Nguyen Q, Chun SG, Chow E, et al.| 2019| Single-Fraction Stereotactic vs Conventional Multifraction Radiotherapy for Pain Relief in Patients With Predominantly Nonspine Bone Metastases: A Randomized Phase 2 Trial| JAMA Oncology doi:10.1001/jamaoncol.2019.0192
Research published in the JAMA Oncology concludes that delivering high-dose, single-fraction (SBRT) seems to be an effective treatment option for patients with painful bone metastases.
Question Does single-fraction stereotactic body radiotherapy (SBRT) for bone metastases lead to better pain response rates than standard multifraction radiotherapy (MFRT)?
Findings In this prospective randomized phase 2 noninferiority trial, 160 patients with mostly nonspine bone lesions were randomly assigned to receive single-fraction SBRT (12 Gy for less than or equal to 4-cm lesions or 16 Gy for more than 4-cm lesions) or MFRT to 30 Gy in 10 fractions. Single-fraction radiation led to more patients experiencing complete or partial pain response at 2 weeks, 3 months, and 9 months compared with standard MFRT.
Meaning Pain response rates were higher for high-dose, single-fraction SBRT, which should be considered for patients with bone metastases and long estimated survival times.
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Di Giuseppe, M., Ciacchini, R., Piarulli, A., Nepa, G., & Conversano, C. |2019|Mindfulness dispositions and defense style as positive responses to psychological distress in oncology professionals| European Journal of Oncology Nursing |Vol.40|2019| P.104-110
A new study published in the European Journal of Oncology Nursing looks at mindfulness dispositions and defense mechanisms as responses to psychological distress in oncology professionals.
Oncology professionals are exposed to work-related stress responses that can be handled with defense style and mindfulness dispositions.
Depression symptoms are reduced by both mindfulness and defense mechanisms, whereas immature defense style increase anxiety symptoms.
The early detection of pitfalls in defensive functioning and mindfulness dispositions might help in providing psychological interventions.
Working in oncology departments is a stressful and emotionally consuming experience and oncology professionals are particularly at risk for developing stress-related syndromes. Defense mechanisms (high-adaptive) and mindfulness dispositions are known as facilitators of well-being and adaptation. In this study we analysed the role of these unconscious and conscious strategies in protecting the oncology clinicians from stress-related symptoms.
A convenience sample of 63 oncology professionals was assessed on defense style, mindfulness disposition, depression and anxiety symptoms using self-reported questionnaires. Demographic and professional information was included in data collection.
Results did not show significance differences in demographic and professional characteristics among all studied variables. Mature defense style and mindfulness were highly and negatively correlated with depression and anxiety, while a positive association was found between immature defense style and both depression and anxiety symptoms. Hierarchical multiple regression analyses found defense styles and mindfulness as predictors of depression, whereas only immature defense style predicted anxiety.
The present study provides the first empirical evidence of the influence of unconscious defense mechanisms and conscious mindfulness dispositions in protecting oncology professionals from depression and anxiety symptoms. Defense mechanisms and mindfulness share several common-points and should be seen as complementary in enhancing physical and psychological well-being. Further studies are required for a deeper understanding of the impact of mindfulness and defenses in improving adaptation.
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