McClure, M.K., McClure, R.J., Day, R., & Brufsky, A.M. (2010). Randomized controlled trial of the Breast Cancer Recovery Program for women with breast cancer-related lymphedema. The American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association, 64(1), 59–72.
To determine effect of completion of a recovery program including gentle exercise and deep breathing on breast cancer-related lymphedma
Patients assigned to the treatment group attended biweekly one-hour exercise and educational sessions for five weeks, then followed a three-month self-monitored home program. Those in the treatment group were instructed to complete use of a video and relaxation daily at home. Exercises included gravity-resistive arm movements incorporating shoulder flexion, abduction, and external rotation. Exercise and compression hose adherence was assessed with a self-report tool designed for the study. Control patients received usual care. Patients were assigned into four groups of treatment and controls.
The study sample (N = 32) was comprised of female patients aged 21–80 years with stage I or II unilateral breast cancer-related lymphedema.
The study took place in an outpatient site in Pittsburgh, PA.
The study used a randomized controlled single blind trial design.
Bioimpedance mean differences of those in treatment compared with controls showed a positive main effect for treatment (p = 0.049). There was no significant effect on volume measures. Patients who complied with compression demonstrated improvement over time. Range of motion, mood, and quality of life improved in those in the treatment group.
The program of combined exercise activity and self-directed practice related to coping and relaxation were associated with improvement in lymphedema and other symptoms.
Findings support the positive benefit of patient upper-extremity exercises in the management of lymphedema.
McAleese, J.J., Bishop, K.M., A’Hern, R., & Henk, J.M. (2006). Randomized phase II study of GM-CSF to reduce mucositis caused by accelerated radiotherapy of laryngeal cancer. British Journal of Radiology, 79(943), 608–613.
GM-CSF 2 mcg/kg (-1) (150 mcg) daily for 14 days starting on day 14 of a 21-day course of RT.
Note: Placebo injections were not given; observer was blinded to treatment.
The study was comprised of 29 patients (GM-CSF = 14).
Power analysis was completed, but not met (n = 17 in each group).
Patients with proven T1 N0 or T2 N0 glottic carcinoma were being treated with radiotherapy using a 16 fraction 3-week regimen.
Required to have a WHO performance status of grade 0 or higher, no renal or hepatic issues, serious infections requiring antibiotics, or likely need for corticosteroids.
Prospective, randomized, observer blind phase II trial
Significant difference in the incidence of mucositis p < 0.05, mean time of healing improved but not significant p = 0.25.
No differences in dysphagia, odynophagia, analgesic use, candida infection, of laryngeal edema.
Mazzocato, C., Buclin, T., & Rapin, C.H. (1999). The effects of morphine on dyspnea and ventilatory function in elderly patients with advanced cancer: A randomized double-blind controlled trial. Annals of Oncology, 10(12), 1511–1514.
Subcutaneous (SC) morphine 5 mg or placebo in opioid-naïve patients and regular oral morphine dose plus half of the every-four-hour (q4h) dose given SC in patients on regularly scheduled opioids
The study was conducted in an inpatient geriatric hospital.
The study was a double-blind, placebo controlled, randomized, cross-over trial.
Intermittent injections of morphine at the doses used reduce cancer-related dyspnea. The changes in respiratory effort and rate but not anxiety support the theory that the benefit of morphine is unlikely related to somnolence or an effect on anxiety.
Mazumdar, A., Mishra, S., Bhatnagar, S., & Gupta, D. (2008). Intravenous morphine can avoid distressing constipation associated with oral morphine: A retrospective analysis of our experience in 11 patients in the palliative care in-patient unit. American Journal of Hospice and Palliative Care, 25, 282–284.
To describe differences in bowel function with oral or IV opioids.
Patients who were admitted to a palliative inpatient unit for pain management had data retrospectively collected related to morphine-induced constipation. After IV morphine was administered and dose requirements were determined, patients were converted to oral morphine and then discharged.
The study has clinical applicability to end-of-life and palliative care.
This was a retrospective, descriptive study.
Visual analog scale
Patients on IV morphine were less likely to need laxative therapy to promote bowel function compared with patients on oral morphine. All patients on oral morphine needed laxative therapy.
Implications are limited because of the small sample size and other uncontrolled variables. More research is needed to determine whether IV morphine is less constipating than oral morphine and the applicability of this information in patient care.
Mazlum, S., Chaharsoughi, N.T., Banihashem, A., & Vashani, H.B. (2013). The effect of massage therapy on chemotherapy-induced nausea and vomiting in pediatric cancer. Iranian Journal of Nursing and Midwifery Research, 18(4), 280–284.
To determine if massage therapy was effective relief for chemotherapy-induced nausea and vomiting (CINV) in children with cancer
Patients in the intervention group received a 20 minute massage 24 hours and 30 minutes before a chemotherapy infusion and 24 hours postinfusion. A trained massage therapist used a Swedish massage technique with effleurage, petrissage, friction, and tapping movements. Mild to moderate pressure was used. Subjects were randomized by a randomized number table. Patients could elect to use olive oil with the massage. No music was used during the therapy. The control group received normal care, but the therapist was present 24 hours and 30 minutes before an infusion as well as 24 hours postinfusion. Data were collected during chemotherapy and 48 hours postinfusion.
Randomized, controlled trial
There were no significant differences between the intervention and the control group in terms of gender, type of cancer, or emetic potential of chemotherapy. There was no difference between groups in regard to nausea during chemotherapy. There was a significant difference in frequency (p = 0.001), duration (p = 0.002), and severity (p = 0.002) of nausea 48 hours after chemotherapy. There was no difference in vomiting at the time of chemotherapy, but there was a significant difference in the severity (p = 0.005) and frequency (p = 0.013) of vomiting 48 hours postinfusion.
Massage therapy may effectively decrease nausea and vomiting 48 hours after chemotherapy infusion in children.
Massage therapy, administered both before and after a chemotherapy infusion, may be effective in limiting CINV in the pediatric population. Massage was not effective at relieving anticipatory CINV that occurred at the time of infusion.
Mayyas, F., Fayers, P., Kaasa, S., & Dale, O. (2010). A systematic review of oxymorphone in the management of chronic pain. Journal of Pain and Symptom Management, 39(2), 296–308.
To assess the effectiveness of oxymorphone in the treatment of chronic pain
The search retrieved nine studies. Authors chose six studies for analysis. Five of the chosen studies were appropriate for meta-analysis. Only one study involved chronic pain resulting from a malignancy. Investigators, using guidelines published by the National Health Service Centre for Reviews and Dissemination, evaluated allocation procedures, concealment of allocation, blinding procedures, distribution of known confounders between groups, whether study groups were treated the same except for the intervention, and whether intention-to-treat analysis was performed. Two reviewers independently reviewed and assessed all studies.
In this study, oxymorphone 40–100 mg was associated with a significant reduction in the pain intensity experienced by patients with chronic pain unrelated to a malignancy. Total mean difference across studies was –12.88 (CI –17.08 through –8.68, p < 0.00001). Studies in which doses were titrated rather than fixed showed greater effect size. Adverse events were mild to moderate and similar to those associated with other opioids. The study of pain associated with malignancy, though small, demonstrated that oxymorphone was effective in the treatment of cancer pain and that switching between oxymorphone and oxycodone was feasible.
Findings suggest that oxymorphone is effective in chronic pain management. Note that the conversion ratio, oxymorphone to oxycodone, was 1:2.
Authors noted the high discontinuation rates in placebo groups; the high rates relate to the fact that some studies do not allow use of rescue medication. This fact has important implications regarding the design of studies in the field of pain management. Authors noted that regulators mandate placebo-controlled trials, and the authors highlighted the ethical concerns that such a requirement raises. In addition, authors noted the lack of placebo-controlled studies of patients with cancer pain.
Mayo, N.E., Moriello, C., Scott, S.C., Dawes, D., Auais, M., & Chasen, M. (2014). Pedometer-facilitated walking intervention shows promising effectiveness for reducing cancer fatigue: A pilot randomized trial. Clinical Rehabilitation, 28, 1198–1209.
To contribute preliminary evidence for the feasibility and potential effectiveness of a structured walking intervention on reducing cancer-related fatigue in order to plan for a full-scale study of effectiveness
The study consisted of an eight-week program with three intervention groups: one with the STEPS (a walking program using a pedometer) during rehabilitation, one with STEPS after rehabilitation, and one group with only the rehabilitation program for people with advanced cancer and a > 4 fatigue level on a Visual Analog Scale (VAS).
A pilot randomized trial. The STEPS program was based on the participants’ current walking status and progressed according to fatigue level.
Instruments chosen to measure fatigue and symptoms of anxiety and depression included the following.
Results demonstrated that the pedometer-facilitated walking intervention adapted to fatigue levels (STEPS program) showed promise as an intervention to decrease cancer-related fatigue.
Compared to rehabilitation alone, the eight-week adaptive walking intervention reduced fatigue and improved physical function and well-being over a 16-week period and was sustained to six months.
Walking intervention is associated with a trend toward less fatigue; however, this study needs replication in the advanced cancer population. Effectiveness not established.
Mayer, K., Hahn-Ast, C., Muckter, S., Schmitz, A., Krause, S., Felder, L., . . . von Lilienfeld-Toal, M. (2015). Comparison of antibiotic prophylaxis with cotrimoxazole/colistin (COT/COL) versus ciprofloxacin (CIP) in patients with acute myeloid leukemia. Supportive Care in Cancer, 23, 1321–1329.
To compare efficacy and development of bacterial resistance with prophylactic antibiotic regimens of either COT/COL or CIP
Patients with acute myeloid leukemia (AML) were given antibiotic prophylaxis with either 960 mg cotrimoxazole twice daily and colistin 200 mg three times daily or 500 mg ciproloxacin twice daily. Those receiving CIP were also given cotrimoxazole twice daily two times per week for pneumocystis prophylaxis. All received antifungal prophylaxis. Colony-stimulating factors were given to some patients at the doctor's discretion. Patients receiving CIP did not receive antiviral prophylaxis. Infection-related outcomes were compared between these two cohorts. The study included patients over a four-year span of time. Environmental antimicrobial interventions were standard across both groups.
In both groups, the incidence of febrile neutropenia was about 80%. There were no differences between groups in infections. There were no differences between groups in detection or colonization of resistant organisms. There were no differences between groups in ICU useor differences in mortality related to underlying disease, infection, or septic shock. In both groups, infection was the major cause of death (70%). Overall, 8% of patients died. There were no differences between groups in treatment toxicity.
Both antibiotic prophylactic regimens resulted in similar patient outcomes, and both appeared to have similar efficacy.
Although antibiotic prophylaxis with quinolones is generally preferred, antibiotic prophylaxis with COT/COL was essentially equally effective in this study, and might be considered an effective combination. Some studies have shown increase in quinolone-resistant organisms with standard quinolone prophylaxis. COT/COL prophylaxis may provide an alternative.
Mayer, D.J. (2000). Acupuncture: An evidence-based review of the clinical literature. Annual Review of Medicine, 51, 49-63.
MEDLINE was searched for the 14 medical conditions for which the National Institutes of Health Acupuncture Consensus Development Panel (NIHCDP) concluded acupuncture was effective or could be useful. The two conditions in which acupuncture was found to be effective are the treatment of chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea and vomiting. The remaining 12 conditions reviewed in the article were the effect of acupuncture on pain and the treatment of other conditions (e.g., addiction, stroke rehabilitation, and asthma).
Three of the studies reviewed examined the effect of P6 acupuncture on CINV. Although the chemotherapy agents were variable and various carcinomas were studied, strong evidence supported the use of acupuncture for greater antiemetic effect than antiemetics alone.
Evidence supports the use of acupuncture in the treatment of CINV and postoperative nausea and vomiting.
Mattiuzzi, G.N., Cortes, J.E., Blamble, D.A., Bekele, B.N., Xiao, L., Cabanillas, M., … Kantarjian, H. (2010). Daily palonosetron is superior to ondansetron in the prevention of delayed chemotherapy-induced nausea and vomiting in patients with acute myelogenous leukemia. Cancer, 116, 5659–5666.
To compare the efficacy of two schedules of palonosetron versus ondansetron given by continuous IV infusion for treatment of chemotherapy-induced nausea and vomiting (CINV)
The study was conducted at an inpatient setting at the University of Texas M.D. Andersen Cancer Center.
All patients were in active treatment.
This was a randomized prospective study.
Palonosetron was superior to ondansetron in reducing the prevalence of delayed nausea.
The study has potential bias because no control group or blinding was used.
Daily palonosetron appears to be more effective than the alternative used here for the prevention of delayed nausea. All the regimens here were similar in the early days of the therapy course, but palonosetron was significantly better in later days. Findings suggest that different drugs might be more helpful on different days throughout the course of chemotherapy, in concert with patterns seen in nausea.