PMID- 31760520
OWN - NLM
STAT- MEDLINE
DCOM- 20200727
LR  - 20200727
IS  - 1433-7339 (Electronic)
IS  - 0941-4355 (Linking)
VI  - 28
IP  - 7
DP  - 2020 Jul
TI  - Association between alcoholism and symptom expression, patient symptom goals, and 
      clinical response in advanced cancer patients.
PG  - 3361-3369
LID - 10.1007/s00520-019-05152-x [doi]
AB  - AIM: The aim of this study was to determine the influence of alcoholism on 
      symptom expression, personalized symptom goal (PSG) and patient goal response 
      (PGR), and patient global impression (PGI) in advanced cancer patients. METHODS: 
      This was a secondary analysis of an international multicenter study. Advanced 
      cancer patients who had a history of alcohol dependence positive, according to 
      CAGE (cut down, annoy, guilt, eye-opener), were selected. Thirty patients (3.45%) 
      were CAGE-positive. This sample was matched with 30 patients with similar 
      characteristics who were CAGE-negative. Patients rated symptom intensity by using 
      the Edmonton Symptom Assessment Score (ESAS) at admission (T0) and then after 1 
      week. For each symptom, patients reported their PSG. After a week of 
      comprehensive palliative care, PSG was measured again (T7), as well as the 
      achievement of PGR, and PGI. Minimal clinically important difference (MCID) was 
      calculated by PGI of improvement or deterioration at T7 (bit better or a little 
      worse, respectively). RESULTS: A significant decrease in intensity was found for 
      most symptoms in both groups. In CAGE-negative and CAGE-positive patients, most 
      patients had a PSG of </= 3 for all ESAS items as a target at T0. All PSG targets 
      did not changed significantly after 1 week of palliative care in both groups. 
      Although CAGE-positive basically had unfavorable PGI and PGR, a statistical 
      significance was achieved only for appetite (P = 0.037; ANOVA test). In 
      CAGE-negative patients, Karnofsky was the only factor independently associated 
      with PGI for pain and dyspnea. Factors independently associated with PGI for 
      nausea were symptom intensity at T0 and home situation. In CAGE-positive 
      patients, Karnofsky was independently associated with PGI for pain, nausea, and 
      well-being. Symptom intensity at T0 was independently associated with PGI for 
      weakness. CONCLUSION: CAGE-positive advanced cancer patients favorably responded 
      to a palliative care intervention. No greater differences have been found in 
      comparison with CAGE-negative patients for PSG, PGR, and PGI, except for 
      appetite. Further studies with large number of patients could confirm some trends 
      observed in this study.
FAU - Mercadante, Sebastiano
AU  - Mercadante S
AD  - Main Regional Center for Pain Relief and Supportive-Palliative Care Unit, La 
      Maddalena Cancer Center, Palermo, Italy. terapiadeldolore@lamaddalenanet.it.
AD  - Anesthesia and Intensive Care Unit & Pain Relief and Palliative Care Unit, La 
      Maddalena Cancer Center, Via san Lorenzo 312, 90145, Palermo, Italy. 
      terapiadeldolore@lamaddalenanet.it.
FAU - Adile, Claudio
AU  - Adile C
AD  - Main Regional Center for Pain Relief and Supportive-Palliative Care Unit, La 
      Maddalena Cancer Center, Palermo, Italy.
FAU - Ferrera, Patrizia
AU  - Ferrera P
AD  - Main Regional Center for Pain Relief and Supportive-Palliative Care Unit, La 
      Maddalena Cancer Center, Palermo, Italy.
FAU - Casuccio, Alessandra
AU  - Casuccio A
AD  - Department of Sciences for Health Promotion and Mother Child Care, University of 
      Palermo, Palermo, Italy.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20191123
PL  - Germany
TA  - Support Care Cancer
JT  - Supportive care in cancer : official journal of the Multinational Association of 
      Supportive Care in Cancer
JID - 9302957
SB  - IM
MH  - Aged
MH  - Alcoholism/*complications
MH  - Female
MH  - Goals
MH  - Humans
MH  - Male
MH  - Neoplasms/*complications
MH  - Symptom Assessment/*methods
OTO - NOTNLM
OT  - Advanced cancer patients
OT  - Alcoholism
OT  - Clinical response
OT  - Global impression
OT  - Patients' goals
OT  - Symptom burden
EDAT- 2019/11/25 06:00
MHDA- 2020/07/28 06:00
CRDT- 2019/11/25 06:00
PHST- 2019/08/05 00:00 [received]
PHST- 2019/10/24 00:00 [accepted]
PHST- 2019/11/25 06:00 [pubmed]
PHST- 2020/07/28 06:00 [medline]
PHST- 2019/11/25 06:00 [entrez]
AID - 10.1007/s00520-019-05152-x [pii]
AID - 10.1007/s00520-019-05152-x [doi]
PST - ppublish
SO  - Support Care Cancer. 2020 Jul;28(7):3361-3369. doi: 10.1007/s00520-019-05152-x. 
      Epub 2019 Nov 23.