Chronic low quality of life in almost half of kids with cancer and FN

Febrile neutropenia (FN) has a heterogeneous impact on health-related quality of life (HRQoL) of children with cancer.

A sub-study of the Australian Predicting Infectious ComplicatioNs in Children with Cancer (PICNICC) study identified three patterns of HRQoL trajectories – chronic (47%), recovering (22% and resilient (32%).

• Children in the chronic group had HRQoL scores that were relatively low, at both the onset of FN and over the 30-day follow-up.
• Children in the recovery group had initially low HRQoL scores which improved after the resolution of the FN episode.
• Children in the resilient group had relatively high HRQoL scores that were initially below population norms but improved after the resolution of the FN episode and were comparable to Australian population norms.

Risk factors for the chronic pattern of HRQoL were the child being male, having solid cancer, the presence of financial stress, and relationship difficulties between the parent and child.

The study said these families may benefit from increased financial and psychosocial support during anti-cancer treatment.

Read more in E Clinical Medicine

Promising improvement in melanoma brain metastases

First-line combined immunotherapy results in sustainable responses in melanoma brain metastases.

The disease control rate (DCR) was 60.3% and overall response rate (ORR) 45% in a retrospective study of 53 patients receiving anti-PD1/anti-CTLA4 agents.

The European and Australian study found the median PFS was 9.6 months and median OS was 44.8 months.

The outcomes were superior to those in 63 patients with BRAF mutations treated with combined targeted therapy.

“Despite the initial increased intracranial response rate and extracranial response rate, sustainable responses at 12 months were achieved only in 12.7% of patients in the Combi-TT cohort,” the study said.

“Predictive models of response and further clinical trials investigating systemic and local treatment sequences will help identify the best responders and direct our therapeutic decisions.”

Read more in the European Journal of Cancer

Doctors hit the bottle to relieve pandemic distress

Alcohol is one of the main coping strategies used by Australian healthcare workers in response to the pandemic, a national survey has revealed.

Conducted in September 2020, the survey on wellbeing and coping strategies elicited responses from 7846 frontline healthcare workers including more than 2400 medical staff, and showed that over a quarter (26.3%) reported increased alcohol use.

The most commonly reported adaptive coping strategies were exercise (45%), social connections (32%) and yoga or meditation (26%), whereas few used workplace support programs (6%) or sought help from a doctor or psychologist (18%).

Use of alcohol was associated with poor mental health and worse personal relationships, the study found.

The study investigators said the widespread use of maladaptive coping strategies by healthcare workers during the second wave highlighted an urgent need to improve access and uptake of professional support services for psychological distress.

Read more in General Hospital Psychiatry