Using Compression Therapy to Treat Bilateral Lower Limb Edema in Patients with Lung Cancer: A Case Series.

ABSTRACT: Although rare, marked bilateral leg edema (BLE) can occur in patients with lung cancer. Systemic therapy for the underlying disease is important, but adjunct therapy might also be helpful. In this case series, the authors report on treating BLE in patients with lung cancer with compression therapy using elastic stockings and bandages. From April 2013 to March 2022, the authors conducted a retrospective survey of seven patients who developed marked BLE and received compression therapy. They evaluated effects based on improvements in subjective symptoms as well as objective findings 2 months after the start of the therapy. The bandage therapy was useful in patients who were driver-gene negative, but it was not effective in those who already had "progressive disease" with specific agents for their driver genes. No adverse events were observed. Compression therapy, even when attached or detached by nonmedical personnel, may provide favorable effects and should be considered as an adjunct treatment option in this population, in addition to effective systemic cancer therapy. These results indicate that a prospective clinical trial would be worthwhile.

Refusal of Subsequent Treatment in Patients With EGFR-mutant Non-small-cell Lung Cancer After Response to EGFR-TKIs.

BACKGROUND/AIM: During the course of effective and long-term treatment with epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI), some elderly patients might decline further treatment after EGFR-TKI. We conducted a study to try and understand the reasons for this treatment decision. PATIENTS AND METHODS: We analyzed the medical records of all patients diagnosed with non-small-cell lung cancer with EGFR mutations between 2016 and 2021. RESULTS: There were 108 patients who received EGFR-TKIs. Of these, 67 patients responded to TKI. These responding patients were divided into two groups according to whether they received subsequent TKI treatment. At their request, 24 patients (group A) did not receive further anticancer treatment following TKI. The other 43 patients (group B) received anticancer therapy following TKI. Progression-free survival in group A patients was significantly longer (median=18 months, range=1-67 months) than in group B patients. The reasons for not wanting subsequent treatment after TKI were older age, reduced general condition, deterioration of physical comorbid disease and dementia. Dementia was the most common reason for patients over 75 years of age. CONCLUSION: Some elderly patients with well-controlled disease might express their refusal of all subsequent anticancer therapy after TKIs. Medical staff should respond seriously to these requests.

INTER-PROFESSIONAL 360-DEGREE EVALUATION OF THE PERFORMANCE OF INTENSIVE CARE UNIT NURSES.

A 360-degree evaluation is an objective evaluation method for people to be surveyed by evaluators from various positions and perspectives. The purpose of this study to create an objective method of 'comprehensive' verification of the entire survey using Spearman rank correlation coefficient and Wilcoxon signed rank test. With these statistical methods, a detailed correlation and comparison between the self-evaluation of intensive care unit nurses and their evaluation by staff of other medical occupations could be assessed. Detailed correlations and differences were clarified for each survey item and surveyees. By a scoring method that takes into account the correlation and comparison results of the evaluation scores in evaluators and surveyees, and the total evaluation scores were visualized as radar charts. Our results could highlight agreement and discrepancies between the evaluations performed by the surveyees and those by the evaluators. This time, the survey was conducted with a small number of surveyors, surveyees, and survey items, but the possibility of responding to a larger scale survey was indicated. It might be meaningful to make full use of statistical methods to comprehensively evaluate the overall survey results and clearly show them in visual methods such as radar charts.