Search Results (1,535)

Background/Objectives: Cancer and their treatments could impact physical, nutritional, and psychological health, negatively influencing overall well-being. Accordingly, Health-Related Quality of Life (HRQoL) could be influenced by lifestyle habits, such as physical activity. This study aimed to assess physical activity levels in patients with a primary cancer diagnosis and their association with HRQoL at the first nutritional assessment. Methods: Data from the NUTRISCREEN project, part of the ONCOCAMP study (ClinicalTrials.gov ID: NCT06270602), were analyzed. Nutritional and sarcopenia risk, anthropometry and body composition parameters were collected. HRQoL and physical activity (as MET levels) were assessed through validated questionnaires. Descriptive statistics summarized categorical and continuous variables, and multivariable ordinal logistic regression models were performed. Results: Nutritional and sarcopenia risk decreased progressively with higher MET levels (p = 0.005 and p < 0.001, respectively). Adjusted multivariable models showed that HRQoL functional scores improved with increasing MET levels, with significant positive trends for physical (p < 0.001), role (p < 0.001), emotional (p = 0.003), and social functioning (p = 0.001), and global health status (p < 0.001). Conversely, symptom burden, including fatigue, nausea and vomiting, pain, dyspnea, insomnia, appetite loss, and constipation, decreased across MET quartiles (all p < 0.05). Conclusions: Overall, our findings suggest that physical activity may positively influence HRQoL among cancer patients. Early assessment helps to identify patients at risk of inactivity and support tailored rehabilitation programs to promote active lifestyles, preserve muscle mass, improve outcomes and overall health status. Full article

Non-invasive monitoring technologies are increasingly being explored to support cancer care, yet most existing approaches focus on isolated parameters and fail to provide a comprehensive view of patients’ health. This study presents a feasibility evaluation of an IoT-based system designed to detect treatment-related problems in oncology patients through the integration of wearable sensors, physiological measurements, and patient-reported outcomes. A monitoring kit, including a smartwatch, tensiometer, weighing scale, and mobile device, was deployed in a cohort of 26 patients undergoing oncological treatment. Data acquisition followed a structured schedule: continuous physiological recording via the smartwatch, daily blood pressure measurements, weekly weight monitoring, and structured surveys capturing treatment-related side effects. These heterogeneous data were transformed into binary clinical metrics using rule-based feature extraction algorithms, covering conditions such as insomnia, nausea, diarrhea, abdominal pain, headache, weight loss, hypertension, and fever. Clinical specialists labeled the dataset to ensure medical validity. Machine Learning models were then trained to analyze the features and generate alerts for potential treatment complications. The results demonstrate the feasibility of integrating IoT and Artificial Intelligence techniques for continuous, patient-centered monitoring in oncology, paving the way for intelligent decision-support systems that enhance early detection and clinical management. Full article

Background/Objectives: There is high demand for Anshenbunao syrup (ABS) in Chinese medicine owing to its steady therapeutic efficacy for insomnia and neurasthenia. However, it contains a substantial proportion of Polygoni Multiflori Radix Praeparata (PMRP), which is associated with reported cases of drug-induced liver injury (DILI). Here, we aim to establish an integrated approach combining PK screening with a dual-model toxicity verification system to systematically identify liver injury components (from high to low concentrations and from direct to idiosyncratic hepatotoxicity) to accurately uncover diverse potential hepatotoxicity markers. Methods: A sensitive UPLC-MS/MS method was used to accurately quantify the components in plasma at the ng/mL level and conduct a pharmacokinetic analysis. Rat models were used to evaluate exposure levels of the eight active constituents and three major metabolites after a single oral gavage dose of 10 mL/kg ABS and identify the quality markers. The early-stage and high-throughput assessment of direct and idiosyncratic hepatotoxicity was conducted in vitro utilizing HepG2 cells. After the administration of the quality markers (0.01–80 μM), CCK-8 was used to detect cell viability on both normal and susceptible cells, and the latter was induced by lipopolysaccharide. Results: As a result, seven quality markers were screened based on their contents and exposure levels in rat plasma by UPLC–MS/MS, including emodin (EM), liquiritin (LI), 2,3,5,4′–Tetrahydroxystilbene–2–O–β–D–glucoside (TSG), icariin, emodin–8–O–β–D–glucoside, baohuoside I (BA), and 18β–glycyrrhetinic acid (GTA). Moreover, the half maximal inhibitory concentration values of both normal cells and the lipopolysaccharide-induced immune stress liver injury cells were fitted within the concentration range of 0.01–80 μM, based on which, EM, BA, and GTA were identified as the principal hepatotoxic constituents in ABS at elevated concentrations. This study is the first to demonstrate that TSG, EM, LI, and GTA exhibit synergistic cytotoxicity in LPS-sensitized hepatocytes at clinically relevant concentrations, whereas EM was also a direct hepatotoxic component. Given that TSG is one of the major ingredients in ABS, the underappreciated idiosyncratic hepatotoxicity could elevate the risk of adverse clinical outcomes. Conclusions: In conclusion, this study effectively identifies hepatotoxic constituents in ABS and evaluates their hazards under immune stress and toxicity profiles in clinical concentrations, which also provides a robust foundation for the awareness of PMRP-induced DILI due to ABS. Full article

Introduction: Postoperative delirium, including emergence agitation, is recognized in the post-anesthesia care unit as a fluctuating disturbance of attention and cognition. The current evidence examined suggests that both anesthetic agents and postoperative pain intensity may influence the risk of delirium. The aim of this review is to discuss the significance of pharmacological agents used during anesthesia and the relationship between the intensity of postoperative pain and the occurrence of postoperative delirium in patients undergoing surgical procedures, regardless of age. Methods: A scoping review was conducted from December 2024 to December 2025. The articles identified in each search were limited to those published between 2015 and 2025. Results: Agents such as dexmedetomidine, remimazolam, and magnesium sulfate were examined in the included trials and were reported to be associated with reducing the incidence and severity of postoperative delirium, particularly in pediatric and elderly patients. Analysis of clinical trial outcomes conducted in pediatric populations undergoing various surgical procedures suggests that dexmedetomidine (administered intranasally and intravenously) and alfentanil were associated with lower incidence and severity of emergence delirium compared to standard care or other agents (e.g., midazolam). Higher doses of dexmedetomidine (2 µg/kg) were reported to be associated with improved postoperative analgesia and reduced agitation, without prolonging recovery time or causing serious adverse effects. Propofol, due to its rapid metabolism, was suggested to contribute to shorter emergence times; however, its impact on cognitive function requires further investigation. Additionally, there remains a lack of agreed-upon and/or validated tools and strategies for pain assessment in patients experiencing delirium. Conclusions: The current evidence examined suggests that the use of intranasal dexmedetomidine at appropriate doses may be associated with reduced postoperative pain and agitation without prolonging recovery time or increasing the risk of serious adverse events. Hydromorphone was reported in the included trials to be associated with better postoperative pain control than sufentanil, whereas remimazolam, although associated with reduced delirium incidence in some trials, did not influence the length of stay in the post-anesthesia care unit. Magnesium sulfate, although not significantly affecting the incidence of delirium, was associated with alleviation of postoperative symptoms such as pain and insomnia in adult patients. Ketamine, while commonly used for analgesic therapy, did not demonstrate a consistent association with delirium prevention and, in some studies, was associated with increased neuropsychiatric events. Further research is required to more precisely define optimal perioperative delirium prevention protocols. Full article

Background: Sleep disturbances are common in occupational settings and may impair health, safety, and work performance. Professional drivers represent a safety-critical occupational group, whereas information technology (IT) workers are frequently exposed to prolonged screen use and high cognitive workload. Methods: A cross-sectional study was conducted during 2023–2025 among 488 workers, including professional drivers and IT workers. Participants completed the Pittsburgh Sleep Quality Index, STOP-Bang questionnaire, Epworth Sleepiness Scale, and Athens Insomnia Scale. Age, sex, body mass index, and total work experience were recorded. Group comparisons and multivariable logistic regression analyses adjusted for demographic and occupational factors were performed. A predefined subgroup analysis was conducted among night-shift workers (n = 113). Results: IT workers were younger and reported poorer subjective sleep quality and more frequent insomnia symptoms compared with professional drivers. In contrast, moderate-to-high OSA risk was more prevalent among drivers. Excessive daytime sleepiness did not differ significantly between groups. In multivariable models, occupational group independently predicted poor sleep quality and insomnia, whereas age and body mass index were the strongest predictors of OSA risk. Conclusions: Sleep-related outcomes differ across occupational groups. Professional drivers appear more vulnerable to OSA-related risk, while IT workers experience a higher burden of insomnia and poor subjective sleep quality. Occupational context should be considered when designing sleep screening and prevention strategies. Full article

Background/Objectives: Plant-based supplements are widely used for the management of anxiety, depression, and insomnia. Despite their over-the-counter availability and perceived safety, these products may pose relevant pharmacological and toxicological risks. This narrative review critically evaluates clinical evidence on commonly used herbal preparations, with particular emphasis on herb–drug interactions, adverse effects, and issues related to product adulteration. Methods: Major scientific databases (PubMed, Scopus, and Web of Science) were searched to identify clinical studies evaluating plant-based supplements for mental health and sleep disorders. Data on study design, dosage, efficacy, and adverse events were analyzed, together with regulatory information and reports of product adulteration and quality concerns. Results: Herbal supplements such as Hypericum perforatum, Passiflora incarnata, Valeriana officinalis, Piper methysticum, Withania somnifera, Crocus sativus, and Curcuma longa demonstrated anxiolytic, antidepressant, and sedative effects in clinical studies, with improvements in mood, stress levels, and sleep quality. Proposed mechanisms include modulation of monoaminergic and GABAergic pathways, serotonergic activity, regulation of the hypothalamic–pituitary–adrenal axis, and anti-inflammatory effects. However, clinically relevant risks were identified, including cytochrome P450–mediated drug interactions, excessive sedation, serotonin syndrome, and toxic effects associated with adulterated products, such as hepatotoxicity, cardiovascular events, and neurological disturbances. Conclusions: While plant-based supplements may provide clinically meaningful benefits for anxiety, depression, and insomnia, their use requires careful clinical monitoring due to potential pharmacokinetic and pharmacodynamic interactions and safety concerns. Increased awareness of herb–drug interactions and stricter quality control are essential to optimize therapeutic outcomes and minimize harm. Full article

Aim: This study investigated the synergistic therapeutic effects and underlying mechanisms of tetrahydroberberine (THB) combined with protopanaxadiol (PPD) on p-chlorophenylalanine (PCPA)-induced insomnia in rats. Methods: Rats were randomly divided into normal, model, diazepam, THB monotherapy, PPD monotherapy, and THB + PPD combination groups. Evaluations included the pentobarbital sleep test, HE staining, ELISA, 16S rRNA sequencing, metabolomics, and Western blot. Results: Results demonstrated that the THB + PPD combination exhibited significant synergistic effects compared with monotherapies: the combination shortened sleep latency by 56.2% (vs. 44.2% for THB alone and 20.7% for PPD alone) and prolonged sleep duration by 112.8% (vs. 70.2% for THB and 59.6% for PPD) relative to the model group, while effectively restoring body weight gain. Histologically, combined treatment significantly alleviated hippocampal neuronal damage and increased the number of intact neurons in the dentate gyrus. Molecularly, it upregulated brain-derived neurotrophic factor (BDNF) and glial cell line-derived neurotrophic factor (GDNF) levels, restored neurotransmitter balance (serotonin, dopamine, and glutamate), suppressed overactivation of the hypothalamic–pituitary–adrenal (HPA) axis (reducing corticotropin-releasing hormone and corticosterone), and decreased pro-inflammatory cytokine expression. Gut microbiota analysis revealed that the combination restored microbial homeostasis (increasing beneficial bacteria such as *Lactobacillus*) and modulated the glycine–serine–threonine metabolic pathway. Mechanistically, THB + PPD synergistically activated the PI3K/AKT neurotrophic pathway (p-PI3K and p-AKT expression increased by 1.9-fold and 2.5-fold, respectively, vs. model), inhibited the AGE/RAGE pro-inflammatory axis (RAGE expression decreased by 31.8%), and enhanced blood–brain barrier integrity by upregulating tight junction proteins (ZO-1, Occludin). Conclusions: THB combined with PPD exerts synergistic anti-insomnia effects through multi-level regulation of the microbiota–gut–brain axis, neurochemical balance, and key signaling pathways, providing a promising foundation for developing safe natural product-based combination therapies. Full article

Objective: Adequate sleep is vital for children’s growth and well-being. This study investigates serum amino acid and fatty acid metabolic indicators in children with sleep disorders, identifies independent factors, and develops a predictive model. Methods: A total of 143 children diagnosed with sleep disorders (n = 143) were compared to 120 typically developing children (n = 120). Serum levels of 12 amino acids and 7 fatty acids were measured using liquid chromatography–tandem mass spectrometry. Differences between groups were assessed using t-tests or Mann–Whitney U tests. Independent factors were identified via multivariate logistic regression, leading to the construction of a predictive model. Its diagnostic efficacy was evaluated through receiver operating characteristic analysis, calibration curves, and decision curve analysis (DCA). Subgroup analysis of different sleep disorder subtypes was also performed to explore metabolic characteristic differences. Results: Significant differences in multiple metabolic indicators were found (p < 0.05) between these two groups. Seven amino acids were elevated, including glutamine and tryptophan, while linoleic acid and taurine levels were reduced. Analysis of four sleep disorder subtypes revealed no significant differences in most metabolic indicators among subtypes, with only taurine levels showing notable heterogeneity, the highest in parasomnia and the lowest in insomnia. Multivariate analysis revealed that arachidonic acid (OR = 0.75, 95% CI: 0.649–0.866), the ratio of cerotic acid to behenic acid (OR = 0.39, 95% CI: 0.186–0.816), aspartic acid (OR = 1.1, 95% CI: 1.040–1.164), glutamine (OR = 1.009, 95% CI: 1.004–1.014), taurine (OR = 0.985, 95% CI: 0.974–0.995), and phenylalanine (OR = 1.047, 95% CI: 1.018–1.078) were identified as independent factors for the development of sleep disorders (p < 0.05). The predictive model achieved the area under the ROC curve of 0.935 (95% CI: 0.904–0.967), with a threshold of 0.748 yielding sensitivity of 0.881 and specificity of 0.867. Ten-fold cross-validation confirmed robust generalizability (AUC: 0.927–0.916), and adjustable thresholds enabled flexible clinical application. Calibration curves and DCA demonstrated good agreement and clinical utility. Conclusions: Children with sleep disorders exhibit notable serum metabolic disturbances. The developed predictive model provides high diagnostic value and practicality for early screening and targeted interventions. Full article

Sleep disorders and primary headache syndromes frequently coexist, and accumulating evidence suggests that this relationship is bidirectional and biologically mediated rather than coincidental. Patients with migraine, tension-type headache, and cluster headache commonly report poor sleep quality, insomnia symptoms, and irregular sleep patterns, while individuals with sleep disorders such as insomnia, obstructive sleep apnea, restless legs syndrome, and narcolepsy experience a higher prevalence, severity, and chronification of headache disorders. This narrative review synthesizes current clinical, epidemiologic, and translational evidence supporting shared neurobiological mechanisms linking sleep and headache disorders. We focus on five major overlapping pathways: dopaminergic dysfunction, iron deficiency, hypothalamic and circadian dysregulation, central sensitization, and neuroinflammation. Evidence from population-based studies, clinical cohorts, neuroimaging, genetic research, and experimental models demonstrates that these mechanisms converge within hypothalamic, brainstem, and trigeminovascular circuits that regulate arousal, pain processing, and homeostasis. Conditions such as insomnia, obstructive sleep apnea, restless legs syndrome, and circadian disruption not only exacerbate headache burden but may act as modifiable risk factors that promote headache onset and progression. Recognizing sleep disorders as integral components of headache pathophysiology has important clinical implications, emphasizing the need for systematic sleep assessment and targeted sleep interventions as part of comprehensive headache management strategies. Full article

Magnesium is an essential micronutrient that exerts fundamental roles at both the cellular and tissue levels, with broad therapeutic and preventive implications across a range of pathological conditions. Accumulating clinical and experimental evidence indicates that optimal magnesium homeostasis modulates key pathophysiological processes and serves as both a biological and prognostic marker in disorders such as stroke, myocardial infarction, type 2 diabetes mellitus, and renal failure. These disease states commonly originate from two major etiological determinants—hypertension and atherosclerosis—which share a unifying pro-inflammatory mediator: platelet-activating factor (PAF). PAF plays a central role in vascular inflammation by promoting platelet aggregation, macrophage infiltration, leukocyte adhesion, and vasomotor dysregulation. Importantly, magnesium demonstrates an inverse association with both platelet aggregation and PAF activity, underscoring its protective capacity in mitigating vascular inflammation and preserving endothelial function. The objective of this updated literature review is to elucidate the antagonistic interplay between magnesium and PAF, with a focus on its physiological and therapeutic significance across multiple organ systems. While emerging data support a modulatory role of magnesium in PAF-mediated inflammatory pathways, current evidence remains limited. Therefore, further mechanistic, pharmacological, and clinical investigations are warranted to clarify the multifaceted role of magnesium in attenuating PAF-driven disease processes. Full article

Background/Objectives: Baichuan Baile (BCBL), a novel functional dietary formula, has been shown to exert antidepressant-like effects through modulation of the 5-HT system in our prior studies. Given the close neurobiological connections between depression and insomnia, along with its pharmacodynamic profile guided by TCM theory and nutritional assessments, BCBL is likely to possess beneficial effects against insomnia. However, this hypothesis and its underlying mechanisms require further validation. Methods: The chemical constituents of BCBL were analyzed by UPLC-Q-TOF-MS, and network pharmacology was applied to predict potential sleep-relevant targets and pathways. Subsequently, BCBL was evaluated for sedative-hypnotic effects using pentobarbital-induced hypnosis, locomotor activity, and polysomnography (EEG/EMG). Its therapeutic efficacy was further assessed in insomnia models induced by environmental stress, serotonin depletion, and rotarod-based sleep deprivation. The rotarod-induced chronic model was selected for mechanistic studies due to its sustained insomnia-like phenotype. Finally, key network-predicted targets were validated in this model through histopathology, Western blotting, and ELISA. Results: Pharmacological evaluation confirmed that BCBL significantly promoted sleep at both behavioral and EEG levels, confirming its sedative-hypnotic properties. BCBL mitigated environmental stress-triggered impairments in NREM sleep continuity and duration, and exerted protective effects against body weight loss and sleep disturbances in a serotonin depletion-induced insomnia model. In the rotarod sleep deprivation model, BCBL treatment increased spontaneous alternation rates and recognition indices, ameliorated hippocampal pathological alterations, and reduced hippocampal levels of HIF-1α, TNF-α, and IL-1β. Furthermore, BCBL elevated the p-GSK3β/GSK3β ratio and enhanced SIRT₁ expression in the hypothalamus. It also modulated the activity of key sleep–wake neurotransmitters/neuromodulators (serotonin, dopamine, adenosine, and glutamate) and key circadian rhythm regulators (BMAL₁, PER₂, and CLOCK) in this region. Conclusions: BCBL exhibits significant therapeutic efficacy against insomnia, indicating its potential as a dietary supplement for managing insomnia. Its mechanisms appear to involve anti-inflammatory effects, rebalancing of neurotransmitters/neuromodulators, and stabilization of circadian rhythm gene expression. Full article

The Acronicta major larva is a toxic agricultural pest that poses severe ecological management challenges. This study presents a sustainable strategy to valorize this hazardous biological waste into functional nanotherapeutics for insomnia by leveraging its unique intrinsic chemical composition. Carbon dots derived from Acronicta major larva (AM-CDs) were synthesized via one-step pyrolysis, which facilitated the natural molecular pre-assembly of N,S-codoping. Their physicochemical properties and cytotoxicity were evaluated using a series of characterizations and the CCK-8 assay. The sedative and hypnotic effects were assessed in mice with PCPA-induced insomnia through hot plate, Open Field and pentobarbital-induced sleep tests, and their potential mechanism was explored via neurotransmitter detection. The thermal process effectively eliminated intrinsic toxicity while retaining bioactivity via in situ heteroatom doping. AM-CDs exhibited favorable biocompatibility and significant sedative–hypnotic activity, reducing anxiety-related agitation without motor impairment. Mechanistically, AM-CDs effectively restored the GABA/5-HT/glutamate axis. Unlike direct central receptor binding, our findings suggest that this therapeutic effect is likely mediated through a systemic or peripheral regulatory pathway. This study demonstrates the conversion of toxic pests into safe and intrinsically bioactive nanomaterials, providing a dual solution for ecological pest management and novel neuroactive agent development, and validating the “Waste-to-Wealth” concept in biomedicine. Full article

Background and Objectives: People with epilepsy frequently complain of poor sleep quality, excessive daytime sleepiness (EDS), and insomnia. Therefore, this study aimed to evaluate differences in anxiety and depression symptoms, as well as clinical characteristics, across groups defined by sleep quality in patients with epilepsy. Materials and Methods: Seventy-eight adults with epilepsy were assessed using standardized questionnaires for sleep quality (Pittsburgh Sleep Quality Index, PSQI), daytime sleepiness (Epworth Sleepiness Scale, ESS), insomnia severity (Insomnia Severity Index, ISI), and psychiatric symptoms (PHQ-9, GAD-7, and HADS). Demographic data (age and sex), seizure frequency and characteristics, use of antiepileptic drugs (AEDs), and EEG findings were collected. Patients were divided into groups based on sleep quality scores, and comparisons were made regarding anxiety, depression, and selected clinical variables. Associations were analyzed using t-tests, chi-squared tests, and Spearman correlation coefficients. Results: Poor sleep quality (PSQI > 5) was present in 70.9% of patients and was significantly associated with insomnia, daytime sleepiness, depression, and anxiety symptoms (p < 0.001 for all comparisons). Patients who had experienced generalized tonic–clonic seizures (GTCS) in the past year had significantly worse sleep quality compared to those without GTCS (p = 0.025). Clinical insomnia (ISI ≥ 15) was observed in 23.1% of cases and was significantly associated with the presence of seizures (p = 0.015). EDS was present in 19% of cases and was associated with depressive symptoms (p = 0.019). A higher concentration of levetiracetam was associated with better sleep quality, whereas a higher concentration of lamotrigine was associated with worse sleep quality (p = 0.024 for both). EEG abnormalities, seizure frequency, and duration of epilepsy were not associated with sleep quality. Conclusions: Poor sleep quality was reported in 70% of the study patients and was associated with increased insomnia severity, EDS, and psychiatric comorbidities. People with EDS were more likely to have higher levels of depression and anxiety. Patients who experienced GTCS within the past year were significantly more likely to report poor sleep quality. Insomnia was associated with older age and female sex. Seizure-free patients had less insomnia. Nevertheless, no associations were found between sleep evaluation scores and other demographic or clinical epilepsy characteristics. Full article

Background: The aim of this study was to identify patient clusters based on acute symptom profiles and individual characteristics most likely to develop pediatric post-acute sequelae of SARS-CoV-2 infection (PASC), as well as clusters among patients with PASC based on post-acute sequelae and associated characteristics. Methods: This multicenter cohort study in 12 Italian pediatric units enrolled patients aged 0–17 years within three months of a laboratory-confirmed SARS-CoV-2 infection. Participants who completed at least two surveys developed by the ISARIC over one year were analyzed. PASC was defined per WHO criteria. Multiple Correspondence Analysis and Hierarchical Clustering were performed. Results: Of 1137 children enrolled, 850 (76%) completed at least two surveys. The most prevalent age group was older children (6–11 years) (46%); adolescents (12–17) and young children (0–5) were numerically similar. Males were more represented (51.9%), except for the adolescent group (45.1%). PASC occurred in 32.8% of participants, with the distribution of sequelae types varying by age. Clustering in COVID-19 cases identified three clusters: young children mainly presented with respiratory symptoms and with a higher risk of hospitalization, while older children were spared in both acute and post-acute phases. Adolescents, particularly females, reported more pronounced acute symptoms and developed PASC more frequently. Clustering analysis of cases with PASC identified three clusters, confirming these age-related patterns. Young children still exhibited respiratory sequelae, and older children confirmed good recovery with minimal complications, while adolescents, especially females, remained the most affected subgroup, reporting persistent neuropsychological sequelae such as fatigue and insomnia. Conclusions: Findings support age-tailored follow-up, emphasizing respiratory monitoring for young children and targeted neuropsychological care for adolescents, particularly girls. Full article

Background: Poly(ADP-ribose) polymerase inhibitor (PARPi) treatment in ovarian cancer patients after first-line chemotherapy and following the response to platinum-based chemotherapy at relapse is associated with survival benefits. Maintenance therapies can be administered over extended periods, making treatment tolerability assessment essential in optimizing patient outcomes. This cohort study aimed to evaluate the agreement between physician and patient reporting of PARP inhibitor-related toxicities and the rate of underestimation of each symptom considered. Methods: Patients treated with PARPis in the first-line or recurrent setting were included. A specific Patient-Reported Outcomes Common Terminology Criteria for Adverse Events (PRO-CTCAE) questionnaire was generated and administered to the cohort. For each toxicity, agreement between patients and physicians was assessed using Cohen’s kappa and Gwet’s AC1; in addition, the rate of toxicity under-reporting by physicians was calculated. Results: Seventy-seven ovarian cancer patients were included; 39 (50.6%) received PARPis in the first-line setting, while 38 (49.4%) were treated for recurrence. Cohen’s kappa values for agreement between patients and physicians across 12 reported toxicities ranged from 0 to 0.15, indicating poor agreement (κ < 0.20) for all assessed toxicities, with the lowest levels of agreement for decreased appetite (κ = 0), rash (κ = 0.02), headache (κ = 0.00), arthralgia (κ = 0.03), insomnia (κ = 0.03), and fatigue (κ = 0.04). When agreement was assessed using Gwet’s AC1, agreement remained poor to moderate for the majority of the symptoms evaluated. Physician under-reporting rates were higher for nausea (51.9%), rash (57.1%), headache (49.3%), arthralgia (70.2%), insomnia (48.1%), and fatigue (67.5%). Conclusions: Our results underscore the importance of systematically integrating patient-reported outcomes into clinical practice, including in maintenance settings, to ensure an accurate assessment of treatment-related toxicities. Full article