Aug 2017 DOI 10.14302/issn.2574-612X.ijpr-17-1604
Bovero AndreaCorresponding author
Clinical Psychology and Psycho-Oncology Unit – Department of Neurosciences, University of Turin, Italy
Objective To compare Brief Adlerian Psychodynamic Psychotherapy (B-APP) plus venlafaxine versus venlafaxine plus usual care on pain and depressive symptomatology of depressed patients with cancer pain. Methods A total of 100 patients with pain and mood depression, according to DSM IV-TR, were randomized to receive treatment with B-APP plus venlafaxine (n=51) or venlafaxine plus usual care (n=49). The sample was evaluated at baseline and after 10 weeks with the Visual Analogue Scale (VAS); the Hospital Anxiety Depression Scale (HADS); the Montgomery Asberg Depression Rating Scale (MADRS); the Clinical Global Impressions (CGI); the Mini-Mental Adjustment to Cancer Scale (Mini-MAC); the European Organization for Research and Treatment of Cancer Quality-of Life Questionnaire (EORTC QLQ-C30) and the Dosage Record and Treatment Emergent Symptom scale (DOTES). Only at the endpoint was the Verona Service Satisfaction Scale (VSSS-54) also administered. Results A significant reduction in VAS and HADS scores was observed in both treatments, but a higher significance (p<0.01) was present only in subjects also treated with psychotherapy. A significant change was obtained in Mini-MAC scores (p<0.01) for Fighting Spirit, Fatalism, Anxious Preoccupation (p<0.01) and Avoidance items (p<0.05) only in patients treated with combined therapy. The combined group also showed more satisfaction with the treatment in their responses to the VSSS-54. Conclusions Brief Adlerian Psychodynamic Psychotherapy (B-APP) in combination with venlafaxine was superior to usual care and venlafaxine in improving depressive symptomatology and reducing pain.
Apr 2017 DOI 10.14302/issn.2372-6601.jhor-17-1463
Szablewska SylwiaCorresponding author
Nicolaus Copernicus University, Faculty of Health Sciences; Department of Oncology, Radiotherapy and Ginecologic Oncology, Poland
Melanoma is considered to be a very aggressive cancer due to its rapid growth, early and multiple metastases and limited response to standard treatment. Many researchers have hypothesized that the combination of radiation therapy and immunotherapy in the treatment of melanoma primary tumors and metastases improves the efficiency of these methods as compared to their use separately. Therefore, combined therapy is an increasingly popular topic in radiation oncology. Although the mechanism of immune response to ionizing radiation remains unclear, known are the factors involved in the immune response, including NK and CD8(+) T cells. Many studies have demonstrated the importance of inflammatory factors, primarily cytokines, in the response to ionizing radiation. In turn, many cytokines released in an irradiated organ, such as tumor necrosis factor α (TNFα), interleukins IL1 and IL6 and transforming growth factor beta (TGFβ), can induce the production of significant amounts of reactive oxygen species that are associated with the induction of DNA damage in tumor cells. In relation to anticancer immunotherapy, the clinical data obtained to date can encourage future studies combining radiation therapy and the inhibitors of cell division checkpoints in the treatment of advanced melanoma. In a recent study, melanoma cell lines became more sensitive to radiation after BRAF inhibition, which provides a potential synergistic mechanism of BRAF inhibitor (BRAFi) combined with radiation therapy for better effects of treatment. In this article, we present a systematic review of the literature on the use of the combination of radiation therapy and immunotherapy in the treatment of melanoma.