Supportive Care In Cancer[JOURNAL]
Sun
200 papers
Management of MRONJ: comparison between SIPMO-SICMF and AAOMS consensus statements and clinical-economic implications for the national health system.
Pieretto G, Dhelpra I, Destro E … +1 more , Bacci C
Support Care Cancer · 2026 Jun · PMID 42322498 · Publisher ↗
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Clinical potential of the gut microbiome in oncology: a scoping review of treatment response, toxicity and biomarker development.
de Souza Menezes JD, da Silva MQ, Dos Santos ER … +4 more , de Carvalho SRPVT, Faria MAG, de Cássia Helú Mendonça Ribeiro R, André JC
Support Care Cancer · 2026 Jun · PMID 42322355 · Full text
PURPOSE: This scoping review aimed to systematically map and critically describe the current evidence on the role of the gut microbiome as a biomarker in oncology, including microbiome-based predictive models and microbi...
PURPOSE: This scoping review aimed to systematically map and critically describe the current evidence on the role of the gut microbiome as a biomarker in oncology, including microbiome-based predictive models and microbial signatures associated with treatment response, toxicity and disease course, and to identify methodological gaps and challenges for clinical translation in precision medicine. METHODS: This scoping review was conducted following the Joanna Briggs Institute (JBI) guidelines for scoping reviews and reported according to the PRISMA Extension for Scoping Reviews (PRISMA-ScR). The search was performed in five electronic databases (PubMed/MEDLINE, Web of Science, Scopus, SciELO, and LILACS) using a structured PICO strategy. Studies involving adult cancer patients undergoing systemic oncological therapies (including chemotherapy, immunotherapy and combined regimens), with gut microbiome analysis and the investigation, development or validation of microbiome-based biomarkers or predictive models, were included. RESULTS: The literature demonstrates that specific microbial taxa significantly influence the efficacy of immunotherapies (e.g., AUCs up to 0.88 for ICI response prediction) and chemotherapies, and modulate toxicity (e.g., mucositis reduction from 47.1% to 25% with probiotics). Microbiome-based predictive models often outperform clinical markers (e.g., AUC of 0.88 vs. 0.50 in urothelial carcinoma), and variations in microbiota composition can predict disease progression. The literature mapping of the 20 included studies demonstrates that specific microbial taxa significantly influence the efficacy of immunotherapies (e.g., AUCs up to 0.88 for ICI response prediction) and chemotherapies. Regarding toxicity, while the review focuses on baseline biomarkers, exploratory intervention-based data were addressed, showing that a probiotic cocktail reduced Grade 3-4 oral mucositis from 47.1% to 25%. Furthermore, microbiome-based predictive models demonstrated enhanced discriminatory accuracy in predicting patient outcomes compared to standard clinical classification markers alone (e.g., achieving an Area Under the Curve [AUC] of 0.88 vs. 0.50 for clinical factors in urothelial carcinoma), though these models remain in early exploratory stages. CONCLUSION: Overall, the evidence suggests a growing interest and potential for microbiome-based predictive models in oncology; however, their clinical translation remains limited by methodological heterogeneity, insufficient external validation, and incomplete mechanistic understanding.
Photobiomodulation for oral mucositis in cancer care: prevention, clinical management, and evidence from randomized controlled trials.
Parra-Rojas S, Cassol-Spanemberg J, Pérez AN … +2 more , Baggio GL, Velázquez-Cayón RT
Support Care Cancer · 2026 Jun · PMID 42319507 · Publisher ↗
PURPOSE: This systematic review aimed to evaluate the efficacy of photobiomodulation (PBM) for the prevention and clinical management of oral mucositis (OM) in adult cancer patients, with particular emphasis on protocol...
PURPOSE: This systematic review aimed to evaluate the efficacy of photobiomodulation (PBM) for the prevention and clinical management of oral mucositis (OM) in adult cancer patients, with particular emphasis on protocol characteristics potentially associated with favorable clinical outcomes. METHODS: A systematic search of PubMed, Web of Science, and Scopus was conducted up to March 31, 2026, in accordance with PRISMA guidelines. Randomized controlled trials in adult cancer patients comparing PBM with sham interventions were included. Outcomes of interest included OM incidence, severity, pain, and related clinical outcomes. The review protocol was prospectively registered in PROSPERO. RESULTS: Fifteen randomized controlled trials involving 868 adult patients were included. Most studies reported favorable effects of PBM, including reductions in severe OM incidence, pain intensity, analgesic requirements, and nutritional support needs compared with controls. Preventive intraoral PBM protocols were generally associated with more favorable outcomes, although variability in treatment parameters, delivery methods, and outcome reporting limited comparability. Most included studies demonstrated acceptable methodological quality. CONCLUSIONS: PBM appears to be a promising supportive care intervention for reducing the burden of OM in adult cancer patients, particularly in preventive settings. However, variability across protocols precludes definitive conclusions regarding optimal treatment parameters. Further high-quality randomized trials with standardized reporting are needed to refine protocol recommendations and expand evidence in therapeutic settings.
A randomized controlled trial comparing the effect of salivary substitute and fluoride varnish on radiation caries in irradiated head and neck cancer patients.
Bhandari S, Wadhwa B, Ghoshal S
Support Care Cancer · 2026 Jun · PMID 42319482 · Publisher ↗
INTRODUCTION: Morbid effects of head and neck cancer (HNC), ensuing treatment, and ignorance of oral health care have been shown to cause multiple oral issues, including progressive radiation caries (RC). Such conditions...
INTRODUCTION: Morbid effects of head and neck cancer (HNC), ensuing treatment, and ignorance of oral health care have been shown to cause multiple oral issues, including progressive radiation caries (RC). Such conditions negatively impact the quality of life in HNC survivors, are costly for healthcare systems to manage, and may generate population-level differences at local, regional, national, and global levels. AIM: To evaluate and compare the effectiveness of salivary substitute and fluoride varnish on RC in irradiated HNC patients. METHODOLOGY: HNC patients meeting the inclusion criteria were randomly assigned into three groups to receive either a saliva substitute (Group I), fluoride varnish (Group II), or both (group III). After providing comprehensive oral care, the Decayed, Missing, and Filled Surfaces (DMFS) score was recorded before RT, then at 3, 6, and 12 months post-RT. Fluoride varnish was applied professionally before RT, immediately after RT, and then at 3-month intervals. Saliva substitute was advised to be used liberally at home before major meals. RESULTS: Four hundred eighty-two patients; 407 males and 75 females with a mean age of 51.32 (18-79) years were recruited for the study. At 12 months, complete data was available for 67 patients in Group I, 73 in Group II, and 80 in Group 3. An increase in DMFS score was statistically significant (P < .05) in all three groups and across all time points. The Bonferroni test for intergroup comparison was non-significant. CONCLUSION: Multiple overlapping factors influence the origin and progression of RC. The amalgamation of salivary gland-sparing RT, professional care, stringent home care measures, regular follow-ups, and patient education is paramount for addressing oral issues in HNC survivors.
Folic acid deficiency in cancer therapy: a review of chemotherapy-induced malabsorption and supportive care strategies.
Tembhurne SV, Kate PM
Support Care Cancer · 2026 Jun · PMID 42319474 · Publisher ↗
PURPOSE: Folic acid (vitamin B9) plays a vital role in DNA synthesis, repair, and methylation, supporting both normal cellular functions and the proliferation of cancer cells. This review aims to explore the complex inte...
PURPOSE: Folic acid (vitamin B9) plays a vital role in DNA synthesis, repair, and methylation, supporting both normal cellular functions and the proliferation of cancer cells. This review aims to explore the complex interplay between folic acid metabolism, antifolate chemotherapy (particularly methotrexate), and chemotherapy-induced malabsorption, with an emphasis on the need for nutritional interventions. METHODS: A comprehensive literature review was conducted using databases such as PubMed, Scopus, and Google Scholar to identify studies addressing folic acid deficiency, chemotherapy-related malabsorption, methotrexate toxicity, and nutritional support strategies in cancer patients. RESULTS: Evidence indicates that methotrexate-induced inhibition of dihydrofolate reductase disrupts folate pathways, contributing to folic acid deficiency and malabsorption syndromes. This can lead to clinical complications such as anaemia, mucositis, immune suppression, and reduced treatment tolerance. Nutritional deficiencies further exacerbate drug toxicity and impair patient outcomes. While folic acid supplementation has shown benefit in reducing toxicity, its dosing must be carefully managed to avoid interference with chemotherapeutic efficacy. CONCLUSION: Folic acid deficiency and malabsorption are significant concerns in cancer therapy involving antifolate drugs. Targeted nutritional strategies, including judicious folic acid supplementation, are essential to improving patient outcomes and minimizing treatment-associated complications. Future clinical approaches should integrate personalized nutritional support alongside chemotherapy regimens.
Beyond the patient: how providers perceive and experience non-medical barriers in gastrointestinal cancer care.
Lal T, Moody D, Chiratanagandla R … +5 more , Meehan G, Davey CH, Bora S, Stange K, Hoehn RS
Support Care Cancer · 2026 Jun · PMID 42315744 · Full text
PURPOSE: Gastrointestinal (GI) cancer care requires coordination across specialties and is sensitive to non-medical barriers like insurance, transportation, and health literacy. Prior survey work at our institution ident...
PURPOSE: Gastrointestinal (GI) cancer care requires coordination across specialties and is sensitive to non-medical barriers like insurance, transportation, and health literacy. Prior survey work at our institution identified these barriers as most prominent during initial treatment planning and as consuming substantial provider time. This qualitative study represents the second phase of a larger effort to inform the development of a transdisciplinary care model designed to address non-medical determinants of care. METHODS: We conducted semi-structured interviews with purposively sampled multidisciplinary providers involved in GI cancer care at a large academic health system in the USA. Interviews explored patient- and system-level barriers and opportunities to improve care coordination. Transcripts underwent inductive thematic analysis with double coding. Pearson correlation coefficients assessed covariation among themes and informed the construction of a directed acyclic graph illustrating hypothesized causal relationships among barrier domains. RESULTS: We interviewed 30 providers, including physicians (n = 7), advanced practice providers (n = 2), nurses (n = 5), dietitians (n = 7), social workers (n = 6), and a care coordinator (n = 1). Seven interconnected themes emerged: health system, financial, access and logistics, provider capacity, patient knowledge and engagement, social and emotional, and communication and coordination. Structural and financial barriers operated as upstream drivers influencing workflow and access, while logistical and social barriers translated these pressures into downstream inefficiencies and provider strain. Providers consistently supported a transdisciplinary care model to centralize navigation and support. CONCLUSION: Non-medical barriers in GI cancer care undermine patient care, provider capacity, and health system efficiency. These findings provide an actionable framework for developing equitable, efficient, and sustainable cancer care models.
The effects of Reiki practice on breast cancer patients: a systematic review.
Turan Z, Tülüce D
Support Care Cancer · 2026 Jun · PMID 42315636 · Full text
PURPOSE: Breast cancer and its treatments cause multifaceted symptoms in women, affecting their physical, psychological, and emotional well-being. Complementary practices such as Reiki are increasingly used to support sy...
PURPOSE: Breast cancer and its treatments cause multifaceted symptoms in women, affecting their physical, psychological, and emotional well-being. Complementary practices such as Reiki are increasingly used to support symptom management, particularly during chemotherapy. This systematic review aims to evaluate the effects of Reiki practice on improving symptoms in breast cancer patients within the framework of Martha E. Rogers' "Science of Unitary Human Beings." METHOD: This study was conducted as a systematic review in accordance with the PRISMA 2020 guidelines. A comprehensive literature search was performed in the PubMed, Web of Science, CINAHL (EBSCOhost), Google Scholar, and DergiPark databases, with the search updated through May 2026 prior to the final analysis. Randomized controlled trials, experimental studies, and quasi-experimental studies investigating Reiki interventions in breast cancer patients were included. Methodological quality and risk of bias were independently assessed by two researchers using Joanna Briggs Institute (JBI) critical appraisal tools and the Cochrane Risk of Bias Tool. RESULTS: Four studies meeting the inclusion criteria included a total of 339 participants. The included studies suggested that Reiki practice may reduce fatigue and improve overall comfort and well-being. Some studies also reported improvements in quality of life, comfort, mental well-being, and mood. CONCLUSION: Reiki appeared to be a safe and well-tolerated complementary intervention in the included studies. Reiki practice may contribute to symptom management, improve quality of life, and support psychological well-being in breast cancer patients. However, due to the limited number of studies, small sample sizes, and methodological differences, larger, well-designed randomized controlled trials are needed.
Correction to: The role of digital rehabilitation therapy in enhancing upper limb function recovery following surgery in breast cancer patients.
Huang W, Yang C, Shen H … +7 more , Han B, Xiao N, Liu Y, Lu S, Yu G, Jiang F, Zhuang M
Support Care Cancer · 2026 Jun · PMID 42307798 · Publisher ↗
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Supportive care for talquetamab-related dysgeusia in multiple myeloma: mixed-methods evidence, nutrition-focused flowchart, and digital companion concept.
Fleischer A, Roll M, Panther F … +13 more , Peter J, Kadel S, Riedhammer C, Strunz PP, Schaefers C, Gesierich A, Mersi J, Waldschmidt J, Gelbrich G, Kortüm KM, Einsele H, Maatouk I, Rasche L
Support Care Cancer · 2026 Jun · PMID 42307796 · Full text
PURPOSE: Talquetamab (TAL) frequently induces a distinctive dysgeusia that diminishes eating enjoyment, oral intake, and quality of life in patients with multiple myeloma (MM). Patient-centered, evidence-based nutritiona...
PURPOSE: Talquetamab (TAL) frequently induces a distinctive dysgeusia that diminishes eating enjoyment, oral intake, and quality of life in patients with multiple myeloma (MM). Patient-centered, evidence-based nutritional guidance tailored to TAL-related sensory phenotypes is scarce. This mixed-methods study aimed to characterize patient experiences, identify preferred dietary adaptations, and translate these findings into a proposed exploratory clinical workflow and a digital companion support concept for future validation. METHODS: A prospective, single-center exploratory mixed-methods study was conducted in talquetamab-treated patients with multiple myeloma who reported new-onset taste change (n = 25). Patient-reported dysgeusia, xerostomia symptoms, dietary experiences, and coping strategies were captured using a structured questionnaire with free-text fields. Taste change and xerostomia were assessed by patient report; objective psychophysical taste testing and sialometry were not performed in this cohort. Free-text responses were analyzed by two independent coders using reflexive thematic analysis with iterative consensus. Quantitative data were summarized descriptively. Integrated findings were translated in interprofessional focus groups into two exploratory supportive-care outputs: a proposed clinical workflow and a digital companion blueprint for future validation. RESULTS: Patients described heterogeneous and individualized taste disturbances, including reduced or unpleasant perception of sweet flavors, bitter/sour aversions, spice-related mucosal sensitivity, and reduced enjoyment of meals. Patient-reported xerostomia symptoms aggravated intolerance to dry or fibrous foods and impaired swallowing comfort. Frequently reported coping strategies included mild herbs and aroma cues, umami-rich additions, sauce- or soup-based texture modification, temperature and plating adjustments, saliva-supportive measures, and environmental or behavioral strategies. Based on these findings, we developed an exploratory supportive-care workflow incorporating cycle-based symptom screening, prospective use of validated taste assessment where feasible, structured xerostomia and nutritional-risk assessment, phenotype-oriented dietary suggestions, safety escalation, and follow-up. A digital companion blueprint (GUSTABOR) was conceptualized to support future individualized dietary guidance after usability and effectiveness testing. CONCLUSIONS: Talquetamab-related dysgeusia is clinically meaningful, heterogeneous, and closely linked to oral dryness symptoms, food texture tolerance, eating enjoyment, and social participation. The proposed workflow and digital companion blueprint should be interpreted as exploratory supportive-care concepts derived from patient-reported experience, not as validated clinical tools. Prospective multicenter studies using validated taste instruments, objective salivary-flow assessment, nutritional endpoints, and implementation outcomes are required before routine clinical adoption. IMPLICATIONS FOR CANCER SURVIVORS: Structured symptom screening, validated taste assessment where feasible, and individualized nutrition support may help identify patients at risk for reduced intake, weight loss, and impaired quality of life during talquetamab therapy. Digital support could broaden access to tailored guidance, but should be implemented only after prospective evaluation of usability, safety, resource requirements, and clinical benefit.
Identifying caregiver-reported modifiable barriers to pediatric oncology clinical trial enrollment and participation.
Whitmire R, Wikstrom D, Lockridge R … +7 more , Holland E, Van Sprang A, Toledo-Tamula MA, Akshintala S, Kaplan RN, Wolters PL, Martin S
Support Care Cancer · 2026 Jun · PMID 42307694 · Publisher ↗
PURPOSE: Clinical trial (ClTr) participation is critical to high-quality pediatric oncology care, but significant sociodemographic disparities in trial enrollment exist. Identifying modifiable barriers to participation s...
PURPOSE: Clinical trial (ClTr) participation is critical to high-quality pediatric oncology care, but significant sociodemographic disparities in trial enrollment exist. Identifying modifiable barriers to participation such as household material hardship (HMH) and limited health literacy (HL) is essential to improving ClTr access. We compared differences in caregiver-reported barriers to pediatric oncology ClTr participation across socioeconomic status (SES) and racial and ethnic groups through a nationwide anonymous online survey of caregivers of children with cancer. We also explored associations among caregiver HL, HMH, and barriers to trial participation. METHODS: English- and/or Spanish-speaking caregivers of children diagnosed with cancer in the last 5 years completed the Research Participation Survey - Caregiver (RPS-C) assessing caregiver-reported barriers to ClTr participation, the validated Health Literacy Survey-12 (HLS-Q12) assessing HL, and the WellRx questionnaire measuring unmet needs. RESULTS: Of 59 participants, 64% were socioeconomically under-resourced, 52.5% identified as racially or ethnically underrepresented per NIH criteria, and 62% reported their child had not participated in a ClTr. Under-resourced caregivers reported higher RPS-C barrier scores than adequately resourced caregivers (z = 3.18, p = 0.001). There were no significant differences in barrier scores across underrepresented vs represented racial and ethnic groups (p = 0.069). Lower HL (rho = -0.51, p < 0.001) and higher HMH (rho = 0.57, p < 0.001) were associated with higher barrier scores. The most frequently identified barrier was difficulty understanding study risks (> 90%). CONCLUSIONS: Under-resourced SES, HMH, and lower HL were associated with increased reported barriers to ClTr participation. Caregivers reported modifiable barriers that could be targets for intervention to improve ClTr participation and reduce disparities in childhood cancer outcomes.
Factors influencing care for patients with gynecologic malignancies from culturally and linguistically diverse backgrounds: a questionnaire study (iCALD-2).
Kasherman L, Braik D, Gonzalez-Ochoa E … +11 more , Shukla A, Odujoko O, Lajkosz K, Wang C, Grant R, Dhani N, Bowering V, Croke J, Philp L, Oza A, Lheureux S
Support Care Cancer · 2026 Jun · PMID 42307686 · Publisher ↗
PURPOSE: Culturally and linguistically diverse (CALD) populations affected by cancer experience challenges within healthcare systems leading to inequities and disparities in care. This study aimed to describe factors tha...
PURPOSE: Culturally and linguistically diverse (CALD) populations affected by cancer experience challenges within healthcare systems leading to inequities and disparities in care. This study aimed to describe factors that affect care for gynecologic cancer patients from CALD backgrounds by gathering perspectives from patients, interpreters, and cancer care professionals. METHODS: This questionnaire-based study was conducted in the Gynecologic Oncology Clinics at Princess Margaret Cancer Center, Toronto, Canada. Study-specific questionnaires were administered to CALD patients, professional interpreters, and cancer care professionals with domains including demographics, clinic experiences, and perceived barriers and facilitators to care. Descriptive statistics summarized survey results and content analysis of free-text answers was performed. RESULTS: Between May 2022 and December 2023, 23 patients, 10 interpreters, and 11 cancer care professionals completed surveys. Twenty (87%) patients reported English proficiency as "poor" or "very poor," but most were confident in participating in treatment decision-making (n = 20, 87%). Most agreed (n = 15, 65%) that interpretive services were beneficial however 12 (52%) preferred family members or bilingual staff to interpret. All interpreters were comfortable facilitating oncology discussions, but eight (80%) had previously been asked by family members to withhold information about cancer diagnosis or prognosis. Ten (91%) cancer care professionals reported interpreters improved care delivery for CALD patients. CONCLUSION: While language interpretation is crucial to effective cancer care delivery for CALD patients, factors including family support and patient preferences may impact consultation dynamics and patient experiences. These factors need to be considered upon implementing future interventions to optimize care.
Sociodemographic disparities and reasons for delayed healthcare among U.S. cancer survivors: an All of Us study.
Ng DQ, Zheng Z, Jemal A … +2 more , Chan A, Islami F
Support Care Cancer · 2026 Jun · PMID 42303910 · Full text
OBJECTIVE: To examine how sociodemographic factors influence healthcare access among cancer survivors. METHODS: From the National Institutes of Health's All of Us dataset (2018-2022, n = 27,589), we analyzed the relation...
OBJECTIVE: To examine how sociodemographic factors influence healthcare access among cancer survivors. METHODS: From the National Institutes of Health's All of Us dataset (2018-2022, n = 27,589), we analyzed the relationship between characteristics like age, income, race/ethnicity, and insurance, and reasons for delayed healthcare, including affordability, transportation, and nervousness. RESULTS: Young adult cancer survivors (ages 18-39), those on Medicaid, and individuals earning less than $25,000 annually consistently experienced higher rates of delayed healthcare. The top reasons for delayed healthcare were affordability issues (12%), nervousness (8%), and transportation barriers (6%). Female survivors were more likely to delay care for all reasons except transportation. Work and caregiving-related delays were more common among minoritized racial/ethnic groups, while non-Hispanic White survivors more often delayed healthcare due to nervousness and socioeconomic factors. CONCLUSIONS: Considerable differences in delayed healthcare were observed among cancer survivors by sociodemographic characteristics. Findings highlight the need for tailored interventions to effectively address the unique social needs of each cancer survivor, ultimately improving healthcare access for all.
Healthcare contact days in cancer survivors relative to those with no cancer history.
Parsons HM, Newton CC, Gupta A … +6 more , Flanders WD, Patel AV, Bodelon C, Zhong C, Westmaas JL, Rees-Punia E
Support Care Cancer · 2026 Jun · PMID 42303887 · Full text
INTRODUCTION: Cancer survivors have unique healthcare needs that require frequent contact with the healthcare system to receive cancer-directed treatment and survivorship care. While there is growing evidence of survivor...
INTRODUCTION: Cancer survivors have unique healthcare needs that require frequent contact with the healthcare system to receive cancer-directed treatment and survivorship care. While there is growing evidence of survivors' time burden for cancer care, we have less information about the trajectory of this burden across a broad range of cancers relative to those without cancer. METHODS: Using the Cancer Prevention Study-II Nutrition Cohort linked to Medicare claims from 1999-2017, we describe trajectories of and factors associated with healthcare contact after a cancer diagnosis relative to those without cancer. We use logistic regression to examine the relationship between sociodemographic and cancer characteristics and being in the highest quartile of healthcare contact days. RESULTS: In the month of diagnosis the median percentage of days with healthcare contact spiked at 20% compared with 4% among controls and remained higher than controls throughout the year after diagnosis. In the last year of life, cancer cases had a higher median percentage of contact days vs. controls for all months except for the month of death. The highest levels of healthcare contact were among individuals with lung and hematologic cancers, those receiving chemotherapy and/or radiation, older individuals, females, Non-Hispanic White individuals, those with more comorbidities or people living in metropolitan areas. CONCLUSION: We identify substantial healthcare contact among cancer survivors relative to controls after diagnosis. Our findings can serve as a framework for discussion between providers and patients to inform interventions focused on non-value added healthcare contact across the cancer continuum.
Clinical vulnerability to chemotherapy in cholangiocarcinoma: impact of nutritional status, frailty, and systemic inflammation.
Lee HS, Lee WJ, Lee JM … +5 more , Jeon HJ, Choi HS, Kim ES, Keum B, Jeen YT
Support Care Cancer · 2026 Jun · PMID 42303816 · Publisher ↗
PURPOSE: To determine the contribution of frailty, nutritional status, and systemic inflammation to early toxicity and treatment modifications in patients with advanced cholangiocarcinoma (CCA) treated with gemcitabine-c...
PURPOSE: To determine the contribution of frailty, nutritional status, and systemic inflammation to early toxicity and treatment modifications in patients with advanced cholangiocarcinoma (CCA) treated with gemcitabine-cisplatin plus immune checkpoint inhibitors (ICIs). METHODS: Patients with unresectable or metastatic CCA who received first-line gemcitabine-cisplatin plus durvalumab or pembrolizumab were retrospectively analyzed. Frailty, nutritional status, and systemic inflammation were assessed using the five-item modified frailty index (mFI-5), prognostic nutritional index (PNI), and neutrophil-to-lymphocyte ratio (NLR). The primary outcome was suboptimal relative dose intensity (RDI < 75%) during the first six weeks of treatment. Secondary outcomes included grade ≥ 3 adverse events (AEs) and overall survival (OS). RESULTS: Fifty-four patients were included. Univariable analyses indicated that lower PNI, hypoalbuminemia, older age, poorer performance status, and initial dose reduction were associated with suboptimal RDI. Lower PNI was independently associated with an increased risk of grade ≥ 3 AEs (adjusted odds ratio, 0.81; 95% confidence interval, 0.69-0.93). Patients with grade ≥ 3 AEs had significantly lower PNI and serum albumin levels; mFI-5, NLR, age, and performance status did not differ significantly between groups. In survival analyses, low PNI (< 42.9) was associated with significantly worse OS (log-rank p = 0.0036). An elevated NLR (≥ 3) was associated with OS; its prognostic impact was limited, whereas mFI-5 ≥ 2 was not. Performance status remained the strongest independent predictor of OS in multivariable models. CONCLUSIONS: Among the evaluated vulnerability measures, PNI appeared to be an important marker associated with early treatment-related toxicity and survival in patients with advanced CCA treated with gemcitabine-cisplatin plus ICIs.
Correction to: Breast cancer survivors' perspectives on a clinical decision tool to support individualized exercise prescriptions and discussions.
Wilson OWA, Wojcik KM, Kerr EM … +10 more , Rivera I, Tian E, Schneider JD, Brick R, Berrigan D, Tamura K, Rogers LQ, Demark-Wahnefried W, Street RL, Jayasekera J
Support Care Cancer · 2026 Jun · PMID 42301493 · Full text
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Health-related quality of life in young pediatric cancer survivors: The role of sarcopenia.
Marmol-Perez A, Ubago-Guisado E, Cadenas-Sanchez C … +8 more , Rodriguez-Solana A, Llorente-Cantarero FJ, Pascual-Gázquez JF, Moreira-Gonçalves D, Mota J, Ness KK, Ruiz JR, Gracia-Marco L
Support Care Cancer · 2026 Jun · PMID 42298229 · Full text
PURPOSE: Sarcopenia is a prevalent musculoskeletal complication after pediatric cancer, and its association with health-related quality of life (HRQoL) remains unknown. This study aimed to investigate health-related qual...
PURPOSE: Sarcopenia is a prevalent musculoskeletal complication after pediatric cancer, and its association with health-related quality of life (HRQoL) remains unknown. This study aimed to investigate health-related quality of life (HRQoL) differences according to sarcopenia status in young pediatric cancer survivors, and determined if these differences were distinct by sex. METHODS: This cross-sectional study included 116 pediatric cancer survivors (12.1 ± 3.3 years old). Muscle strength was evaluated by handgrip strength test, while appendicular lean mass index (ALMI, kg/m) was estimated via dual‑energy X‑ray absorptiometry. "Sarcopenia probable" was defined when muscle strength was ≤ decile 2 and ALMI Z-score was > -1.5 standard deviation (SD). "Sarcopenia confirmed" was defined when muscle strength was ≤ decile 2 and ALMI Z-score ≤ -1.5 SD. HRQoL was assessed using the Spanish version of the PedsQL 4.0 Generic Core Scales, and compared with age-specific reference values of healthy young population to calculate Z-scores. RESULTS: Only female survivors without sarcopenia had significantly better total HRQoL (-0.3 [95% CI: -0.8 to 0.2] vs. 1.5 [95% CI: -2.1 to -0.8]), physical HRQoL (-0.3 [95% CI: -0.8 to 0.2] vs. -1.6 [95% CI: -2.3 to -0.9]), psychosocial HRQoL (-0.2 [95% CI: -0.7 to 0.3] vs. -1.2 [95% CI: -1.8 to -0.6]) and school HRQoL (-0.1 [95% CI: -0.6 to 0.4] vs. -1.3 [95% CI: -2.0 to -0.7]) than female survivors with sarcopenia confirmed. CONCLUSION: Most HRQoL domains are similar across sarcopenia status in young pediatric cancer survivors. However, female survivors without sarcopenia seem to have better HRQoL Z-score than those with sarcopenia.
Patient experience after pelvic exenteration: chronic pain and quality of life.
Louis O, Young J, Power C … +2 more , Atkin C, Behrenbruch C
Support Care Cancer · 2026 Jun · PMID 42298118 · Full text
BACKGROUND: Pelvic exenteration is a major surgery involving resection of the pelvic viscera and surrounding structures. Performed on patients with locally advanced or recurrent pelvic cancer, it is associated with high...
BACKGROUND: Pelvic exenteration is a major surgery involving resection of the pelvic viscera and surrounding structures. Performed on patients with locally advanced or recurrent pelvic cancer, it is associated with high morbidity, persistent pain and low quality of life (QoL). This study aimed to determine the long-term prevalence of chronic pain and to characterise the pain and QoL experience in pelvic exenteration patients. METHODS: A telephone survey was undertaken, utilising patient-reported outcome measures: the Chronic Pain Grade Scale (CPGS) to assess pain and the Short Form-12 (SF-12) to measure QoL. Historic and demographic data were retrieved from hospital records to capture potential pre-, peri- and post-operative determinants. Data was analysed using descriptive statistics, correlation and comparative tests. RESULTS: This study comprised 48 individuals, up to 13 years post-pelvic exenteration. Pain prevalence was 75%, with most patients reporting no to low-intensity pain, without disability (54%). SF-12 scores varied; physical scores were significantly lower than population norms, while mental scores were preserved. Pain intensity and disability (CPGS sub-scores) were associated with lower QoL, a relationship that was consistent across pain grades. CONCLUSIONS: These findings indicate that the post-pelvic exenteration experience is characterised by reduced physical QoL and notable pain, highlighting the importance of early pain management optimisation. This research provides surgical candidates with authentic patient insight into life after surgery in a complex yet understudied population. Prospective longitudinal research is recommended to further examine patient trajectories and predictors of pain and poor QoL, enabling better targeted pain management.
Impact of disease status and general condition on changes in physical function before and after allogeneic hematopoietic stem cell transplantation.
Takekiyo T, Ito Y, Dozono K … +8 more , Miyazono T, Tokunaga M, Odawara J, Nakano N, Fujino S, Nara S, Shimoyama S, Utsunomiya A
Support Care Cancer · 2026 Jun · PMID 42295484 · Publisher ↗
PURPOSE: Physical function frequently declines after allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, the influence of disease status and general condition at the time of transplantation on longit...
PURPOSE: Physical function frequently declines after allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, the influence of disease status and general condition at the time of transplantation on longitudinal functional changes remains unclear. METHODS: This retrospective study included 135 adult patients with hematological malignancies who underwent their first allo-HSCT and completed physical function assessments before transplantation and at discharge. Handgrip strength and 6-min walk distance (6MWD) were evaluated. Patients were stratified according to disease status (complete remission [CR] vs. non-CR) and general condition (performance status [PS]). RESULTS: Both handgrip strength and 6MWD decreased significantly after transplantation in all groups. No significant differences in functional changes were observed between the CR and non-CR groups. In contrast, patients with poor PS at transplantation tended to show a greater decline in 6MWD than those with good PS. Multiple regression analysis identified PS at transplantation, age, sex, and change in the hemoglobin level as significant factors associated with changes in 6MWD. CONCLUSION: Pre-transplant PS was associated with a greater post-transplant decline in endurance capacity, regardless of disease status. PS may serve as a practical clinical indicator for identifying patients at higher risk of physical function deterioration and guiding early targeted rehabilitation interventions.
Development and pre-testing of a family-centered digital intervention to help families know what to EXPECT from pediatric acute lymphoblastic leukemia therapy.
Hatch CC, Levy LH, Kelly KM … +8 more , Revette A, Krieger M, Moynihan L, Carter N, Selig R, Vrooman LM, Kahn JM, Greenzang KA
Support Care Cancer · 2026 Jun · PMID 42295452 · Full text
PURPOSE: Acute lymphoblastic leukemia (ALL), the most common pediatric malignancy, involves multi-year treatment with substantial outpatient care, which contributes to high parent/caregiver burden. Communication gaps and...
PURPOSE: Acute lymphoblastic leukemia (ALL), the most common pediatric malignancy, involves multi-year treatment with substantial outpatient care, which contributes to high parent/caregiver burden. Communication gaps and complex treatment regimens can leave families feeling unprepared for care of their children with ALL. To address this, we co-developed and pre-tested a digital health intervention supporting communication about what to expect during and after pediatric ALL treatment. METHODS: Employing an iterative, stakeholder-driven process, we co-developed and pre-tested a family-centered interactive website, "EXPECT," in two phases. Phase 1 included a secondary synthesis of stakeholder needed information and functionality (contextual inquiry), content creation, and website development, overseen by a multidisciplinary steering committee of clinical experts, patients, and families. In Phase 2 pre-testing, parents of patients with ALL rated the website's acceptability and provided feedback during semi-structured interviews. RESULTS: Synthesis of previous patient, parent, and provider interviews revealed key priorities for intervention content and design which were addressed in content creation and web development. Pre-testing demonstrated high acceptability (4.7/5). Participants highlighted EXPECT's user-friendliness and innovative features such as the interactive treatment roadmap. Participants preferred to receive early access to the website, within weeks of initiating treatment, and anticipated using EXPECT throughout therapy and the post-treatment period, primarily on mobile devices. CONCLUSION: EXPECT co-development resulted in an acceptable digital health intervention to support families of children with ALL. EXPECT is being refined in response to feedback and will be tested in real-time treatment discussions in a multi-center pilot study to evaluate feasibility, use, and preliminary efficacy.
Suicide among patients with cancer: a retrospective study of medical treatment-related factors associated with suicide.
Chiang YC, Yi CH, Yin CH … +4 more , Couper J, Chang CH, Pan CC, Chen JS
Support Care Cancer · 2026 Jun · PMID 42295441 · Publisher ↗
PURPOSE: This study aimed to identify the treatment-related factors associated with suicide in patients with cancer within the first two years following diagnosis. METHODS: We analyzed data from a hospital clinical datab...
PURPOSE: This study aimed to identify the treatment-related factors associated with suicide in patients with cancer within the first two years following diagnosis. METHODS: We analyzed data from a hospital clinical database and national cause-of-death statistics to identify patients with cancer admitted to Kaohsiung Veterans General Hospital between January 2011 and December 2020 who died by suicide. Demographic characteristics and medical treatment information were collected. Patients with cancer who died by suicide (suicide group) were matched in a 1:4 ratio with those who did not die by suicide (non-suicide group) according to sex, age at diagnosis, year of diagnosis, cancer type, and cancer stage. Treatment-related factors were compared between the two groups using univariate and multivariate logistic regression analyses. RESULTS: Among 32,479 patients with cancer, 78 died by suicide. Of these, 59 met the inclusion criteria and were included in the final analysis, alongside 236 matched patients who did not die by suicide. Univariate analyses revealed that the suicide group had higher rates of benzodiazepine and/or hypnotic use, antidepressant use, and psychiatric consultations. In multivariate analyses, benzodiazepine and/or hypnotic use and psychiatric consultation remained significantly associated with suicide, whereas antidepressant use did not. CONCLUSION: Patients with cancer who died by suicide were more likely to have received benzodiazepines and/or hypnotics and psychiatric consultations within two years of diagnosis. These associations likely reflect greater underlying psychiatric distress and unmet mental health needs rather than treatment-related harm.
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