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Quality of Life and Side Effects Management in Cancer Treatment (3rd Edition)

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A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Survivorship and Quality of Life".

Deadline for manuscript submissions: 20 February 2026 | Viewed by 9281

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Special Issue Editor

Prof. Dr. António Araújo

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Guest Editor

1. Centro Hospitalar Universitário do Porto, Porto, Portugal
2. Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
Interests: clinical and translational research; mechanisms and control of adverse events; strategies to improve cancer patients’ quality of life
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Special Issue Information

Dear Colleagues,

This Special Issue is the Third Edition of a previous Special Issue, titled “Quality of Life and Side Effects Management in Cancer Treatment” (link 1: https://www.mdpi.com/journal/cancers/special_issues/Quality_Effects_Cancer_Treatment; link 2: https://www.mdpi.com/journal/cancers/special_issues/35Y41G0VUJ).

In recent years, cancer treatment has evolved in ways previously unimaginable, giving our patients an increased rate of progression-free and/or overall survival. However, most importantly, these new drugs and new drug combinations are more patient-friendly, increasing quality of life. Nevertheless, we still have to learn how to control the adverse events that occur in target therapy and immunotherapy, and with the new drugs of hormonotherapy.

At present, we still struggle with these adverse events when combining different drugs for immunotherapy, immunotherapy with chemotherapy, or immunotherapy with target agents. Nausea and emesis induced by chemotherapy are still stressful events that we continually try to control; additionally, immune-mediated toxicity, rashes, and diarrhea induced by target therapy, and the numerous forms of pain that affect most of our cancer patients, are all still of significant concern and are the object of investigation.

We are, therefore, pleased to invite you to contribute to this Special Issue highlighting the current state of the art in the control of cancer treatments’ adverse events and in improving the quality of care for cancer patients, as well as featuring future prospects for improving therapies.

Prof. Dr. António Araújo
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

cancer treatment adverse events
quality of life in cancer patients
chemotherapy adverse events
target therapy adverse events
immunotherapy adverse events
hormonotherapy adverse events
chemotherapy-induced nausea and vomiting
cancer pain

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Published Papers (4 papers)

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Research

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30 pages, 1422 KB

Open AccessArticle

Psychometric Properties and Interpretability of PRO-CTCAE^® Average Composite Scores as a Summary Metric of Symptomatic Adverse Event Burden

by Minji K. Lee, Sandra A. Mitchell, Ethan Basch, Allison M. Deal, Blake T. Langlais, Gita Thanarajasingam, Brenda F. Ginos, Lauren Rogak, Tito R. Mendoza, Antonia V. Bennett, Brie N. Noble, Gina L. Mazza and Amylou C. Dueck

Cancers 2025, 17(21), 3459; https://doi.org/10.3390/cancers17213459 - 28 Oct 2025

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Abstract

Background: The PRO-CTCAE provides patient-reported data on symptomatic AEs. A summary metric—the ACS—reflecting total AE burden can be calculated by averaging AE-level composite scores at a given timepoint for each participant. This study investigated the psychometric properties and interpretability of this PRO-CTCAE ACS in patients with breast, lung, or head/neck cancers. Methods: We conducted a secondary analysis of a PRO-CTCAE validation dataset comprising 940 adults undergoing chemotherapy or radiation therapy (clinicaltrials.gov: NCT02158637). We focused on empirically recommended symptom terms for three cancer sites. Analyses included Spearman’s correlations, coefficient alpha, and eigenvalues from the correlation matrices, confirmatory factor analysis (CFA), and principal component analysis (PCA). Latent profile analysis (LPA) was used to assess ACS interpretability in the lung cohort. Results: Mean composite score inter-correlations were moderate (0.30–0.35), and coefficient alphas were high (0.81–0.91). Eigenvalue ratios and CFA supported retention of a single factor/component, with suitable model fit indices. ACS correlated highly with factor scores and the first principal component from the PCA. Reduced sets of terms produced reliable scores that closely approximated the full set scores and aligned with external criteria. LPA in the lung subgroup identified four latent classes; ACS differentiated high vs. low symptom burden groups but did not distinguish the two groups expressing distinct symptom profiles. Conclusion: The ACS demonstrated structural validity through adequately fitting linear factor models and effectively summarized symptomatic AE burden. However, similar ACS values may mask clinically distinct symptomatic AE profiles, underscoring the value of both summary metrics and profile-based approaches. Full article

(This article belongs to the Special Issue Quality of Life and Side Effects Management in Cancer Treatment (3rd Edition))

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16 pages, 1375 KB

Open AccessArticle

Predicting Cardiovascular Risk in Patients with Prostate Cancer Receiving Abiraterone or Enzalutamide by Using Machine Learning

by Dong-Yi Chen, Chun-Chi Chen, Ming-Lung Tsai, Chieh-Yu Chang, Ming-Jer Hsieh, Tien-Hsing Chen, Po-Jung Su, Pao-Hsien Chu, I-Chang Hsieh, See-Tong Pang and Wen-Kuan Huang

Cancers 2025, 17(15), 2414; https://doi.org/10.3390/cancers17152414 - 22 Jul 2025

Cited by 1 | Viewed by 2784

Abstract

Purpose: The identification of cardiovascular risk factors in metastatic prostate cancer (PCa) patients prior to the initiation of androgen receptor pathway inhibitors (ARPIs) is important yet challenging. Methods and Results: A nationwide cohort study was conducted utilizing data from the National Health Insurance Research Database containing the Taiwan Cancer Registry. The study population comprised 4739 PCa patients who received abiraterone or enzalutamide between 1 January 2014, and 28 February 2022. The cohort was divided into a training set (n = 3318) and a validation set (n = 1421). Machine learning techniques with random survival forest (RSF) model incorporating 16 variables was developed to predict major adverse cardiovascular events (MACEs). Over a mean follow-up period of 2.1 years, MACEs occurred in 10.9% and 11.3% of the training and validation cohorts, respectively. The RSF model identified five key predictive indicators: age < 65 or ≥75 years, heart failure, stroke, hypertension, and myocardial infarction. The model exhibited robust performance, achieving an area under the curve (AUC) of 85.1% in the training set and demonstrating strong external validity with an AUC of 85.5% in the validation cohort. A positive correlation was observed between the number of risk factors and the incidence of MACEs. Conclusions: This machine learning approach identified five predictors of MACEs in PCa patients receiving ARPIs. These findings highlight the need for comprehensive cardiovascular risk assessment and vigilant monitoring in this patient population. Full article

(This article belongs to the Special Issue Quality of Life and Side Effects Management in Cancer Treatment (3rd Edition))

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12 pages, 818 KB

Open AccessArticle

Risk Factors for Arterial Thromboembolic Events in Male Germ Cell Tumors Treated with Chemotherapy

by Daniele Frisone, Melinda Charrier, Grégoire Berthod, Sara Manzocchi-Besson, Daniel Danzer, Sandro Anchisi and Petros Tsantoulis

Cancers 2025, 17(14), 2370; https://doi.org/10.3390/cancers17142370 - 17 Jul 2025

Viewed by 692

Abstract

Background/Objectives: Germ cell tumors are the most common neoplasia in males < 50 y. In two case series, thromboembolic events (TEs) were reported in 8% and 13% of patients undergoing chemotherapy, whereas arterial thromboembolic events (ATEs) in other types of cancer treated with cisplatin had a frequency of 2% in a retrospective series and 0.67% in a meta-analysis. Recent data found a frequency of 2.4% for ATE in a large cohort of testicular cancer patients. Risk factors are not clearly identified, and given the severity of these events, further exploration is needed to determine appropriate preventive measures. Methods: We performed a retrospective cohort study of 171 patients undergoing chemotherapy for germ cell tumors in two centers in Switzerland and recorded the occurrence of ATE or venous thromboembolic events (VTEs) during chemotherapy or in the 3 months after its completion. Results: of 171 patients, 33.3% underwent adjuvant chemotherapy for stage I disease. Overall, 32 patients had a TE (18.7%, 95% CI 13.3–25.5%), 26 (15.2%, 95% CI 10.3–21.7%) had VTEs, and 11 (6.4%, 95% CI 3.4–11.5%) had ATEs. Five patients had both a VTE and ATE. VTEs were associated with disease stage (II, III, or relapse, with OR 15.6, p = 0.0002), retroperitoneal lymph nodes ≥ 3.5 cm (OR 3.2, p = 0.012), LDH > 500 UI/L (OR 5.3, p = 0.0025), and age > 35 y (OR 3.4, p = 0.005). The Khorana Score (KS) varied between 1 and 2 in 96% of the patients. ATEs were associated with active smoking (OR 6.5 p = 0.010), KS of ≥2 (OR 6.4 p = 0.004), and age > 35 y (OR 6.3, p = 0.01). Conclusions: Our findings show that ATEs are more frequent in our cohort than previous reports. We found a strong association between smoking and ATEs, which should be further assessed. Platinum-induced endothelial damage may be amplified by smoking in young patients in the absence of other risk factors and preventive medication. Full article

(This article belongs to the Special Issue Quality of Life and Side Effects Management in Cancer Treatment (3rd Edition))

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Review

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25 pages, 1127 KB

Open AccessReview

Ozone Treatment in the Management of Chemotherapy-Induced Peripheral Neuropathy: A Review of Rationale and Research Directions

by Bernardino Clavo, Angeles Cánovas-Molina, Mario Federico, Gregorio Martínez-Sánchez, Gretel Benítez, Saray Galván, Yolanda Ramallo-Fariña, Himar Fabelo, Sara Cazorla-Rivero, Elba Lago-Moreno, Carla Antonilli, Juan A. Díaz-Garrido, Ignacio J. Jorge, Gustavo Marrero-Callico, Delvys Rodríguez-Abreu and Francisco Rodríguez-Esparragón

Cancers 2025, 17(14), 2278; https://doi.org/10.3390/cancers17142278 - 8 Jul 2025

Cited by 1 | Viewed by 4623

Abstract

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of chemotherapy. CIPN can lead to a dose reduction and/or the interruption of chemotherapy, limiting its effectiveness, while chronic CIPN decreases patients’ quality of life. Improvements in cancer treatment and patients’ survival have increased the number of patients living with CIPN. The only evidence-based treatment for CIPN-related pain, duloxetine, provides only modest clinical benefit, and there is no effective clinical management option for numbness and tingling. Several experimental studies and clinical reports suggest that adjuvant ozone treatment may be beneficial in managing CIPN. Methods: This narrative review aims to provide an overview of current knowledge regarding CIPN and ozone therapy. Specifically, it summarizes experimental studies (18) and clinical reports (27) published between 1995 and 2025 that offer preliminary evidence supporting the potential role of ozone treatment in managing CIPN, highlighting the need for ongoing randomized clinical trials to establish its efficacy. Additionally, this review highlights existing gaps in the literature and proposes directions for future research. Results: The hypothesized mechanisms of action and experimental findings suggest that ozone therapy may be a valuable intervention for CIPN, a concept supported by preliminary clinical observations. Conclusions: Clinically relevant approaches for established CIPN are currently unavailable. While preliminary data suggest a potential role of ozone therapy, clinical evidence remains limited. Further high-quality randomized controlled trials are needed to confirm its efficacy and safety in this context; several trials are currently ongoing. Full article

(This article belongs to the Special Issue Quality of Life and Side Effects Management in Cancer Treatment (3rd Edition))

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