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Annals of Oncology abstracts

CN56 When symptom complexity is the norm: A mediation analysis between CN58 Effect of aromatherapy massage on chemotherapy-induced peripheral
pain, anxiety, depression and fatigue neuropathic pain and fatigue in patients receiving oxaliplatin
A. Charalambous N. Izgu1, L. Ozdemir1, F. Bugdayci Basal2
Nursing Science, Cyprus University of Technology - Nursing Science, Limassol, Cyprus 1
Nursing Faculty, Hacettepe University, Ankara, Turkey, 2Medical Oncology, Ataturk
Chest Diseases and Surgery Training and Research Hospital, Ankara, Turkey
Background: The treatment phase for cancer is a particularly stressful period for the
patient. The patient frequently experiences simultaneously various somatic and psy- Background: Patients receiving oxaliplatin may experience peripheral neuropathic
chological side-effects resulting in a diminishing of the patient’s health related quality pain and fatigue. Aromatherapy massage, a nonpharmacological method, may help to
of life-HRQoL. The study provides evidence on the co-occurrence and interrelations control these symptoms.
between pain, anxiety, depression and fatigue in patients diagnosed with breast and
prostate cancer. Methods: The aim of this open-label, parallel-group, quasi-randomized controlled
pilot study was to investigate the effect of aromatherapy massage on chemotherapy-
Methods: Data used for the analysis came from patients (n ¼ 208) recruited in a induced peripheral neuropathic pain and fatigue in patients receiving oxaliplatin.

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Randomised Control Trial designed to test the effectiveness of Guided Imagery and Stratified randomization was used to allocate 46 patients to 2 groups: intervention
Progressive Muscle Relaxation on pain, fatigue, anxiety and depression. Non-paramet- (n ¼ 22) and control (n ¼ 24). Between week 1 and week 6, participants in the interven-
ric bootstrapping analyses were used to test the meditational model of Anxiety, Fatigue tion group (IG) received aromatherapy massage 3 times a week. There was no interven-
and Depression as parallel mediators of the relationship between Pain and HRQoL. tion in weeks 7 and 8. The control group (CG) received routine care. Neuropathic pain
Results: The three mediators fully mediate the relationship between Pain and HRQoL was identified using the Douleur Neuropathique 4 Questions; severity of painful pares-
(IEoverall¼-0.3839, 95% C.I.: LL¼-0.5073, UL¼-0.2825) indicating that patients with thesia was assessed with the numerical rating scale; fatigue severity was identified with
increased Pain are more likely to have higher levels of Anxiety, Fatigue and Depression. the Piper Fatigue Scale.
Gender significantly moderated the mediational effect of Fatigue (IMM¼-0.2867 Results: At week 6, the rate of neuropathic pain was significantly lower in the IG, when
SE ¼ 0.1526, LL¼-0.6127, UL¼-0.0226) but did not moderate mediational effect of compared with the CG. The severity of painful paresthesia based on numerical rating
Anxiety (IMM¼-0.0709, SE ¼ 0.1414, LL¼-0.3459, UL ¼ þ0.2089). The results show scale in the IG was significantly lower than that in the CG at weeks 2, 4, and 6. At week
that the three mediators in a serial causal order fully mediate the relationship between 8, fatigue severity in the IG was significantly lower when compared with CG (P < .05).
Pain and HRQoL (IEoverall¼-0.384, 95% C.I.: LL¼-0.51, UL¼-0.284) and the ratio of
the overall indirect effect to the total effect, is 0.8315 (95% CI: LL ¼ 0.5683, Conclusions: Aromatherapy massage may be useful in the management of chemother-
UL ¼ 1.1718). apy-induced peripheral neuropathic pain and fatigue. This pilot study suggests that
aromatherapy massage may be useful to relieve neuropathic pain and fatigue. However,
Conclusions: This work provides evidence that targeting fatigue, anxiety and depres- there is a need for further clinical trials to validate the results of this study.
sion may have a meaningful effect on pain as a related symptom and potentially have a
positive impact on HRQoL of patients with breast cancer and prostate cancer. Legal entity responsible for the study: Hacettepe University.
Clinical trial identification: NCT01275872. Funding: Hacettepe University Scientific Research Projects Coordination Unit.
Legal entity responsible for the study: Cyprus University of Technology. Disclosure: All authors have declared no conflicts of interest.
Funding: Cyprus University of Technology.
Disclosure: The author has declared no conflicts of interest.
CN59 Cancer pain knowledge and attitudes of nursing and medical
professionals in a Greek general hospital

CN57 Does individual genetic background predict acute radiation skin C. Palassari, S. Katsaragakis, J. Kaklamanos, D. Protogiros, E. Patiraki
reactions in women undergoing adjuvant breast cancer radiotherapy? Nursing, National and Kapodistrian University of Athens, Athens, Greece
D. Oliva1, F. Lewin1, N. Lewin2, M.P. Nilsson3, M. Strandéus1, B-Å. Andersson2, L. Sharp4 Background: Health care professional’s knowledge and attitudes are strongly related
1
Oncology, County Hospital Ryhov, Jönköping, Sweden, 2Department of Laboratory with sufficient cancer pain management. The study explored nursing and medical pro-
Medicine, Region Jönköping, Laboratory Medicine, Jönköping, Sweden, 3Futurum - The fessionals’ cancer pain management knowledge and attitudes.
Academy for Healthcare and Department of Medical and Health Sciences, Linköping Methods: A cross-sectional survey was conducted. The convenience sample consisted
University, Linköping, Futurum -, Jönköping, Sweden, 4Cancer Care Improvments, of nursing and medical professionals (internal medicine sector) of a public general hos-
Regional Cancer Center Stockholm Gotland, Stockholm, Sweden pital, Athens. Sample’s inclusion criteria: informed consent and > 5 months’ work
experience. Between September - December 2016, 98 physicians (P), 70 registered
Background: Skin reactions during radiotherapy (RT) are common in women with nurses (RN) and 36 nurse assistants (NA) with response rates 81.8%, 77.8%, 90%
breast cancer (BC). Different methods have been tested to reduce or prevent this toxic- respectively, completed the Greek version of the Nurses’ Knowledge and Attitudes
ity. The aim of this study was to explore if genetic variation can be linked to acute radia- Survey Regarding Pain: a 39 items tool divided into 22 true/ false, 13 multiply choices
tion skin reactions (ARSR). and 4 pain case studies items, as well as a demographic form.
Methods: One hundred and nineteen women undergoing RT for BC during the period Results: Most of the participants were women (76.5%), reporting caring for more than
of 2011 to 2013 were included. Symptoms such as itching, burning and irritation were 100 patients in cancer pain per year (40.7%). The sample’s mean age was 39.5 years and
self-reported twice (during the first and last week of RT) using the VAS-scale. work experience 12.8 years. The prevalence of the five most frequent wrong responses
Assessments of the irradiated skin were measured using the Radiation Therapy (over 88.2%) was related with assessment and pain management interventions, addic-
Oncology Group scoring system for acute RT (RTOG-scale). Blood-based SNP analysis tion, patient pain self-report, and route of medication’s administration. Opioids titra-
were performed using peripheral blood sample (obtained before start of RT). In total, tion, patients’ religious and cultural related pain behaviors, older patients and pain
29 SNPs of well-defined functional genes were investigated. tolerance were the five most frequent correct answers (over 80.4%). P responded more
Results: All women were assessed with ARSR in various degree according to the correct answers (mean 20.8) than RN (17.5) and NA (15.8) (p < 0.0001). Age, educa-
RTOG-scale. During the last week of RT, the women self-reported itching (n ¼ 97, 82 tion and clinical experience in cancer care explained 28% variance of correct answers.
%), burning (n ¼ 64, 54 %) and irritation (n ¼ 96, 81 %.). Three SNPs in the following Younger participants, working at oncology wards, holders of a doctoral and attending
genes were found to be associated with ARSR: XRCC2, IFNg and CCL5/Rantes. continouing cancer pain education (strongest indepented factor (R2Change¼.007)),
Conclusions: We found an association between three SNPs and ARSR. The possibility were related with more correct answers.
of using these SNPs as prognostic biomarkers for radiation-induced toxicity needs fur- Conclusions: Greek participants knowledge deficits in pain management support the
ther investigation. universal concern of inadequate knowledge and attitudes of health care professionals,
Legal entity responsible for the study: County Hospital Ryhov, Jönköping Sweden. however, encouraging theoretical and clinical training may enhance their ability to
Funding: This investigation was partly supported by Foundation for Clinical Cancer improve practice. We thank Special Account for Research Grants and National and
Research in Jönköping and Futurum Academy for Health and Care, Region Jönköping Kapodistrian University of Athens for funding to attend the meeting.
County, Sweden and FORSS - Medical Research Council of Southeast Sweden. Legal entity responsible for the study: Nursing Department, National and
Disclosure: All authors have declared no conflicts of interest. Kapodistrian University of Athens.
Funding: Has not received any funding.
Disclosure: All authors have declared no conflicts of interest.

Volume 29 | Supplement 8 | October 2018 doi:10.1093/annonc/mdy278 | viii699

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