The edition · Oncology
Weekly online symptom reporting was linked to five months' longer survival in lung cancer
Long-term follow-up of the Dutch SYMPRO-Lung trial extends the case for routine patient-reported monitoring to all stages. Also: barrier films against radiation dermatitis, whether exercise protects the heart during anthracyclines, and grief support for caregivers.
The edition in brief
In a post hoc analysis of the SYMPRO-Lung stepped-wedge cluster trial, 446 Dutch patients with stage I to IV lung cancer who completed weekly online symptom reports for a year had a median overall survival of 26 months, against 21 months in the control period (adjusted HR 0.80, 0.63 to 1.00, p=0.049), with no clear difference in progression-free survival. A MASCC clinical practice statement recommends barrier-forming topical agents to prevent acute radiation dermatitis in patients at high risk, especially at irregular sites such as the head and neck. A meta-analysis of seven trials (513 women) found no consistent effect of structured exercise on ejection fraction or strain during anthracycline or anti-HER2 therapy, with low certainty and wide intervals. A randomised trial of 111 family caregivers found structured grief counselling from the terminal phase into early bereavement lowered anticipatory grief scores and improved quality of life, but not anxiety, depression or guilt. The pearl covers the first hour of febrile neutropenia.
A consensus statement backs barrier-forming topical agents for patients at high risk of severe radiation dermatitis
For patients at high risk of severe radiation dermatitis, especially in head and neck fields, consider a barrier-forming agent from the start of treatment.
Exercise did not consistently protect ejection fraction during anthracycline or anti-HER2 therapy
Exercise has many benefits during breast cancer treatment, but randomised data do not show it protects the heart from anthracyclines or anti-HER2 drugs.
Grief counselling for caregivers, starting before the death, eased anticipatory grief and improved quality of life
Structured grief counselling that starts before the death eased anticipatory grief and improved caregivers' quality of life, though not anxiety or depression.
Febrile neutropenia: the first hour
In fever after recent chemotherapy, give empirical antibiotics within an hour without waiting for the neutrophil count.
Weekly patient-reported symptom monitoring was associated with longer survival across all stages of lung cancer
Consider weekly patient-reported symptom monitoring for patients treated for lung cancer; it was linked to longer survival, though the analysis was post hoc.
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