PMID- 37992848
OWN - NLM
STAT- MEDLINE
DCOM- 20240209
LR  - 20240209
IS  - 1873-6513 (Electronic)
IS  - 0885-3924 (Linking)
VI  - 67
IP  - 3
DP  - 2024 Mar
TI  - A Phase II Study of High-Flow Nasal Cannula for Relieving Dyspnea in Advanced 
      Cancer Patients.
PG  - 204-211.e1
LID - S0885-3924(23)00782-0 [pii]
LID - 10.1016/j.jpainsymman.2023.11.009 [doi]
AB  - CONTEXT: The efficacy and tolerability of high-flow nasal cannula (HFNC) for 
      relieving dyspnea in advanced cancer patients with limited prognosis requires 
      elucidation. OBJECTIVES: The primary aim of this trial was to assess the efficacy 
      and tolerability of HFNC regarding dyspnea including severe as well as moderate 
      for longer durations in patients under palliative care. METHODS: In this 
      prospective study, hospitalized patients with advanced cancer who had dyspnea at 
      rest (numeric rating scale, NRS>/=3) and hypoxemia were enrolled. They were treated 
      with HFNC for five days in the respiratory unit. Primary endpoint was mean change 
      of modified Borg scale at 24 hours. Key secondary endpoints consisted of mean 
      changes in modified Borg scale during the study period and feasibility (Trial 
      Identifier, UMIN000035738). RESULTS: Between February 2019 and February 2022, 25 
      patients were enrolled and 21 were analyzed. Twenty patients used inspired oxygen 
      and the mean fraction of inspired oxygen (FiO2) was 0.34 (range, 0.21-1.0). At 
      baseline, mean NRS (dyspnea) was 5.9 (range, 3-10). Median survival time was 19 
      days (range, 3-657). The mean change of modified Borg scale was 1.4 (80% 
      confidence interval [CI]: 0.8-1.9) at 24 hours, 12 patients (57%) showed 1.0 
      points improvement of modified Borg scale. Within two hours, 15 patients showed 
      1.0 points improvement of modified Borg scale and such early responders were 
      likely to maintain dyspnea improvement for 24 hours. Nineteen patients could 
      continue HFNC for 24 hours and 11 patients completed five days of HFNC. 
      CONCLUSION: To our knowledge, this trial is the first prospective study to assess 
      the five-day efficacy and tolerability of HFNC for dyspnea in patients under 
      palliative care. Although this did not reach the prespecified endpoint, about 
      half of the patients showed 1.0 point improvement, a minimally clinically 
      important difference (MCID) in the chronic lung disease. HFNC can be a palliative 
      treatment option in advanced cancer patients with dyspnea.
CI  - Copyright (c) 2023 The Authors. Published by Elsevier Inc. All rights reserved.
FAU - Takase, Eri
AU  - Takase E
AD  - Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., 
      T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical 
      University, Wakayama, Japan.
FAU - Akamatsu, Hiroaki
AU  - Akamatsu H
AD  - Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., 
      T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical 
      University, Wakayama, Japan. Electronic address: hiroakiakamatsu@gmail.com.
FAU - Teraoka, Shunsuke
AU  - Teraoka S
AD  - Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., 
      T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical 
      University, Wakayama, Japan.
FAU - Nakaguchi, Keita
AU  - Nakaguchi K
AD  - Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., 
      T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical 
      University, Wakayama, Japan.
FAU - Tanaka, Masanori
AU  - Tanaka M
AD  - Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., 
      T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical 
      University, Wakayama, Japan.
FAU - Kaki, Takahiro
AU  - Kaki T
AD  - Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., 
      T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical 
      University, Wakayama, Japan.
FAU - Furuta, Katsuyuki
AU  - Furuta K
AD  - Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., 
      T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical 
      University, Wakayama, Japan.
FAU - Sato, Koichi
AU  - Sato K
AD  - Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., 
      T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical 
      University, Wakayama, Japan.
FAU - Murakami, Eriko
AU  - Murakami E
AD  - Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., 
      T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical 
      University, Wakayama, Japan.
FAU - Sugimoto, Takeya
AU  - Sugimoto T
AD  - Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., 
      T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical 
      University, Wakayama, Japan.
FAU - Shibaki, Ryota
AU  - Shibaki R
AD  - Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., 
      T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical 
      University, Wakayama, Japan.
FAU - Fujimoto, Daichi
AU  - Fujimoto D
AD  - Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., 
      T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical 
      University, Wakayama, Japan.
FAU - Hayata, Atsushi
AU  - Hayata A
AD  - Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., 
      T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical 
      University, Wakayama, Japan.
FAU - Tokudome, Nahomi
AU  - Tokudome N
AD  - Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., 
      T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical 
      University, Wakayama, Japan.
FAU - Ozawa, Yuichi
AU  - Ozawa Y
AD  - Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., 
      T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical 
      University, Wakayama, Japan.
FAU - Koh, Yasuhiro
AU  - Koh Y
AD  - Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., 
      T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical 
      University, Wakayama, Japan; Center for Biomedical Sciences (Y.K.), Wakayama 
      Medical University, Wakayama, Japan.
FAU - Nakanishi, Masanori
AU  - Nakanishi M
AD  - Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., 
      T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical 
      University, Wakayama, Japan.
FAU - Kanai, Kuninobu
AU  - Kanai K
AD  - Department of Respiratory Medicine (K.K.), Naga Municipal Hospital, Wakayama, 
      Japan.
FAU - Shimokawa, Toshio
AU  - Shimokawa T
AD  - Clinical Study Support Center (T.S.), Wakayama Medical University, Wakayama, 
      Japan.
FAU - Yamamoto, Nobuyuki
AU  - Yamamoto N
AD  - Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., 
      T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical 
      University, Wakayama, Japan; Center for Biomedical Sciences (Y.K.), Wakayama 
      Medical University, Wakayama, Japan.
LA  - eng
PT  - Clinical Trial, Phase II
PT  - Journal Article
DEP - 20231121
PL  - United States
TA  - J Pain Symptom Manage
JT  - Journal of pain and symptom management
JID - 8605836
RN  - S88TT14065 (Oxygen)
SB  - IM
MH  - Humans
MH  - Cannula
MH  - Prospective Studies
MH  - Dyspnea/etiology/therapy
MH  - Oxygen
MH  - *Neoplasms/complications/therapy
MH  - Oxygen Inhalation Therapy
MH  - *Respiratory Insufficiency/therapy
OTO - NOTNLM
OT  - Clinical trial
OT  - dyspnea
OT  - neoplasms
OT  - oxygen
EDAT- 2023/11/23 00:42
MHDA- 2024/02/09 06:42
CRDT- 2023/11/22 19:28
PHST- 2023/08/10 00:00 [received]
PHST- 2023/11/08 00:00 [revised]
PHST- 2023/11/15 00:00 [accepted]
PHST- 2024/02/09 06:42 [medline]
PHST- 2023/11/23 00:42 [pubmed]
PHST- 2023/11/22 19:28 [entrez]
AID - S0885-3924(23)00782-0 [pii]
AID - 10.1016/j.jpainsymman.2023.11.009 [doi]
PST - ppublish
SO  - J Pain Symptom Manage. 2024 Mar;67(3):204-211.e1. doi: 
      10.1016/j.jpainsymman.2023.11.009. Epub 2023 Nov 21.