associée au cancer (TAC) chez les patients en soins palliatifs. Cette proposition s’appuie sur une revue systématique de la littérature scientifique récente. Chez les patients cancéreux en soins palliatifs avancés, le rapport bénéfice/risque de l’anticoagulation semble défavorable, avec un risque hémorragique plus élevé que le bénéfice associé à la prévention de la récidive des TAC, en l’absence de tout bénéfice sur la qualité de vie. Pour cette raison, nous recommandons que la décision de prescription des anticoagulants se fasse au cas par cas. Le choix de traiter ou pas, ainsi que le choix de l’anticoagulant prescrit, tiendront compte de l’espérance de vie et des préférences du patient, ainsi que de facteurs cliniques tels que le risque hémorragique estimé, le type de MTEV et le temps écoulé depuis le diagnostic de l’événement thromboembolique veineux
Traduction et republication de : « Thrombose veineuse profonde du membre supérieur associée à un cathéter veineux central chez les patients cancéreux : diagnostic et prise en charge thérapeutique »
International audienceCatheter-related thrombosis (CRT) is a relatively frequent and potentially fatal complication arising in patients with cancer who require a central catheter placement for intravenous treatment. In everyday practice, CRT remains a challenge for management; despite its frequency and its negative clinical impact, few data are available concerning diagnosis and treatment of CRT. In particular, no diagnostic studies or clinical trials have been published that included exclusively patients with cancer and a central venous catheter (CVC). For this reason, many questions regarding optimal management of CRT remain unanswered. Due to the paucity of high-grade evidence regarding CRT in cancer patients, guidelines are derived from upper extremity DVT studies for diagnosis, and from those for lower limb DVT for treatment. This article addresses the issues of diagnosis and management of CRT through a review of the available literature and makes a number of proposals based on the available evidence. In symptomatic patients, venous ultrasound is the most appropriate choice for first-line diagnostic imaging of CRT because it is noninvasive, and its diagnostic performance is high (which is not the case in asymptomatic patients). In the absence of direct comparative clinical trials, we suggest treating patients with CRT with a therapeutic dose of either a LMWH or a direct oral factor Xa inhibitor, with or without a loading dose. These anticoagulants should be given for a total of at least 3 months, including at least 1 month after catheter removal following initiation of therapy.La thrombose liée au cathéter (TLC) est une complication relativement fréquente et potentiellement fatale chez les patients atteints de cancer qui nécessitent la pose d’un cathéter central pour un traitement intraveineux. Malgré sa fréquence et son retentissement clinique, peu de données sont disponibles pour guider le diagnostic et le traitement de la TLC. Aucune étude diagnostique ni aucun essai clinique n’ont été menés chez des patients porteurs d’un cathéter veineux central (CVC) dans un contexte de cancer. De nombreuses questions concernant la prise en charge optimale de la TLC restent ainsi sans réponse. En raison de la rareté de données de haut niveau de preuve, les recommandations sont dérivées des études sur la thrombose veineuse profonde des membres supérieurs pour le diagnostic, et des membres inférieurs pour le traitement. Cet article aborde les questions du diagnostic et de la prise en charge de la TLC à travers une revue de la littérature disponible. Chez les patients symptomatiques, l’échographie veineuse est l’examen d’imagerie le plus approprié en première ligne pour le diagnostic de la TLC, étant non invasive et ayant une performance diagnostique élevée (ce qui n’est pas le cas chez les patients asymptomatiques). En l’absence d’essais cliniques comparatifs directs, nous suggérons de traiter les patients atteints de TLC avec une héparine de bas poids moléculaire (HBPM) à dose curative, ou un inhibiteur direct du facteur Xa par voie orale (DXI), avec ou sans dose de charge. Les anticoagulants doivent être administrés pendant une durée totale d’au moins 3 mois, dont au moins 1 mois après le retrait du cathéter
Traduction et republication de : « Maladie thromboembolique veineuse récidivante chez les patients cancéreux anticoagulés : diagnostic et traitement »
International audiencePatients with cancer are at significantly increased risk of venous thromboembolism (VTE), due both to the impact of malignant disease itself and to the impact of certain anticancer drugs on haemostasis. This is true both for first episode venous thromboembolism and recurrence. The diagnosis and management of VTE recurrence in patients with cancer poses particular challenges, and these are reviewed in the present article, based on a systematic review of the relevant scientific literature published over the last decade. Furthermore, it is uncertain whether diagnostic algorithms for venous thromboembolism, validated principally in untreated non-cancer patients, are also valid in anticoagulated cancer patients: the available data suggests that clinical decision rules and D-dimer testing perform less well in this clinical setting. In patients with cancer, computed tomography pulmonary angiography and venous ultrasound appear to be the most reliable diagnostic tools for diagnosis of pulmonary embolism and deep vein thrombosis respectively. Options for treatment of venous thromboembolism include low molecular weight heparins (at a therapeutic dose or an increased dose), fondaparinux or oral direct factor Xa inhibitors. The choice of treatment should take into account the nature (pulmonary embolism or VTE) and severity of the recurrent event, the associated bleeding risk, the current anticoagulant treatment (type, dose, adherence and possible drug–drug interactions) and cancer progression.Les patients atteints de cancer présentent un risque significativement accru de maladie thromboembolique veineuse (MTEV), en raison à la fois de l’impact de la maladie maligne elle-même et de l’impact de certains médicaments anticancéreux sur l’hémostase. Cela est vrai à la fois pour le premier épisode de MTEV et pour sa récidive. Le diagnostic et la prise en charge de la récidive de la MTEV chez les patients atteints de cancer posent des problèmes particuliers, qui sont examinés dans le présent article, sur la base d’une revue systématique de la littérature publiée au cours de la dernière décennie. Il n’est pas certain que les algorithmes de diagnostic de la MTEV, validés principalement chez les patients sans cancer et ne recevant pas d’anticoagulant, soient également valables chez les patients cancéreux sous traitement anticoagulant. Les données disponibles suggèrent que dans ce contexte clinique, les algorithmes diagnostiques utilisant la probabilité clinique et le dosage des D-dimères seraient moins performants. Chez les patients atteints de cancer, l’angioscanner pulmonaire et l’échographie veineuse semblent être les outils les plus fiables pour le diagnostic de l’embolie pulmonaire et de la thrombose veineuse profonde, respectivement. Les options de traitement de la MTEV récidivante sous anticoagulant comprennent les héparines de bas poids moléculaire (à une dose thérapeutique ou à une dose plus élevée), le fondaparinux ou les inhibiteurs directs du facteur Xa par voie orale. Le choix du traitement doit tenir compte de la nature (embolie pulmonaire ou thrombose veineuse profonde) et de la gravité de l’événement récurrent, du risque hémorragique associé, du traitement anticoagulant en cours (type, dose, observance et interactions médicamenteuses éventuelles) et de l’évolution du cancer