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1609P PHYSICAL ACTIVITY (PA) AND PHYSICAL FITNESS (PF) IN
LYMPHOMA PATIENTS BEFORE DURING AND AFTER
CHEMOTHERAPY (PAFILP): A PROSPECTIVE
OBSERVATIONAL PILOT-STUDY
P. Wolter 1 , N. Vermaete 2 , D. Dierickx 3 , A. Janssens 3 , P. Schöffski 1 , G. Verhoef 3
and R. Gosselink 2
1 Department of General Medical Oncology, University Hospitals Leuven, Leuven,
BELGIUM, 2 Department of Rehabilitation Sciences, KU Leuven, Leuven,
BELGIUM, 3 Department of Hematology, University Hospitals, Leuven, BELGIUM
Background: We performed a prospective longitudinal single-center pilot study to
investigate physical activity (PA) and physical fitness (PF) in Hodgkin Lymphoma
(HL) and Non-Hodgkin-Lymphoma (NHL) patients before, during and after
first-line systemic chemotherapy. Further aims were to correlate different patient-,
disease-, and treatment-related factors with the possible decline or increase of PA
and PF and to identify patients at risk of developing a significant decline in PA and
PF who might be candidates for an individualized exercise training program.
Methods: PA was assessed with an activity monitor (Dynaport MiniMod McRoberts,
The Hague, The Netherlands), PF by incremental cycle ergometry and by a 6 minute
walking test (6MWD). Isometric quadriceps strength was measured using a Cybex II
dynamometer (Lumex, Bay Shore, United States). Pulmonary function tests,
electrocardiogram, echocardiography, blood pressure measurements were routinely
performed.
Results: The pilot study involved a total of 22 lymphoma patients (♂: 19, ♀: 3,
median age 57 years, NHL: 14, HL: 8) from 10/2010 to 01/2012. At baseline PA,
6MWD, maximal inspiratory pressure, quadriceps strenght, diffusion capacity at
pulmonary function tests were significantly lower than predicted. In contrast, forced
expiratory volume in one second (FEV1), forced vital capacity (FVC), maximal
oxygen consumption (VO2max), maximal expiratory force and hand grip force were
not significantly different. We observed a broad variation in the different test results
between patients at baseline. After 2-3 cycles of chemotherapy we did not identify a
significant decrease in PA, whereas VO2max decreased significantly after 2-3 cycles
but recovered after completion of chemotherapy (6-8 cycles). Importantly, a huge
interpatient variability could be observed at all different time points.
Conclusions: Preliminary results of the PAFILP pilot study suggest that levels of PA
and PF probably evolve very differently between lymphoma patients. The study is
ongoing to identify possible risk factors predictive for decline in PA and PF. Such a
screening tool would allow us to identify early in the course of treatment patients at
risk of developing a significant decline in PA and PF who might benefit from an
individualized exercise training program.
Disclosure: All authors have declared no conflicts of interest.
1610P SURVEY OF OUTPATIENT CANCER CHEMOTHERAPY:
OCCURRENCE OF SIDE EFFECTS AND REASONS FOR
DISCONTINUATION OR DELAY
H. Kushihara 1 , K. Kawada 2 , T. Kushihara 3 , N. Hamajima 4 , M. Amano 4 , K. Ooji 4 ,
K. Honda 2 , F. Nomura 2 , Y. Ikeda 1 and K. Mori 1
1 Pharmacy, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, JAPAN,
2 Medical Oncology, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya,
JAPAN, 3 Pharmacy, Japanese Red Cross Nagoya First Hospital, Nagoya,
JAPAN, 4 Nursing, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya,
JAPAN
Background: In cancer chemotherapy, patients have various side effects. In general, if
patients’ quality of life is negatively affected (e.g., toxicity of grade 3 or higher), the
treatment will be discontinued. On the other hand, if symptoms are mild or
moderate (e.g., toxicity of grade 2 or lower), the treatment will be continued with
supportive therapy. Patients with mild or moderate side effects must tolerate such
adverse effects for a prolonged period. Therefore, to continue chemotherapy safety, it
is very important to understand the extent of symptoms and to provide suitable
supportive care as required. We conducted a survey of outpatient cancer
chemotherapy.
Methods: We retrospectively investigated the characteristics of side effects and the
reasons for discontinuation or delay of chemotherapy between July 2009 and March
2011 at Nagoya Daiichi Red Cross Hospital in Japan.
Result: Data on 924 patients (8221 cases) were analyzed. The following data are
presented in the order of grade 2 and grade 3 or higher. Nonhematologic toxicities
were constipation (32.0, 0.7%), fatigue (21.3, 2.7%), anorexia (17.0, 0.6%), neuropathy
(15.3, 1.4%), nausea (14.4, 0.6%), pain (13.7, 1.0%), vomiting (7.5, 0.6%), diarrhea
(6.3, 0.2%), dysgeusia (6.0, − %), oral mucositis (4.1, 0.1%), and nail changes (3.6,
0.1%). Hematologic toxicities were neutropenia (16.3, 19.1%), thrombocytopenia (4.1,
2.1%), and anemia (26.1, 7.0%). Nonhematologic toxicities Grade 2 or lower had a
high average incidence of 44.6%. Chemotherapy was discontinued in 1341 patients
(16.3%). The reasons for discontinuation or delay were laboratory abnormalities
(35.4%), chief complaints of patients (34.0%), and others (30.1%).
Conclusion: In patients with grade 3 or higher toxicity, appropriate care was
provided, including dose reduction or discontinuation of treatment. In patients with
grade 2 or lower toxicity, treatment tended to be continued. Our results showed that
a large proportion of patients tolerate mild or moderate side effects that do not lead
to discontinuation or delay of treatment. It is necessary to evaluate the extent of
symptoms and to provide supportive care from an early stage.
Disclosure: All authors have declared no conflicts of interest.
1611P IMPROVING PATIENT ADHERENCE BY USING THE
FLOWCHART TYPE LEAFLET
Annals of Oncology
S. Suzuki 1 , M. Yoshida 1 , Y. Yajima 2 , T. Kobayashi 2 , S. Kobayashi 1 , T. Enokida 2 ,
H. Ishiki 2 , K. Endo 3 , K. Izumi 1 and M. Tahara 4
1 Pharmacy, National Cancer Center Hospital East, Kashiwa, JAPAN, 2 Head and
Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa,
JAPAN, 3 Drug Safety Management, Meiji Pharmaceutical University, Tokyo,
JAPAN, 4 Endoscopy & Gi Oncology, National Cancer Center Hospital East,
Kashiwa, JAPAN
Background: Most information sheets cover the schedule of chemotherapy sessions
and the adverse reactions of the respective drugs. However, the leaflets do not
provide enough information instructing them how to take their supportive
medications while at home for patients that have adverse drug reactions. We have
developed a flowchart type leaflet to help improve the patients’ adherence. The
flowchart consisted of yes/no questions to guide how to take supportive medicine for
adverse drug reactions or when patients should call to a hospital.
Objective: This study was designed to evaluate the benefits associated with the
flowchart type leaflet (FC). [Subjects and methods] Subjects include head and neck
cancer inpatients who received induction chemotherapy, TPF (docetaxel, cisplatin,
and 5FU) or TPS (docetaxel, cisplatin, and S-1), from September 2009 to April 2012.
Group A used FC while Group B did not use FC in their chemotherapy. A
retrospective study was performed using patient records. The endpoints of this study
were: (1) To determine the emergency hospital admissions/visits, (2) To determine
the nonadherence, (3) To determine the telephone calls from patients.
Results: There were 49 patients and a total of 139 chemotherapy sessions in group A
while there were 60 patients and a total of 163 chemotherapy sessions in group B with
no significant differences in age, performance status, and their chemotherapy regimen.
The results are: (1) Incidence of emergency hospital admission was significantly lower
in group A compared to group B. (Group A v.s. Group B: 1% v.s. 10%, p < 0.01) (2)
The nonadherence rate in supportive medication for adverse drug reactions due to
chemotherapy was significantly lower in group A than group B (Group A v.s. Group
B: 5% v.s. 23%, p < 0.01). (3) Telephone call rates were statistically significant in group
A (16%, total 30 calls) compared to group B (7%, total 11 calls) in each chemotherapy
regimen. Of the 30 telephone calls in group A, 24 calls (80%) were in a situation
where patients needed to call a hospital and 5 calls (45%) in group B.
Conclusions: The FC could contribute to reducing emergency hospital admissions to
prevent nonadherence and encourage patients’ judgments in chemotherapy.
Disclosure: All authors have declared no conflicts of interest.
1612P BREAKTHROUGH PAIN (BTP) IN OPIOID-TOLERANT
CANCER PATIENTS: A PAN-EUROPEAN OPEN-LABEL
MULTICENTRE STUDY WITH FENTANYL BUCCAL TABLET
(FBT)
S. Mercadante 1 , A. Davies 2 , J. Jarosz 3 , U.R. Kleeberg 4 ,T.O’Brien 5 , P. Poulain 6
and H. Schneid 7
1 Anesthesia and Intensive Care Unit & Pain Relief and Palliative Care Unit, La
Maddacena Cancer Center, Palermo, ITALY, 2 Palliative Medicine, Royal Surrey
County Hospital NHS Foundation Trust, Guildford, UNITED KINGDOM, 3 Palliative
Medicine Unit, SCMCC and Institute of Oncology, Warsaw, POLAND,
4 Hematology and Medical Oncology, H, Hamburg, GERMANY, 5 Palliative
Medicine, Marymount Hospice, Cork, IRELAND, 6 Palliative Unit, Polyclinique de
l’Ormeau, Tarbes, FRANCE, 7 Medical Affairs EU, Teva Pharmaceutical,
Maisons-Alfort, FRANCE
BTP, a transitory exacerbation of pain that occurs on a background of otherwise
controlled persistent pain, is a common problem in cancer patients. FBT is indicated
for the treatment of BTP in adults with cancer already receiving maintenance opioid
therapy for chronic cancer pain and should be titrated to an effective dose that
provides adequate analgesia and minimises undesirable events. In this study, patients
entered a screening period and were randomized during an open-label titration
period to a starting FBT dose of 100 µg (group A) or 200 µg (group B) to identify
the FBT effective dose and then treated in an open-label period (for 8 BTP episodes).
Patients’ inclusion followed the FBT label. 442 patients were screened from 135
European sites (7 countries) and 330 were enrolled into the titration period [group A
(156); group B (174)]. Cancer history of the patients: breast (20.3%), lung (14.2%),
colon/rectum (12.1%), other (24.5%). The most frequent extent of the disease was
bone metastasis and local disease, for 45.8% and 40.6% of patients, respectively. 312
(94.5%) received at least one dose of study drug during the titration period [group A
(145; 92.9%); group B (167; 96.0%). The effective dose rate (primary outcome) was
75.2% in the group A compared to 81.4% in the group B with non-inferiority
ix518 | Abstracts Volume 23 | Supplement 9 | September 2012