Patients with advanced cancer participating in phase I clinical trials often face limited survival while experiencing significant symptom burden. Despite evidence supporting early palliative care integration alongside active cancer treatment to improve quality of life, the role of palliative care in phase I trials remains unclear.

To explore perspectives of patients, informal caregivers, and healthcare providers on quality of life and palliative care in phase I oncology trials, including perceived benefits, barriers, and integration strategies.

We conducted a multi-perspective qualitative interview study across three Belgian university hospitals from September 2022 to July 2024, using convenience and snowball sampling. The semi-structured interviews were analyzed using qualitative content analysis. Ethical approval was gained from the relevant institutions.

Participants included sixteen patients, five informal caregivers, twelve phase I staff, six oncologists, five palliative care specialists, and four general practitioners. Patients generally reported positive experiences with trial participation, often viewing it as a final opportunity that provided hope and structure. However, quality of life support was inconsistently addressed and largely reactive. While patients reported feeling supported, non-trial providers and caregivers noted limited person-centered care. No systematic approach for introducing palliative care was in place. Palliative care was rarely discussed, hindered by misconceptions such as equating palliative care with terminal care, reluctance from patients and clinicians, and lack of communication between providers. Participants suggested the introduction of routine yet flexible palliative care conversations, as well as improved communication between providers, as strategies towards integration.

Despite recognized care needs, palliative care is not systematically integrated in phase I oncological trials. Quality of life remains a secondary concern. Integrating palliative care in a structured yet flexible manner could support more holistic, patient-centered care. These findings underscore the need to normalize palliative care as a complementary component of phase I oncological trials.

Esophageal cancer surgery frequently leads to post-extubation atelectasis. The efficacy of high-flow nasal cannula (HFNC) oxygen therapy in the post-anesthesia care unit (PACU) for these patients remains unvalidated.

This randomized controlled trial enrolled 100 patients after esophageal cancer surgery, allocated to a control group (conventional oxygen therapy at 5 L/min, n = 50) or an HFNC group (heated and humidified oxygen at 40% FiO₂, 37°C, 10 L/min, n = 50). The primary outcome was the lung ultrasound score at pre-extubation (T1), 30 minutes post-intervention (T2), and before PACU discharge (T3). The secondary outcome measures included PaO2/FiO2, hypoxemia, incidence of pulmonary complications within 7 days post-intervention.

The reduction in lung ultrasound score from T1 to T3 was significantly greater in the HFNC group (mean change: -5.6 points) than in the control group (mean change: -1.4 points), with a between-group difference of -4.2 points (95% CI: -4.7 to -3.7; P < 0.001). At T2 and T3, lung ultrasound score were significantly lower in the HFNC group (T2: 8.7 ± 1.2 vs. 12.7 ± 1.5; T3: 7.6 ± 1.0 vs. 11.7 ± 1.1; both P < 0.001). The HFNC group also had significantly higher PaO₂/FiO₂ ratios at T2 (325 ± 38 vs. 295 ± 35 mmHg) and T3 (340 ± 32 vs. 305 ± 30 mmHg) (both P < 0.001), and a lower incidence of hypoxic events (12.0% vs. 28.0%, P = 0.046) and 7-day postoperative pulmonary complications (10.0% vs. 36.0%, P = 0.002). No significant differences were found in sedation scores or hemodynamic parameters.

The utilization of HFNC oxygen therapy in the PACU may provide a safe and effective means of mitigating the severity of atelectasis subsequent to extubation, enhancing oxygenation levels, and decreasing the incidence of early pulmonary complications in patients who have undergone surgical interventions for esophageal cancer.

This study investigated whether elevated ward noise aggravates cancer-related fatigue (CRF) in lung cancer patients.

This retrospective single-centre study allocated 86 patients who underwent thoracoscopic lobectomy (March 2021-June 2022) into high- and low-noise groups (43 patients each) in accordance with postoperative ward decibel levels. Data on CRF (Visual Analogue Scale [VAS] and Brief Fatigue Inventory [BFI]), sleep quality (Athens Insomnia Scale [AIS]), psychological status (Hospital Anxiety and Depression Scale), quality of life (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30), clinical recovery and satisfaction were collected 2 weeks postsurgery. Multivariable linear regression analysed the noise-CRF association, adjusting for age, gender, body mass index, and clinical stage.

The high-noise group had a significantly higher noise level (A-weighted equivalent continuous sound level: 58.2 ± 2.1 dB vs. 50.8 ± 2.4 dB) and exhibited more severe CRF (BFI: 6.8 ± 1.5 vs. 5.2 ± 1.7, P < 0.001; VAS: 7.5 ± 1.3 vs. 5.9 ± 1.6, P < 0.001), poorer sleep (AIS: 10.2 ± 2.8 vs. 6.1 ± 2.9), higher anxiety/depression, poorer quality of life, delayed ambulation (28.5 ± 6.1 h vs. 23.2 ± 5.8 h), longer hospital stays (7.5 ± 1.4 days vs. 6.4 ± 1.2 days), and lower satisfaction than the low-noise group. After adjustment, higher A-weighted equivalent continuous sound level was independently associated with higher BFI ( β  = 0.380) and VAS scores ( β  = 0.420).

High ward noise independently predicts increased CRF, suggesting noise reduction as a key management approach.

A significant proportion of patients with leukemia experience anxiety disorders, which negatively affect their quality of life and sense of hope. Music therapy, a noninvasive and cost-effective treatment, may help regulate emotions, reduce anxiety, and alleviate pain.

This study examined the effects of music therapy as an adjunct treatment on mood and hope levels in patients with leukemia and anxiety disorders.

We analyzed 86 adult patients with leukemia and anxiety admitted between August 2023 and October 2024. Patients were divided into a standard treatment group ( n  = 43, the conventional treatment) and a music group ( n  = 43, the conventional treatment plus 12 music therapy sessions over 4 weeks, each lasting 60 min, based on mindfulness). General data, Medical Coping Modes Questionnaire (MCMQ, coping styles), Profile of Mood States (POMS, mood states), Herth Hope Index (HHI, hope levels), Hamilton Anxiety Rating Scale (HAMA, anxiety), World Health Organization Quality of Life Measurement Scale Brief Form (WHOQOL-BREF, quality of life), and Piper Fatigue Scale (PFS, fatigue) were compared at admission ( T1 ) and 1 month later ( T2 ).

At T1 , no significant differences existed between the groups ( P > 0.05). At T2 , the music group showed reduced MCMQ avoidance/resignation scores ( P < 0.05), increased POMS positive mood, diminished negative mood ( P < 0.05), and elevated HHI scores ( P < 0.05). Additionally, their HAMA, PFS, and WHOQOL-BREF scores improved significantly ( P < 0.05).

In this study, we found that self-reported levels of hope and mood improved in patients with leukemia and anxiety disorder following music therapy treatment. Further studies are needed to optimize treatment timing and methods to improve efficacy.

To evaluate the effects of music relaxation training combined with hierarchical nursing management on vomiting symptoms and psychological resilience in patients with chemotherapy-induced nausea and vomiting (CINV).

In this retrospective study, 142 patients with CINV treated between June 2023 and January 2025 were stratified into three groups: the control group ( n  = 46, routine multidisciplinary care), the observation group 1 ( n  = 47, additional hierarchical nursing) and the observation group 2 ( n  = 49, hierarchical nursing plus music relaxation training). All care continued over three chemotherapy cycles. Outcomes were assessed by using the Index of Nausea, Vomiting and Retching (INVR), Connor-Davidson Resilience Scale (CD-RISC), State Anxiety Inventory (S-AI), Cancer Fatigue Scale (CFS), Functional Living Index-Emesis (FLIE) and compared pre- and post-intervention. Data were analysed using the chi-squared test, t -test and one-way analysis of variance.

After care, observation groups 1 and 2 showed superior outcomes to the control group across all measures. Specifically, INVR subscale scores (nausea, vomiting and retching) were significantly lower in the observation groups than in the control group, with the observation group 2 demonstrating further reductions compared with the observation group 1 (e.g., nausea: 2.81 vs. 3.87; P < 0.05). All CD-RISC dimension scores were higher in the observation groups than in the control groups and again were highest in the observation group 2 (e.g., optimism: 11.42 vs. 9.64; P < 0.05). Similarly, S-AI and CFS scores were lower in the observation groups, with the observation group 2 showing the lowest scores amongst all groups (S-AI: 29.46 vs. 34.25; CFS: 27.97 vs. 31.24; P < 0.05). Finally, FLIE nausea and vomiting subscale scores were higher in the observation groups than in the control group, with the observation group 2 scoring highest amongst groups (nausea: 56.64 vs. 53.46; vomiting: 53.48 vs. 51.37; P < 0.05).

Integrated music relaxation training and hierarchical nursing may alleviate CINV symptoms, enhance psychological resilience, reduce anxiety and fatigue and improve quality of life.

This study aimed to examine the effects of an optimised environmental noise management protocol on sleep quality and fatigue levels in patients with colorectal cancer.

A retrospective analysis was conducted. Patients admitted before the implementation of the optimised protocol (January 2023 to December 2023, receiving conventional noise management) were assigned to the conventional care group ( n  = 63). Those admitted after implementation (January 2024 to December 2024, receiving optimised environmental noise management) were assigned to the optimised management group ( n  = 64). A comparison was made between the two groups regarding noise decibel levels (daytime and nighttime), sleep quality (Pittsburgh Sleep Quality Index [PSQI]), fatigue (Cancer Fatigue Scale [CFS]) and comfort status (General Comfort Questionnaire [GCQ]).

The optimised management group demonstrated significantly lower noise decibel levels during daytime and nighttime compared with the conventional care group ( P < 0.05). Significantly reduced scores were observed in all PSQI domains and the global PSQI score in the optimised management group ( P < 0.05). Similarly, scores across all domains of the CFS and its total score significantly decreased in this group ( P < 0.05). Conversely, scores for all domains of the GCQ and its total score were significantly elevated in the optimised management group ( P < 0.05). Pearson correlation analysis revealed a significant positive correlation between noise decibel levels and PSQI ( r > 0, P < 0.05) and CFS scores ( r > 0, P < 0.05). A significant negative correlation was observed between noise decibel levels and GCQ scores ( r < 0, P < 0.05).

Implementing an optimised environmental noise management protocol can effectively reduce noise levels in patient care units, thereby improving sleep quality, reducing fatigue, and enhancing overall patient comfort during hospitalisation.

Percutaneous transhepatic biliary drainage (PTBD) is a well-established palliative intervention for patients with malignant biliary obstruction, yet outcomes remain heterogeneous across patient populations. A clear understanding of factors influencing survival and complications is essential for optimizing patient selection and procedural strategies.

To evaluate clinical and procedural predictors of outcome in a large single-center cohort of patients undergoing PTBD for malignant biliary obstruction.

This retrospective study included 383 consecutive patients, who underwent PTBD over a 9-year period at a tertiary referral center. Demographic parameters, underlying malignancy type, laboratory values, procedural details, and post-procedural complications were recorded. Survival outcomes were analyzed using Kaplan-Meier methods and multivariable regression models to identify independent predictors of mortality and complication-related outcomes.

Pancreatic cancer (41.5%) and cholangiocarcinoma (30.5%) were the most common etiologies. Post-procedural complications occurred in 33.7% of patients, led by cholangitis (17.8%), and overall, in-hospital mortality was 30.3%. For in-hospital mortality, total bilirubin (AUC: 0.613, P < 0.001), direct bilirubin (AUC: 0.610, P < 0.001), and WBC count (AUC: 0.597, P = 0.002) were significant predictors. The presence of complications (HR: 1.92) and specifically sepsis/septic shock (HR: 3.89) were strongly associated with increased mortality risk. Median in-hospital survival was 62 days, and it was significantly shorter in patients, who developed complications (49 vs. 82 days, P < 0.001).

PTBD remains an effective and indispensable palliative treatment for malignant biliary obstruction. However, patient outcomes are strongly influenced by baseline clinical status and post-procedural complications.

Parotid gland tumors constitute a significant proportion of head and neck neoplasms, and accurate non-invasive differentiation is essential for appropriate clinical management. Recent advances in ultrasound techniques, including shear-wave elastography (SWE), have shown promising diagnostic potential.

To evaluate the diagnostic performance of long-to-short axis ratio (L/S) and shear-wave velocity (SWV) values obtained by virtual touch imaging quantification (VTIQ) in differentiating pleomorphic adenoma (PA), Warthin tumor (WT), and malignant tumors (MT) of the parotid gland.

This study included 66 parotid masses from 63 patients who underwent conventional ultrasound and SWE examinations. B-mode features, Doppler vascular patterns, L/S ratios, and SWV values were recorded and compared with histopathological findings. Receiver operating characteristic (ROC) analysis was performed to determine optimal cutoff values, sensitivity, and specificity.

The cutoff value for differentiating WT and PA was 1.57 for the L/S ratio (sensitivity: 83.33%, specificity: 88.46%, p < 0.001). For distinguishing MT from PA, the L/S cutoff was 1.68 (sensitivity: 50.00%, specificity: 96.15%, p < 0.001). The optimal SWV cutoff for WT and PA differentiation was 5.02 m/s (sensitivity: 91.67%, specificity: 73.08%, p < 0.001), while for MT and PA differentiation, it was 6.30 m/s (sensitivity: 84.62%, specificity: 62.50%, p < 0.001).

The combined use of L/S ratio and SWV values obtained by VTIQ provides a reliable and non-invasive diagnostic approach for differentiating parotid gland tumors and may help reduce unnecessary biopsies.

Primary hepatic neuroendocrine tumour (PHNET) is an exceptionally rare neoplasm, accounting for approximately 0.3% of all neuroendocrine tumours. It presents with non specific clinical and radiological features, making pre operative diagnosis difficult. Differentiation from other paediatric liver lesions, such as hepatoblastoma, haemangioma and hepatocellular carcinoma, is challenging. We report the rare case of PHNET in a 9 year old boy who presented with abdominal pain and vomiting. Routine laboratory investigations, including liver function tests and serum alpha fetoprotein levels, were within the normal limits. Radiological evaluation suggested a diagnosis of sclerosed hepatic haemangioma. Definitive diagnosis was established by histopathological examination and immunohistochemistry. Surgical resection was performed, which remains the mainstay of treatment. The post operative course was uneventful and regular follow up. This case highlights the diagnostic difficulty of PHNET and underscores the importance of histopathological evaluation for accurate diagnosis and appropriate management.

Breast cancer remains the most prevalent malignancy among women worldwide, contributing significantly to global cancer-related morbidity and mortality. It is responsible for nearly 15% of all female cancer fatalities. It has a higher prevalence in developed nations.

The present study aimed to assess the predictive utility of Atherogenic index of plasma (AIP) in carcinoma breast cases in correlation with oxidative stress, immuno-biomarkers and body mass index (BMI).

Prospective interventional study. The Prospective Interventional Study was conducted in the Department of Biochemistry, Jawaharlal Nehru Medical College and the Histopathology and Radiology division of the Department of Pathology, JNMC, in collaboration with the Department of Surgery, JNMC and Acharya Vinoba Bhave Rural Hospital, Wardha, for the duration of 3 years. Total 81 samples were recruited for the study. The patient's history was taken, and a proper medical examination was carried out. The SPSS program for Windows, version 26.0 (SPSS, Chicago, Illinois, USA), was employed to conduct the statistical analysis. Categorical variables were analysed using either the Chi-square test or Fisher's exact test, while continuous variables were compared using the unpaired t -testing method. P ≤0.05 was deemed to be statistically significant.

A significant positive correlations between AIP and various parameters, including BMI ( r = 0.591, P < 0.001), superoxide dismutase ( r = 0.407, P < 0.001), high-sensitivity C-reactive protein ( r = 0.507, P < 0.001), Interleukin-10 (IL-10) ( r = 0.706, P < 0.001) and IL-18 ( r = 0.652, P < 0.001). Furthermore, a strong positive correlation with lipid profile was observed.

AIP could serve as a useful surrogate marker to assess not only lipid imbalance but also broader systemic changes that accompany breast cancer.