ARGININE DEPRIVATION THERAPY (ADI-PEG 20) AND THE INCIDENCE OF FATIGUE IN ADVANCED HCC PATIENTS: A CHALLENGE FOR NURSES

2.50
Hdl Handle:
http://hdl.handle.net/10755/165207
Category:
Abstract
Type:
Presentation
Title:
ARGININE DEPRIVATION THERAPY (ADI-PEG 20) AND THE INCIDENCE OF FATIGUE IN ADVANCED HCC PATIENTS: A CHALLENGE FOR NURSES
Author(s):
Connola, Marianna; Foggia, Margherita; Galeani, Laura; Bryce, Jane; Falanga, Marzia; Piccirillo, Mauro; Izzo, Francesco
Author Details:
Marianna Connola, RN, Research Nurse, NCI - Naples, Naples, Italy, email: maria.annar@libero.it; Margherita Foggia; Laura Galeani; Jane Bryce; Marzia Falanga; Mauro Piccirillo, MD; Francesco Izzo, MD
Abstract:
Pegylated arginine deiaminase (ADI-PEG 20) is a novel anti-cancer enzyme therapy currently being tested in phase III trials, whose efficacy is based on blocking the production of arginine, an amino acid required for growth of certain tumors such as hepatocellular carcinoma (HCC). It is administered weekly by IM injection for at least 6 months, and is associated with moderate to severe and persistent fatigue, believed to be largely due to the inhibition of arginine production. The purpose of this study is to describe the incidence and level of fatigue in patients with HCC undergoing experimental weekly therapy with ADIPEG20, and to evaluate the impact of the implementation of evidence based nursing (EBN) interventions on fatigue incidence and grade. We used the Orem's Conceptual Model, to help patient recognize, refer and manage symptoms when they occur, because it is consistent with our institute's philosophy. 120 patients were enrolled in our center from November 2003 to December 2006. Fatigue is evaluated at baseline and weekly using self report (0-10 scale) and CTC criteria (grade 1-4) fatigue scales, and Karnofsky performance status. Clinical exam and interview are conducted at each patient visit, and fatigue cofactors are documented. Individualized EBN interventions, adapted from the ONS PEP resources and NCCN guidelines, are designed for each patient after clinical exam and interview. All patients receive education about energy conservation, activity management, measures to optimize sleep quality, dietary indications including the avoidance of arginine. We also created a brochure providing patients information to use at home to help them recognize and correctly refer symptoms to the medical team. Nearly 80% of all patients experienced grade 2 or 3 fatigue early in the treatment course. Data reveal a reduction in patient reported fatigue by 3 points and in clinician assessed fatigue level by 1 grade in 60% of patients who received nursing interventions and emotional support. We reported data on fatigue experience over the course of treatment as well as the difference in fatigue experience in patients helped with psychological support. Findings support the use of EBN interventions for fatigue management in HCC patients receiving experimental therapy.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2007
Conference Name:
32nd Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
Las Vegas, Nevada, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleARGININE DEPRIVATION THERAPY (ADI-PEG 20) AND THE INCIDENCE OF FATIGUE IN ADVANCED HCC PATIENTS: A CHALLENGE FOR NURSESen_GB
dc.contributor.authorConnola, Mariannaen_US
dc.contributor.authorFoggia, Margheritaen_US
dc.contributor.authorGaleani, Lauraen_US
dc.contributor.authorBryce, Janeen_US
dc.contributor.authorFalanga, Marziaen_US
dc.contributor.authorPiccirillo, Mauroen_US
dc.contributor.authorIzzo, Francescoen_US
dc.author.detailsMarianna Connola, RN, Research Nurse, NCI - Naples, Naples, Italy, email: maria.annar@libero.it; Margherita Foggia; Laura Galeani; Jane Bryce; Marzia Falanga; Mauro Piccirillo, MD; Francesco Izzo, MDen_US
dc.identifier.urihttp://hdl.handle.net/10755/165207-
dc.description.abstractPegylated arginine deiaminase (ADI-PEG 20) is a novel anti-cancer enzyme therapy currently being tested in phase III trials, whose efficacy is based on blocking the production of arginine, an amino acid required for growth of certain tumors such as hepatocellular carcinoma (HCC). It is administered weekly by IM injection for at least 6 months, and is associated with moderate to severe and persistent fatigue, believed to be largely due to the inhibition of arginine production. The purpose of this study is to describe the incidence and level of fatigue in patients with HCC undergoing experimental weekly therapy with ADIPEG20, and to evaluate the impact of the implementation of evidence based nursing (EBN) interventions on fatigue incidence and grade. We used the Orem's Conceptual Model, to help patient recognize, refer and manage symptoms when they occur, because it is consistent with our institute's philosophy. 120 patients were enrolled in our center from November 2003 to December 2006. Fatigue is evaluated at baseline and weekly using self report (0-10 scale) and CTC criteria (grade 1-4) fatigue scales, and Karnofsky performance status. Clinical exam and interview are conducted at each patient visit, and fatigue cofactors are documented. Individualized EBN interventions, adapted from the ONS PEP resources and NCCN guidelines, are designed for each patient after clinical exam and interview. All patients receive education about energy conservation, activity management, measures to optimize sleep quality, dietary indications including the avoidance of arginine. We also created a brochure providing patients information to use at home to help them recognize and correctly refer symptoms to the medical team. Nearly 80% of all patients experienced grade 2 or 3 fatigue early in the treatment course. Data reveal a reduction in patient reported fatigue by 3 points and in clinician assessed fatigue level by 1 grade in 60% of patients who received nursing interventions and emotional support. We reported data on fatigue experience over the course of treatment as well as the difference in fatigue experience in patients helped with psychological support. Findings support the use of EBN interventions for fatigue management in HCC patients receiving experimental therapy.en_GB
dc.date.available2011-10-27T12:14:25Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:14:25Z-
dc.conference.date2007en_US
dc.conference.name32nd Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationLas Vegas, Nevada, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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