RESUMEN
Context: In Hodgkin's lymphoma [HL], PET-CT scan has established itself as the functional imaging modality of choice when it comes to evaluation and guiding treatment decisions. However, it remains an expensive imaging technique and therefore the number of PET-CTs is limited for each patient. Recent studies show that Interim PET-CT scan is gaining an important role as a predictor of survival and an influencer for treatment modifications
Objective: To identify the patients that are most likely to benefit from interim PET-CT scan and to acknowledge the utility of this imaging technique in the daily practice of Lebanese oncologists
Methods: We retrospectively reviewed the charts of 98 patients diagnosed with HL, treated and followed from 2009 to 2016 in our center. Patients were divided into three groups according to the stage of their disease: Group A[limited], Group B [intermediate] and Group C [advanced] according to ESMO guidelines. We studied the characteristics and the progression free survival [PFS] of patients in each group
Results: The progression free survival of the limited, intermediate and advanced stages were 75 months, 84 months and 61.51 months, with a p value of 0.482, 0.343 and 0.025 respectively. Patients who had a positive interim PET-CT scan had a PFS of 59.51 months, whereas patients who had a negative interim PET-CT scan had a PFS of 80.85 months, with a significant p value [p = 0.033]. In the advanced stage, patients with a positive interim PETCT scan were more likely to relapse with a PFS of 16.6 months vs 71.8 months for patients with negative interim PET-CT of the same category [p = 0.025]
Conclusion: In a country with limited resources, where functional imaging techniques remain restricted to a certain number of patients, interim PET-CT scan is most valuable in patients with advanced Hodgkin's lymphoma, where a positive Interim PET-CT is an indicator of a poor prognosis and therefore should influence an escalation in treatment strategies
RESUMEN
Objective: To estimate the frequency of patients in Lebanon who report an impact of chemotherapy-induced nausea and vomiting [CINV] on their daily life and to evaluate the determinants of such impact, considering not only the prognostic factors related to the patient, disease and treatment, but also the intrinsic characteristics of the CINV, namely, the distinction between acute and delayed phase, and the intensity of nausea and vomiting
Methods: This prospective cross-sectional study, performed between January 2016 and December 2016, included 328 patients. The Functional Living Index - Emesis [FLIE] score was used to evaluate the impact of CINV on patients' daily lives and day-to-day functioning
Results: The results of the backward logistic regression taking the two-category FLIE score as dependent variable showed that current alcohol drinking would increase the odds of having a high FLIE score . 108 by more than 8 times [p = 0.047; ORa = 8.114], while having an anticipatory feeling of nausea/vomiting, number of acute vomiting episodes and the intensity of late nausea would significantly increase the odds of having a FLIE score < 108 by 98.6 percent, 48.4 percent and 29.6 percent respectively [p < 0.0001, ORa = 0.014; p < 0.0001, ORa = 0.516 and p = 0.006, ORa = 0.704]
Conclusion: Chemotherapy-induced nausea and vomiting are still affecting the quality of life[QOL] of oncology patients despite all treatment novelties. Astrong association between the number of vomiting episodes, the intensity of late nausea and the anticipatory feeling of nausea/vomiting and a decrease in the patient's QOL and comfort was found. This research was able to shed the light on the importance of well-controlling CINV to preserve the patient's QOL