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5. Development of a predictive model for patients with bone metastases referred to palliative radiotherapy: Secondary analysis of a multicenter study (the PRAIS trial).

Author

Rossi, Romina, Medici, Federica, Habberstad, Ragnhild, Klepstad, Pal, Cilla, Savino, Dall'Agata, Monia, Kaasa, Stein, Caraceni, Augusto Tommaso, Morganti, Alessio Giuseppe, and Maltoni, Marco

Subjects
LEUKOCYTE count, LYMPHOCYTE count, BODY mass index, BONE metastasis, RECEIVER operating characteristic curves, CANCER pain
Abstract

Background: The decision to administer palliative radiotherapy (RT) to patients with bone metastases (BMs), as well as the selection of treatment protocols (dose, fractionation), requires an accurate assessment of survival expectancy. In this study, we aimed to develop three predictive models (PMs) to estimate short‐, intermediate‐, and long‐term overall survival (OS) for patients in this clinical setting. Materials and Methods: This study constitutes a sub‐analysis of the PRAIS trial, a longitudinal observational study collecting data from patients referred to participating centers to receive palliative RT for cancer‐induced bone pain. Our analysis encompassed 567 patients from the PRAIS trial database. The primary objectives were to ascertain the correlation between clinical and laboratory parameters with the OS rates at three distinct time points (short: 3 weeks; intermediate: 24 weeks; prolonged: 52 weeks) and to construct PMs for prognosis. We employed machine learning techniques, comprising the following steps: (i) identification of reliable prognostic variables and training; (ii) validation and testing of the model using the selected variables. The selection of variables was accomplished using the LASSO method (Least Absolute Shrinkage and Selection Operator). The model performance was assessed using receiver operator characteristic curves (ROC) and the area under the curve (AUC). Results: Our analysis demonstrated a significant impact of clinical parameters (primary tumor site, presence of non‐bone metastases, steroids and opioid intake, food intake, and body mass index) and laboratory parameters (interleukin 8 [IL‐8], chloride levels, C‐reactive protein, white blood cell count, and lymphocyte count) on OS. Notably, different factors were associated with the different times for OS with only IL‐8 included both in the PMs for short‐ and long‐term OS. The AUC values for ROC curves for 3‐week, 24‐week, and 52‐week OS were 0.901, 0.767, and 0.806, respectively. Conclusions: We successfully developed three PMs for OS based on easily accessible clinical and laboratory parameters for patients referred to palliative RT for painful BMs. While our findings are promising, it is important to recognize that this was an exploratory trial. The implementation of these tools into clinical practice warrants further investigation and confirmation through subsequent studies with separate databases. [ABSTRACT FROM AUTHOR]

Published
2024
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6. A European pharmacogenomic study of the response to opioids in advanced cancer patients identifies germline variants associated with nausea-vomiting side effect

Author

Minnai, Francesca, primary, Shkodra, Morena, additional, Noci, Sara, additional, Brunelli, Cinzia, additional, Pigni, Alessandra, additional, Zecca, Ernesto, additional, Skorpen, Frank, additional, Klepstad, Pal, additional, Kaasa, Stein, additional, Corli, Oscar, additional, Pallotti, Maria Caterina, additional, Maltoni, Marco Cesare, additional, Caraceni, Augusto Tommaso, additional, and Colombo, Francesca, additional

Published
2024
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9. Integrated Short-term Palliative Rehabilitation to improve quality of life and equitable care access in incurable cancer (INSPIRE):A multi-national European research project

Author

Bayly, Jo, Ahmedzai, Hilde, Blandini, Maria Grazia, Bressi, Barbara, Caraceni, Augusto Tommaso, Vasconcelos, Joana, Costi, Stefania, Fugazzaro, Stefania, Guberti, Monica, Guldin, Mai-Britt, Hauken, May, Higginson, Irene, Laird, Barry, Ling, Julie, Normand, Charles, Oldervoll, Line, Payne, Cathy, Prevost, Toby, Stene, Guro B, Vanzulli, Elisa, Veber, Eduardo, Economos, Guillaume, and Maddocks, Matthew

Abstract

Background Disability related to incurable cancer affects over a million Europeans each year and people with cancer rank loss of function among the most common unmet supportive care needs. Objectives To test the clinical and cost effectiveness of an integrated short-term palliative rehabilitation intervention, to optimise function and quality of life in people affected by incurable cancer. Design Multinational, parallel group, randomised, controlled, assessor blind, superiority trial Methods The INSPIRE consortium brings together leaders in palliative care, oncology and rehabilitation from partner organisations across Europe, with complementary expertise in health services research, trials of complex interventions, mixed method evaluations, statistics and economics. Partnership with leading European civil society organisations ensures citizen engagement and dissemination at the highest level. We will conduct a multinational randomised controlled trial across five European countries, recruiting participants to assess the effectiveness of palliative rehabilitation for people with incurable cancer on the primary outcome—quality of life—and secondary outcomes including disability, symptom burden and goal attainment. To support trial conduct and enhance analysis of trial data, we will also conduct: comparative analysis of current integration of rehabilitation across oncology and palliative care services; mixed-method evaluations of equity and inclusivity, processes and implementation for the intervention, at patient, health service and health system levels. Finally, we will conduct an evidence synthesis, incorporating INSPIRE findings, and a Delphi consensus to develop an international framework for palliative rehabilitation practice and policy, incorporating indicators, core interventions, outcomes, and integration methods. Scientific contribution If positive, the trial could produce a scalable and equitable intervention to improve function and quality of life in people with incurable cancer and reduce the burden of care for their families. It could also upskill the practitioners involved and motivate future research questions. The intervention could be adapted and integrated into different health systems using existing staff and services, with little or no additional cost.

Published
2023

12. sj-doc-1-pcr-10.1177_26323524231179979 – Supplemental material for Integrated Short-term Palliative Rehabilitation to improve quality of life and equitable care access in incurable cancer (INSPIRE): a multinational European research project

Author

Bayly, Joanne, Ahmedzai, Hilde Hjelmeland, Blandini, Maria Grazia, Bressi, Barbara, Caraceni, Augusto Tommaso, Carvalho Vasconcelos, Joana, Costi, Stefania, Fugazzaro, Stefania, Guberti, Monica, Guldin, Mai-Britt, Hauken, May, Higginson, Irene, Laird, Barry J.A., Ling, Julie, Normand, Charles, Nottelmann, Lise, Oldervoll, Line, Payne, Cathy, Prevost, A. Toby, Stene, Guro B., Vanzulli, Elisa, Veber, Eduardo, Economos, Guillaume, and Maddocks, Matthew

Subjects
111702 Aged Health Care, FOS: Health sciences
Abstract

Supplemental material, sj-doc-1-pcr-10.1177_26323524231179979 for Integrated Short-term Palliative Rehabilitation to improve quality of life and equitable care access in incurable cancer (INSPIRE): a multinational European research project by Joanne Bayly, Hilde Hjelmeland Ahmedzai, Maria Grazia Blandini, Barbara Bressi, Augusto Tommaso Caraceni, Joana Carvalho Vasconcelos, Stefania Costi, Stefania Fugazzaro, Monica Guberti, Mai-Britt Guldin, May Hauken, Irene Higginson, Barry J.A. Laird, Julie Ling, Charles Normand, Lise Nottelmann, Line Oldervoll, Cathy Payne, A. Toby Prevost, Guro B. Stene, Elisa Vanzulli, Eduardo Veber, Guillaume Economos and Matthew Maddocks in Palliative Care and Social Practice

Published
2023
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13. Integrated Short-term Palliative Rehabilitation to improve quality of life and equitable care access in incurable cancer (INSPIRE):a multinational European research project

Author

Bayly, Joanne, Ahmedzai, Hilde Hjelmeland, Blandini, Maria Grazia, Bressi, Barbara, Caraceni, Augusto Tommaso, Carvalho Vasconcelos, Joana, Costi, Stefania, Fugazzaro, Stefania, Guberti, Monica, Guldin, Mai Britt, Hauken, May, Higginson, Irene, Laird, Barry J.A., Ling, Julie, Normand, Charles, Nottelmann, Lise, Oldervoll, Line, Payne, Cathy, Prevost, A. Toby, Stene, Guro B., Vanzulli, Elisa, Veber, Eduardo, Economos, Guillaume, and Maddocks, Matthew

Subjects
palliative care, quality of life, incurable cancer, palliative rehabilitation, rehabilitation
Abstract

Background: Disability related to incurable cancer affects over a million Europeans each year and people with cancer rank loss of function among the most common unmet supportive care needs. Objectives: To test the clinical and cost-effectiveness of an integrated short-term palliative rehabilitation intervention, to optimise function and quality of life in people affected by incurable cancer. Design: This is a multinational, parallel group, randomised, controlled, assessor blind, superiority trial. Methods: The INSPIRE consortium brings together leaders in palliative care, oncology and rehabilitation from partner organisations across Europe, with complementary expertise in health service research, trials of complex interventions, mixed-method evaluations, statistics and economics. Partnership with leading European civil society organisations ensures citizen engagement and dissemination at the highest level. We will conduct a multinational randomised controlled trial across five European countries, recruiting participants to assess the effectiveness of palliative rehabilitation for people with incurable cancer on the primary outcome – quality of life – and secondary outcomes including disability, symptom burden and goal attainment. To support trial conduct and enhance analysis of trial data, we will also conduct: comparative analysis of current integration of rehabilitation across oncology and palliative care services; mixed-method evaluations of equity and inclusivity, processes and implementation for the intervention, at patient, health service and health system levels. Finally, we will conduct an evidence synthesis, incorporating INSPIRE findings, and a Delphi consensus to develop an international framework for palliative rehabilitation practice and policy, incorporating indicators, core interventions, outcomes and integration methods. Scientific contribution: If positive, the trial could produce a scalable and equitable intervention to improve function and quality of life in people with incurable cancer and reduce the burden of care for their families. It could also upskill the practitioners involved and motivate future research questions. The intervention could be adapted and integrated into different health systems using existing staff and services, with little or no additional cost.

Published
2023
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14. Integrated Short-term Palliative Rehabilitation to improve quality of life and equitable care access in incurable cancer (INSPIRE): a multinational European research project

Author

Bayly, Joanne, primary, Ahmedzai, Hilde Hjelmeland, additional, Blandini, Maria Grazia, additional, Bressi, Barbara, additional, Caraceni, Augusto Tommaso, additional, Carvalho Vasconcelos, Joana, additional, Costi, Stefania, additional, Fugazzaro, Stefania, additional, Guberti, Monica, additional, Guldin, Mai-Britt, additional, Hauken, May, additional, Higginson, Irene, additional, Laird, Barry J.A., additional, Ling, Julie, additional, Normand, Charles, additional, Nottelmann, Lise, additional, Oldervoll, Line, additional, Payne, Cathy, additional, Prevost, A. Toby, additional, Stene, Guro B., additional, Vanzulli, Elisa, additional, Veber, Eduardo, additional, Economos, Guillaume, additional, and Maddocks, Matthew, additional

Published
2023
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15. Outpatient palliative care referral system (PCRS) for patients with advanced cancer: an impact evaluation protocol

Author

Brunelli, Cinzia, primary, Zecca, Ernesto, additional, Pigni, Alessandra, additional, Bracchi, Paola, additional, Caputo, Mariangela, additional, Lo Dico, Silvia, additional, Fusetti, Viviana, additional, Tallarita, Antonino, additional, Bergamini, Cristiana, additional, Brambilla, Marta, additional, Raimondi, Alessandra, additional, Niger, Monica, additional, Provenzano, Salvatore, additional, Sepe, Pierangela, additional, Alfieri, Sara, additional, Tinè, Gabriele, additional, De Braud, Filippo, additional, and Caraceni, Augusto Tommaso, additional

Published
2022
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17. Common Clinical Practice for Opioid-Induced Constipation: A Physician Survey

Author

Coluzzi,Flaminia, Alvaro,Domenico, Caraceni,Augusto Tommaso, Gianni,Walter, Marinangeli,Franco, Massazza,Giuseppe, Pinto,Carmine, Varrassi,Giustino, Lugoboni,Fabio, Coluzzi,Flaminia, Alvaro,Domenico, Caraceni,Augusto Tommaso, Gianni,Walter, Marinangeli,Franco, Massazza,Giuseppe, Pinto,Carmine, Varrassi,Giustino, and Lugoboni,Fabio

Abstract

Flaminia Coluzzi,1,2 Domenico Alvaro,3 Augusto Tommaso Caraceni,4 Walter Gianni,5 Franco Marinangeli,6 Giuseppe Massazza,7 Carmine Pinto,8 Giustino Varrassi,9 Fabio Lugoboni10 1Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, LT, Italy; 2Anesthesiology, Intensive Care, and Pain Medicine Unit, Sant’Andrea University Hospital, Rome, RM, Italy; 3Department of Translational and Precision Medicine, Gastroenterology Division, Sapienza University of Rome, Rome, RM, Italy; 4Palliative Care, Pain Therapy, and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, MI, Italy; 5Department of Internal Medicine and Geriatric Medicine, University Hospital Policlinico Umberto I, Rome, RM, Italy; 6Department of Anesthesiology, Pain Medicine, and Palliative care, University of L’Aquila, L’Aquila, AQ, Italy; 7Division of Physical Medicine and Rehabilitation, Department of Surgical Sciences, University of Turin and “Città della Salute e della Scienza” University Hospital, Torino, TO, Italy; 8Medical Oncology Unit, Clinical Cancer Center, AUSL-IRCCS of Reggio Emilia, Reggio Emilia, RE, Italy; 9Fondazione Paolo Procacci, Rome, RM, Italy; 10Department of Medicine, Addiction Unit, University Hospital of Verona, Verona, VR, ItalyCorrespondence: Flaminia ColuzziDepartment of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, Latina, Corso della Repubblica 79, Latina, LT, 04100, ItalyTel +39 06 33775673Email flaminia.coluzzi@uniroma1.itBackground: Opioid-induced constipation (OIC) remains an important clinical obstacle despite the availability of several guidelines and pharmacological options for its management. Here, we surveyed common practices and perceptions about OIC among physicians who prescribe opioids in Italy.Methods: The online survey included 26 questions about OIC. Responses were analyzed descriptively and aggregated by physician specialty.Results: A tot

Published
2021

18. Action observation therapy in pediatric patients with neuromotor deficits of the upper limbs secondary to central nervous system tumors

Author

Chisari, Marco, primary, Sensi, Raffaella, additional, Clerici, Carlo Alfredo, additional, Gariboldi, Fulvia Angela, additional, Spreafico, Filippo, additional, Biassoni, Veronica, additional, Schiavello, Elisabetta, additional, Gasparini, Patrizia, additional, Caraceni, Augusto Tommaso, additional, Ferrari, Andrea, additional, and Massimino, Maura, additional

Published
2019
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19. What to Do and What Not to Do in the Management of Opioid-Induced Constipation: AChoosing WiselyReport

Author

Alvaro, Domenico, Caraceni, Augusto Tommaso, Coluzzi, Flaminia, Gianni, Walter, Lugoboni, Fabio, Marinangeli, Franco, Massazza, Giuseppe, Pinto, Carmine, and Varrassi, Giustino

Abstract

Introduction: Despite the essential utility of opioids for the clinical management of pain, opioid-induced constipation (OIC) remains an important obstacle in clinical practice. In patients, OIC hinders treatment compliance and has negative effects on quality of life. From a clinician perspective, the diagnosis and management of OIC are hampered by the absence of a clear, universal diagnostic definition across disciplines and a lack of standardization in OIC treatment and assessment. Methods: A multidisciplinary panel of physician experts who treat OIC was assembled to identify a list of ten corrective actions—five “things to do” and five “things not to do”—for the diagnosis and management of OIC, utilizing the Choosing Wiselymethodology. Results: The final list of corrective actions to improve the diagnosis and clinical management of OIC emphasized a need for: (i) better physician and patient education regarding OIC; (ii) systematic use of diagnostically validated approaches to OIC diagnosis and assessment (i.e., Rome IV criteria and Bristol Stool Scale, respectively) across various medical contexts; and (iii) awareness about appropriate, evidence-based treatments for OIC including available peripheral mu-opioid receptor antagonists (PAMORAs). Conclusions: Physicians who prescribe long-term opioids should be forthcoming with patients about the possibility of OIC and be adequately versed in the most recent guideline recommendations for its management.

Published
2020
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20. Time for a consensus conference on pain in neurorehabilitation

Author

Sandrini, G, Tamburin, S, Paolucci, S, Boldrini, P, Saraceni, V, Smania, N, Italian Consensus Conference on Pain in Neurorehabilitation, Agostini, M, Alfonsi, E, Aloisi, A, Alvisi, E, Aprile, I, Armando, M, Avenali, M, Azicnuda, E, Barale, F, Bartolo, M, Bergamaschi, R, Berlangieri, M, Berlincioni, V, Berliocchi, L, Berra, E, Berto, G, Bonadiman, S, Bonazza, S, Bressi, F, Brugnera, A, Brunelli, S, Buzzi, M, Cacciatori, C, Calvo, A, Cantarella, C, Caraceni, A, Carone, R, Carraro, E, Casale, R, Castellazzi, P, Castelnuovo, G, Castino, A, Cella, M, Cerbo, R, Chiò, A, Ciotti, C, Cisari, C, Coraci, D, Dalla Toffola, E, Defazio, G, De Icco, R, Del Carro, U, Dell’Isola, A, De Tanti, A, D’Ippolito, M, Fazzi, E, Federico, A, Ferrari, A, Ferrari, S, Ferraro, F, Formaglio, F, Formisano, R, Franzoni, S, Gajofatto, F, Gandolfi, M, Gardella, B, Geppetti, P, Giammò, A, Gimigliano, R, Giusti, E, Greco, E, Ieraci, V, Invernizzi, M, Jacopetti, M, Jedrychowska, I, Lacerenza, M, La Cesa, S, Lobba, D, Magrinelli, F, Mandrini, S, Manera, U, Manzoni, G, Marchettini, P, Marchioni, E, Mariotto, S, Martinuzzi, A, Masciullo, M, Mezzarobba, S, Miotti, D, Modenese, A, Molinari, M, Monaco, S, Morone, G, Nappi, R, Negrini, S, Pace, A, Padua, L, Pagliano, E, Palmerini, V, Pazzaglia, C, Pecchioli, C, Pietrabissa, G, Picelli, A, Polli, A, Porro, C, Porru, D, Romano, M, Roncari, L, Rosa, R, Saccavini, M, Sacerdote, P, Saviola, D, Schenone, A, Schweiger, V, Scivoletto, G, Solaro, C, Spallone, V, Springhetti, I, Tassorelli, C, Tinazzi, M, Togni, R, Torre, M, Torta, R, Traballesi, M, Trabucco, E, Tramontano, M, Truini, A, Tugnoli, V, Turolla, A, Valeriani, M, Vallies, G, Verzini, E, Vottero, M, Mario, P, Sandrini, Giorgio, Tamburin, Stefano, Paolucci, Stefano, Boldrini, Paolo, Saraceni, Vincenzo M., Smania, Nicola, Agostini, Michela, Alfonsi, Enrico, Aloisi, Anna Maria, Alvisi, Elena, Aprile, Irene, Armando, Michela, Avenali, Micol, Azicnuda, Eva, Barale, Francesco, Bartolo, Michelangelo, Bergamaschi, Roberto, Berlangieri, Mariangela, Berlincioni, Vanna, Berliocchi, Laura, Berra, Eliana, Berto, Giulia, Bonadiman, Silvia, Bonazza, Sara, Bressi, Federica, Brugnera, Annalisa, Brunelli, Stefano, Buzzi, Maria Gabriella, Cacciatori, Carlo, Calvo, Andrea, Cantarella, Cristina, Caraceni, Augusto Tommaso, Carone, Roberto, Carraro, Elena, Casale, Roberto, Castellazzi, Paola, Castelnuovo, Gianluca, Castino, Adele, Cella, Monica, Cerbo, Rosanna, Chiò, Adriano, Ciotti, Cristina, Cisari, Carlo, Coraci, Daniele, Toffola, Elena Dalla, Defazio, Giovanni, De Icco, Roberto, Del Carro, Ubaldo, Dell'Isola, Andrea, De Tanti, Antonio, D'Ippolito, Mariagrazia, Fazzi, Elisa, Federico, Angela, Ferrari, Adriano, Ferrari, Sergio, Ferraro, Francesco, Formaglio, Fabio, Formisano, Rita, Franzoni, Simone, Gajofatto, Francesca, Gandolfi, Marialuisa, Gardella, Barbara, Geppetti, Pierangelo, Giammò, Alessandro, Gimigliano, Raffaele, Giusti, Emanuele Maria, Greco, Elena, Ieraci, Valentina, Invernizzi, Marco, Jacopetti, Marco, Jedrychowska, Iwona, Lacerenza, Marco, La Cesa, Silvia, Lobba, Davide, Magrinelli, Francesca, Mandrini, Silvia, Manera, Umberto, Manzoni, Gian Mauro, Marchettini, Paolo, Marchioni, Enrico, Mariotto, Sara, Martinuzzi, Andrea, Masciullo, Marcella, Mezzarobba, Susanna, Miotti, Danilo, Modenese, Angela, Molinari, Marco, Monaco, Salvatore, Morone, Giovanni, Nappi, Rossella, Negrini, Stefano, Pace, Andrea, Padua, Luca, Pagliano, Emanuela, Palmerini, Valerio, Pazzaglia, Costanza, Pecchioli, Cristiano, Pietrabissa, Giada, Picelli, Alessandro, Polli, Andrea, Porro, Carlo Adolfo, Porru, Daniele, Romano, Marcello, Roncari, Laura, Rosa, Riccardo, Saccavini, Marsilio, Sacerdote, Paola, Saviola, Donatella, Schenone, Angelo, Schweiger, Vittorio, Scivoletto, Giorgio, Solaro, Claudio, Spallone, Vincenza, Springhetti, Isabella, Tassorelli, Cristina, Tinazzi, Michele, Togni, Rossella, Torre, Monica, Torta, Riccardo, Traballesi, Marco, Trabucco, Erika, Tramontano, Marco, Truini, Andrea, Tugnoli, Valeria, Turolla, Andrea, Valeriani, Massimiliano, Vallies, Gabriella, Verzini, Elisabetta, Vottero, Mario, and Zerbinati, Paolo

Subjects
Male, peripheral neuropathy, Time Factors, Physical Therapy, consensus conference, Consensus Development Conferences as Topic, Sports Therapy and Rehabilitation, Settore M-PSI/08 - PSICOLOGIA CLINICA, pain, diabetic neuropathy, neurorehabilitation, neuropathic pain, Settore MED/13 - Endocrinologia, Humans, Pain Management, Randomized Controlled Trials as Topic, Physical Therapy, Sports Therapy and Rehabilitation, Rehabilitation, Female, Italy, Neurological Rehabilitation, neurorehabilitation, pain, consensus conference, Settore MED/34 - Medicina Fisica e Riabilitativa, Settore MED/26 - Neurologia, Human

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