Understanding treatment toxicity patterns through remote symptom monitoring and examining the effect of frailty in older men with metastatic prostate cancer.
Notice bibliographique
Résumé
12054 Background: Advancements in metastatic prostate cancer (mPC) treatments have increased survival, but using multiple lines of therapy has increased the prevalence and severity of toxicities. Older men and those living with frailty experience higher symptom burden associated with treatment. Although toxicities have been described in previous trials, much of the focus has been on pain and fatigue among fit and younger men, and only a few trials have examined the effects of frailty on toxicity. Thus, the aims of this study were to (1) understand the prevalence, duration, and changes in symptom severity among older men receiving mPC treatments; and (2) examine differences among frail and non-frail men. Methods: Men aged 65+ with mPC starting chemotherapy (chemo), androgen receptor-axis-targeted (ARAT) therapies, or radium-223 (Rad223) from two academic Canadian cancer centres were enrolled in a prospective cohort study. Participants self-reported symptoms daily using the Edmonton Symptom Assessment Scale (ESAS) for the first treatment cycle via internet or telephone. Frailty status was determined using the Vulnerable Elders Survey (VES-13). Study outcomes were the development of moderate-to-severe symptoms (ESAS≥4), their duration, and the proportion of participants who had improvements in symptom severity (ESAS<4) after reporting moderate-to-severe symptoms at baseline. Outcomes were determined using descriptive statistics. Associations between symptom prevalence, duration, and frailty were assessed using t-tests and chi-square tests. Results: 90 men (mean age=77 +/- 6.1 years, 58% frail (VES-13≥3)) starting chemo (n=34), an ARAT (n=43), or Rad223 (n=13) were included. The most common moderate-to-severe symptoms across cohorts were fatigue (46.8%), insomnia (42.9%), poor wellbeing (41.2%), decreased appetite (37.1%), and pain (35.9%). These symptoms were numerically higher in frail men, but differences between frail and non-frail were only statistically significant for poor wellbeing (62.5% in frail vs. 31.4% in non-frail, p=0.039). On average, poor wellbeing lasted 6.5 days (SD=7.6) days, decreased appetite lasted 5.5 days (SD=4.9), fatigue lasted 5.1 days (SD=7.3), pain lasted 4.7 days (SD=5.6), and insomnia lasted 4.6 days (SD=6.2) across cohorts. Fatigue and pain lasted numerically longer in frail men whereas insomnia, poor wellbeing, and decreased appetite lasted numerically longer in non-frail men, but these differences were not statistically significant. Among participants who reported moderate-to-severe symptoms at baseline, 15.4%, 10.7%, 7.7%, 5.3% and 3.6% had improvements in pain, appetite, wellbeing, insomnia, and fatigue, respectively. Conclusions: Understanding temporal patterns of symptoms and the impact of frailty in older men receiving mPC treatments may help inform supportive care approaches. Clinical trial information: NCT04193657 .
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».