شیمی درمانی

Breast cancer is the most common cancer and the leading cause of death in women. Given the psychological pressures and lack of education and research in this field, it is essential to pay attention to patient empowerment.The present study was conducted to determine the effect of an empowerment program on the life expectancy of breast cancer patients undergoing chemotherapy.

The present study is an experimental study with a pre-test-post-test design with random selection and a control group, the statistical population of which was breast cancer patients referred to Shahid Rajaee and Imam Ali (AS) hospitals in Alborz. According to the inclusion criteria, 88 patients were randomly assigned to two intervention and control groups. In the intervention group, the empowerment program was implemented in 4 sessions of 60 minutes in groups of 3-4 people using the group discussion method. Data were completed before and after the intervention using the Herth Hope Index. Data were analyzed using SPSS version 16 statistical software and Chi-square, Fisher's exact, independent t-test, and paired t-test statistical tests.

There was no statistically significant difference between the two groups in terms of demographic variables (p>0.05). The mean hope scores of patients before the intervention were 36.15±6.07 in the intervention group and 36.59±5.35 in the control group, which was not statistically significant (p=0.725). After the intervention, it was 40.77±5.31 in the intervention group and 36.91±4.92 in the control group, and this difference was significant in the intervention group (p<0.001). Also, the empowerment program, with an effect size of 0.75 (Cohen effect), significantly increased patients' life expectancy.

Implementing a self-care empowerment program through group discussion and telephone follow-up to resolve ambiguities and consolidate learning can be effective in promoting hope in breast cancer patients undergoing chemotherapy. Therefore, it is essential to emphasize the education and empowerment of these patients by nurses.

Chemotherapy-induced fever and neutropenia are side effects of chemotherapy regimens that, in addition to disrupting the treatment process of patients, threaten their health as well. In this study, the prevalence of chemotherapy-induced fever and neutropenia in different chemotherapy regimens in hospitalized patients with non-metastatic breast cancer was investigated.

In this descriptive cross-sectional study, a total of 200 adult patients hospitalized at Seyed al-Shohada (Omid) Hospital in Isfahan, Iran, from 2016 to 2021 due to breast cancer were selected. These patients had received chemotherapy regimens including AC, AC-T, and TAXANE. The data were extracted from the breast cancer registry and the hospital's HIS systems and analyzed with the SPSS software at a 95% confidence level.

The mean age of the patients was 46.90±11.28 years. The frequency of chemotherapy-induced neutropenia and fever was 15.5% and 9.5%, respectively. A significant relationship was observed between chemotherapy-induced fever and neutropenia with older age, higher cancer stage, and hypertension (P<0.05 for all). However, no significant relationship was found between the type of chemotherapy regimen and diabetes.

Chemotherapy-induced neutropenia and fever caused by neutropenia are relatively common side effects in breast cancer chemotherapy regimens. Older age, higher stage of cancer, and hypertension increased the prevalence of chemotherapy-induced neutropenia and neutropenia-induced fever.

A key trigger for many of the complications that are symptoms of cancer types is changes in the gastrointestinal environment, which is a major obstacle in the way of managing side effects. The purpose of this research was to investigate the benefits and challenges of using medicinal cannabis in reducing physical and psychological problems caused by chemotherapy and intestinal inflammation as a review study.

In this review study, a comprehensive search in English was conducted in reputable scientific databases such as PubMed, ProQuest, Google, Google Scholar, Scopus, Web of Science, and CINAHL from 2019 to 2023, using a combination of keywords to find relevant sources and studies. . Based on the established inclusion and exclusion criteria, and the removal of duplicate studies, texts relevant to the objectives of this study were extracted from a total of 81 reviewed articles.

The studies reviewed showed that the breakdown of the mucosal barrier (mucositis) was a common and primary side effect of cancer treatments, contributed to a wide range of severe physical and psychological symptoms such as diarrhea, nausea, vomiting, infection, malnutrition, fatigue, depression, and insomnia, for which medical cannabis may be effective in alleviating these symptoms.

Considering the potential challenges and benefits of medicinal cannabis in reducing physical and psychological problems caused by chemotherapy and intestinal inflammation, it is necessary to investigate more research in this field and if more clinical evidence is confirmed, medicinal cannabis can be used as a treatment.

The physical and mental health of the people in society is very important, one of the areas worthy of study is the study of the psychological aspects of cancer patients, which causes a lot of stress due to long-term treatment. Therefore, this study was conducted to determine the relationship between stress-coping approaches and mental health in patients undergoing chemotherapy. This descriptive-correlational study was conducted on 229 patients referred to the chemotherapy clinic at Baqiyatallah Hospital in Tehran, Iran. The sampling method was available. The study tools included a personal information questionnaire, a 28-item general health questionnaire, and a Billings and Moss coping strategies questionnaire. The data collected from the research units were analyzed by SPSS version 22 software and statistical regression tests. In this study, the age range of chemotherapy patients was between 18 and 81 years, and their average age was 51.27±13.90 years. The findings showed that 65.4% of patients undergoing chemotherapy have an unfavorable health level. According to Pearson's correlation test, there was a negative and significant relationship between general health domains and coping strategies of cognitive assessment, emotion-oriented, and physical restraint in patients undergoing chemotherapy (P=0.001). The general health of chemotherapy patients is related to the coping strategies adopted by them. The results of this study can have an effective role in knowing as much as possible the effective factors in the adaptive adaptation to this disease, reducing the side effects of chemotherapy and as a result the psychological well-being of cancer patients.

Chemotherapy affects the immune system of cancer patients and makes them susceptible to opportunistic infections such as cytomegalovirus (CMV). In this study, the prevalence of CMV was investigated in cancer patients undergoing chemotherapy in Khorramabad city.

In this study, 235 people, including 96 women (40.9%) and 139 men (59.1%), were examined for IgM and IgG antibodies against CMV and PCR test. In the present study, the effects of type of cancer, duration of chemotherapy, age, gender and marital status on the prevalence of CMV were investigated.

In this study, positive cases included 78.3% IgG, 3.8% IgM and 42.9% PCR. There was no significant relationship between the prevalence of CMV and the type of cancer, gender and marital status (P≥0.05). The frequency of positive IgG in the age group of 61-80 years was significantly higher than other age groups (P=0.01). The results of the PCR test showed that the prevalence of CMV was significantly higher in people undergoing longer chemotherapy (19-24 months compared to less than 6 months, P=0.001).

In the present study, there were positive cases in PCR test with negative serology results. Therefore, it is suggested to use the molecular test to confirm the serological assay. Also, a significant relationship between the duration of chemotherapy and the prevalence of CMV was observed. People with weakened immune systems, such as cancer patients undergoing chemotherapy, should be routinely evaluated for CMV in order to reduce complications related to this infection.

In today's era, with the advances made in science, it has been shown that most cancer patients survive more than 5 years after diagnosis and many of them rely on their caregivers during this time. Health, quality of life and survival of cancer patients depend on the ability and characteristics of their caregivers; but studies have shown that caregivers of cancer patients receive little support. The aim of the current research was to evaluate the effectiveness of the implementation of supportive care program on mood states, general health, competence of caregivers and supportive care needs of caregivers of cancer patients undergoing chemotherapy.

Methods & Materials: 

The current study was a double-blind randomized controlled trial that was conducted in the chemotherapy center of Peymaniye Hospital in Jahrom. Random sampling was determined for the participants and then the caregivers were randomly assigned to two groups of intervention (30 people) and control (30 people). Participants in the intervention group, in addition to usual care, also received the supportive care program. Data collection was done by the scale of supportive care needs, characteristics of mood states, general health and caregiver competence scale at the beginning, immediately and one month after the intervention; Also, the questionnaire, supportive care needs were completed by the patients at the beginning, immediately and one month after the intervention. The data was analyzed by IBM SPSS 16.0 and repeated measurement tests, chi-square, Friedman, Man-Whitney and independent t tests were used.

The results of the present study showed that the implementation of the supportive care program was effective on mood states, general health, competence and supportive care needs of caregivers of cancer patients undergoing chemotherapy. It can be said that having the role of a caregiver for a person causes new needs to arise, and if these needs are not met, we will witness anxiety, fatigue and a decrease in the quality of life of the caregiver; Therefore, it is recommended that the nurses of the oncology and chemotherapy departments receive the necessary training and be empowered in this field, and on the other hand, the decision makers of the health system and managers pay more attention to the caregivers of cancer patients.

 Oral complications can significantly impact not only the treatment process of patients undergoing chemotherapy and radiotherapy but also their overall quality of life. This study aimed to evaluate the frequency of oral complications in patients undergoing radiotherapy with or without chemotherapy in Milad Hospital of Isfahan in 2020-2021.

 This descriptive and analytical study was conducted on 43 patients diagnosed with cancer who were admitted to the chemotherapy and radiotherapy department at Milad Hospital. Two dental students examined the patients for oral lesions and complications. The data were recorded in SPSS and analyzed using Spearman's correlation, Fisher's exact test, Mann-Whitney U test, Kruskal-Wallis test, and the t-test (p-value < 0.05).

Among the 43 patients, the most common oral lesions included mucositis, xerostomia, taste dysfunction and dysphasia. Statistically significant correlations were found between mucosal hemorrhage and cancer site, oropharyngeal ulcer and average radiotherapy dose, mucositis grade and average radiotherapy dose, xerostomia and average radiotherapy dose, and nausea and average radiotherapy dose. However, no significant relationships were observed between other factors and the study variables.

 The intensity of some complications caused by radiotherapy on oral mucosa, including mucositis, xerostomia, oropharynx ulcer and neusa in patients, increased with higher radiations doses. Therefore, clinicians can potentially manage oral complications more effectively by implementing various strategies, including carefully controlling radiotherapy doses and providing comprehensive oral hygiene education to patien

Melanoma cancer is the most dangerous and deadly skin cancer, for which preventive treatments such as surgery, radiation therapy, and chemotherapy have been suggested. In this study, we tried to investigate the effect of the simultaneous use of electron beam and cisplatin drug.

Cells in DMEM-F12 culture medium containing 10% fetal bovine serum (FBS) and streptomycin and penicillin antibiotics in an incubator at 37°C and 5% carbon dioxide in the amount of 2×104 They were cultured to perform the MTT test. The cytotoxic effect of Cisplatin with concentrations of 0.6, 1.5, 5, 10, and 20 μg/ml and electron beam of 1, 2, and 3 Gy was measured separately by MTT test and, then the effect of the combined treatment on cells was measured using all drug concentrations and radiation doses. The statistical tests for drugs, radiation, and their combination were fully performed.

Based on statistical tests, increasing the concentration of the drug alone or in combination with an electron beam increased the level of toxicity, and this significant increase was reported. Also, increasing the dose of the drug separately and in combination with the drug significantly increased the toxicity gave.

The combination of two treatment methods can prevent the use of high concentrations of drugs or high doses of electron beams and significantly reduce the application limitations and side effects of drugs and radiation.

Quality of life, physical and mental performance (psychological well-being) have been reported to be poor in breast cancer patients who have received chemotherapy. Therefore, a proper follow-up method is essential. This systematic review was conducted with the aim of investigating the effect of telemedicine using a mobile application in the management of chemotherapy complications and the breast cancer patients’ quality of life.

A systematic review was conducted on randomized controlled trial studies by searching keywords in the title, abstract and keywords of the studies in the reliable scientific databases including Embase, Web of Science, Scopus and PubMed on February 1 in 2024. We followed the Preferences and Items of Systematic Reviews (PRISMA) guidelines. Studies of randomized controlled trials that used telemedicine using a mobile application to manage chemotherapy complications, quality of life in breast cancer patients, and their English full text were considered as inclusion criteria.

Out of 16 included studies, 12 studies (75%) showed a significant improvement in the quality of life and reduction of side effects and self-management of breast cancer patients in the intervention group compared to the control group. However, in 4 studies (25%), there was not any significant difference between the control and intervention groups in terms of improving quality of life. In 3 of the included studies (19%), although the patients’ quality of life in the intervention group improved significantly compared to the control group. However, there was not any statistically significant difference regarding the level of depression and anxiety of the control and intervention groups.

The findings of this systematic review confirm that telemedicine approaches have the potential to be effective compared to traditional face-to-face treatments in the management of chemotherapy side effects and the breast cancer patients’ quality of life. These broad approaches may minimize barriers such as distance, time, and cost. Furthermore, improving the knowledge of patients by providing self-care recommendations and activating the role of patients in the care process will improve the health of breast cancer survivors.

Anemia in cancer patients and following chemotherapy in affected patients is one of the factors affecting the health status and even the survival of patients, which should be evaluated. Considering the significant prevalence of cancer in Mazandaran province, this study was conducted to determine the incidence of anemia caused by chemotherapy and determine some factors related to it in patients with solid tumors in Imam Sari Hospital.

The current research is a cross-sectional study. The samples were selected from patients with solid tumors who were referred to the chemotherapy centers of Imam Sari Hospital in 2021 and 2022. The convenience sampling method was used. The inclusion criteria were patients over 18 years of age with solid tumors and the exclusion criteria were history of receiving blood in the last three months, radiotherapy, and anemia requiring treatment at the beginning of the study. CBC results of patients before and after chemotherapy cycles were recorded, and anemia was determined based on hemoglobin values. According to hemoglobin, the patients were classified into 4 categories: normal, mild anemia, moderate anemia, and severe anemia. Also, a decrease in hemoglobin (2 units or more) in the intervals between chemotherapy cycles was considered chemotherapy-induced anemia. In addition, information such as age, gender, type of cancer, and the type of chemotherapy regimen received were also recorded.

The total number of people who entered the study was 146, and the number of males was 91 (62.3%). The mean±standard deviation of the age of the participants was 56.8±12.7 years. Breast tumors in 56 people (38.4%), stomach in 48 people (32.9%), colorectal in 18 people (12.3%), and lung in 7 people (4.8%) were more than others. 51 people (34.9%) had Platinum-based chemotherapy, at first 39 people (26.7%) had normal hemoglobin, 80 people (54.8%) had mild anemia and 27 people (18.5%) had moderate anemia. 51.8% of patients with breast tumors, 22.2% of genitourinary tumors, and 8.8% of patients with gastrointestinal tumors had normal hemoglobin at the beginning of the study. The frequency of moderate anemia increased from 18.5% before chemotherapy to 36.1% after the third cycle of chemotherapy and 1.4 to 2.7% of patients developed severe anemia after different cycles of chemotherapy. 23 people (15.8 percent) of the examined patients had 2 or more units of hemoglobin drop after the first stage of chemotherapy, which happened in 10 people after the second stage (8.8 percent) and after the third cycle in 1 person (1.8 percent), it was observed. There was no significant relationship between 2 units or more hemoglobin drop with gender, age, tumor type, and type of chemotherapy regimen after the first cycle of chemotherapy (P<0.05).

The results of the present study showed that there was mild anemia in a large number of cancer patients, which increased after the first cycle of chemotherapy. Age, sex, type of tumor, and type of chemotherapy regimen had no significant relationship with hemoglobin drop in cancer patients undergoing chemotherapy.

This article discusses the diagnosis and monitoring of patients with colorectal cancer using liquid biopsy. Colorectal cancer is one of the most common types of cancer worldwide; moreover, its diagnosis and monitoring is of great importance due to various factors such as lifestyle, environmental and genetic factors. There are various methods for diagnosing and monitoring colorectal cancer which can be used as the basis for selecting appropriate treatment methods such as surgery, chemotherapy, targeted therapy, immunotherapy, gene therapy and combination therapies.

Methods and Materials:

the current study has been performed through searching “Liquid biopsy”, “Colorectal Cancer”, “Tumor educated platelets”, “Biomarker”, and “Chemotherapy” keywords in various databases including PubMed, Scopus, Web of Science, and Google Scholar until Dec 2023. Out of the 297 articles, 49 articles were selected and they were included in the study based on the inclusion and exclusion criteria.

Liquid biopsy-based analysis of circulating tumor cells (CTCs), circulating tumor DNA (ctDNA), and tumor-educated platelets (TEPs) provide useful tools for early detection, monitoring treatment response, detecting disease recurrence, and identifying tumor heterogeneity and drug resistance mechanisms in colorectal cancer.

This article examines that due to the molecular characteristics of the tumor during the course of the disease and the genetic and phenotypic heterogeneity of the tumor between primary and metastatic lesions, liquid biopsy can be used as a new solution for diagnosis and monitoring of patients with colorectal cancer.

Up to 60% of breast cancer patients treated with chemotherapy is confronted with cognitive problems, which can have a significant impact on daily activities and quality of life. Therefore, the purpose of the study was to “determine the cognitive function of breast cancer patients receiving adjuvant chemotherapy.

In this cross-sectional study, the research population was cancer patients referred to the oncology department of Taw Heed Hospital in Sanandaj. All patients were included in the study by census method. The data collection tool in this study was the form of demographic characteristics and cognitive function assessment of cancer patients FACT-cog. To analyze the research data, version 14 of STATA software and descriptive statistics and analytical statistics including independent chi-square t test were used. A significance level of less than 0.05 was considered.

In this study, 101 breast cancer patients of Taw Heed Hospital, all of whom were women, were included in the study. Their average age was 44.06 ± 15.15 years. The average duration of disease of the participants was 18.7±23.61 months. The results of the study showed that the average cognitive performance score was (68.32±24.15), which is lower than the average score and in the average range.

The results of this study showed that in people with breast cancer who are undergoing chemotherapy, the cognitive function is at an average level, and the necessary training should be done to improve the cognitive function of these patients.

Today, mobile phones have become an integral part of daily life and have various functions for self-care education. One of the main methods is the short message service, which does not require access to the Internet and a smartphone. The aim of this study is investigating the effect of using this method on self-care and quality of life of patients with cancer undergoing chemotherapy.

The present study is a clinical trial that was conducted at the Ayat-Allah Khansari a tertiary cancer hospital in Arak city. The participants (n=92) were randomly assigned to two control and interventional groups. The intervention group received educational messages (2-3 SMS) about self-care including diet, physical activity, sleep and rest, and managing side effects for one month. Before and after the intervention, demographic, quality of life and awareness and self-care process questionnaires were completed by the participants. The data was analyzed using SPSS-16 software.

The average score of awareness and benefits of prevention significantly increased after the intervention in the intervention group (P<0.05). After the intervention, the total score of the quality of life increased significantly in the intervention group and the symptoms of insomnia, pain, nausea and vomiting decreased significantly (P<0.05).

In this research, education through short message has effectively increased self-care awareness and the quality of life of patients. Therefore, this method can be used especially in the case of patients who do not have access to the Internet and a smartphone or who do not have the ability to use a smartphone. This method can reduce the time of face-to-face education, improve the quality of education, increase the possibility of reviewing the education by the patient and family, their satisfaction, as well as reduce the workload of nurses and reduce the costs of patient care and treatment.

It is observed that crises such as a child suffering from cancer and chemotherapy can lead to a decline in mental cohesion and resilience in mothers, which in turn can affect their ability to care for their children. This study aimed to explore the relationship between resilience and the caregiving burden of mothers of children who have cancer and are undergoing chemotherapy in the teaching hospitals of the University of Iran.

In this descriptive, cross-sectional, and correlational study, 123 mothers of children with cancer undergoing chemotherapy were selected using convenience sampling in Hazrat Ali Asghar and Hazrat Rasool Akram educational centers. The data collection tools were the demographic questionnaire of mothers and children, the Connor and Davidson resilience measurement scale (2003), and the parental care burden questionnaire Zarit et al. (1980). After collecting the data, SPSS version 22.0 statistical software was used to analyze data using descriptive and inferential statistical tests (independent t-test, Pearson's correlation coefficient, and regression analysis). The significance level for all data was considered 0.05.

The mean age of the mothers was 36.05 ± 7.56 years. The mean resilience total score of mothers was 21.19 ± 71.01, indicating the moderate resilience of the mothers. The burden of care in 43.9% of mothers was low, and 32.5% at an average level. The mothers' total care burden mean score was 27.05 ± 19.79. A statistically significant relationship existed between mothers' resilience mean score and the caring burden mean score (P < 0.001). Also, the findings showed a significant relationship between the mean resilience score and the education level of mothers (P=0.03) and an inverse relationship between the mean resilience score of mothers and the number of children (P=0.01). There was a significant relationship between the mean score of care burden of mothers and income level (P=0.009).

The study results indicate that the level of resilience in mothers who care for children undergoing chemotherapy due to cancer is average. Furthermore, based on mothers' and children's demographic factors related to resilience and caregiving burden, and the relation between the caregiving burden on mothers and the impact of resilience on their caregiving burden, the study suggests designing and implementing programs to educate and provide nursing services to these mothers. Such programs aim to reduce their care burden and promote resilience.

Pain as one of the side effects of chemotherapy is associated with physical and psychological discomforts in breast cancer patients. The aim of this study was designing, validating and evaluate the effectiveness of a pain management program for pain and life expectancy in breast cancer patients during chemotherapy.

The program was designed using a qualitative thematic analysis method. Relevant studies were identified from the background and used to develop a six-session program by identifying primary, secondary, and main component codes. Then, to evaluate the validity, 10 experts in this field were asked to assess the program. A semi-experimental method was used to assess the effectiveness of the program. In 2022, 28 breast cancer patients with a cancer severity of 1 to 3 undergoing chemotherapy at Namazi and Amir hospitals in Shiraz city were randomly assigned to intervention and control groups (n=14). Both groups were evaluated by Brief Pain Inventory and Hope Scale in three phases: pre-test, post-test, and one-month follow-up. Moreover, the variance analysis with repeated measures was used to analyze the data.

Based on the evaluation results, the pain management program demonstrated sufficient content validity and reliability. In addition, the intervention group reported significantly lower pain and higher life expectancy scores in post-test (p<0.01). The difference reminded significant in follow-up (p<0.01).

Based on the study findings, the pain management program effectively moderates pain and improves the life expectancy of breast cancer patients during chemotherapy. Hence, this program is a suitable option to moderate the side effects of chemotherapy.

Chemotherapy is one of the most common treatments for children with cancer, which is associated with gastrointestinal diseases. Synbiotics are supplements containing probiotics and prebiotics that potentially have a significant effect in modulating the intestinal microbiota.

This double-blind clinical trial was conducted on 88 children with non-hematological neoplasms. Patients were randomly divided into two groups to receive Lactocare® and placebo (46 patients in the Lactocare group and 42 patients in the placebo group). Patients receive the drugs twice a day for 14 days. The number of times diarrhea, vomiting, nausea, and constipation caused by chemotherapy were evaluated after the start of receiving Lactocare and placebo until the end of the study.

In the Lactocare® group, the duration of diarrhea and constipation (in days) after the first week was significantly less than in the placebo group (P < 0.05). There was no significant difference between the two groups in terms of the severity of nausea and vomiting (P > 0.05). The placebo group in our study was 1.37 times more likely to have diarrhea compared to the LactoCare®-treatment group (P = 0.041, odds ratio: 1.37; confidence interval: 1.05-3.31).

In this study, the use of Lactocare® reduced diarrhea and constipation caused by chemotherapy in patients. It seems that the use of Lactocare® synbiotic supplement is an easy and effective way to reduce diarrhea and constipation caused by chemotherapy in patients with neoplasms.

Recent studies on the lifestyle of cancer patients have shown that environmental factors have a significant impact on the onset and progression of cancer. The sensitivity of cancer cells to food and energy restriction is one of the topics studied in the field of cancer prevention and treatment. One of these calorie restriction methods is fasting, which has various types. Fasting in Islam is a form of worship in which a Muslim refrains from eating, drinking, etc. from the morning call to the evening call. This is a review article by reviewing articles from various databases including PubMed, Google Scholar and Science Direct and searching for keywords: intermittent fasting, Ramadan fasting, fasting, food restriction, cardiovascular diseases, diabetes, obesity, system Immunity and Cancer deals with the effect of fasting in the prevention of cancer and its treatment, by reducing the side effects of chemotherapy and increasing its effectiveness. The results of the study show that calorie restriction can prevent the growth and development of cancer, as well as its effectiveness. to increase chemotherapy and radiation therapy, although more and more detailed studies in larger groups are needed to definitively conclude the clinical effectiveness of fasting in the prevention and treatment of people with cancer. Also, oncologists should carefully assess the health conditions of patients and prohibit them from fasting in case of metastasis or aggressive cancers.

Cancer-related sleepiness is a common symptom in patients and can impact their quality of life. Distance education and support, with the help of technology, can play a significant role in improving sleep in these patients. This study aimed to investigate the effect of education and support based on virtual social network on the sleepiness of cancer patients undergoing chemotherapy.

The study was conducted on 66 patients with cancer: intervention (n = 33) and control (n = 33) groups. Training and support in the field of sleep was provided through a virtual social network for the intervention group for two months. The control group received usual care. The data collection tool included demographic, clinical, and Epworth sleepiness scale questionnaires, which were completed before, one, and two months after the start of the intervention. Data were analyzed with SPSS 16 software.

The intervention group scored significantly higher on the average sleepiness score before intervention than the control group (p=0.048). The average sleepiness score was not significantly different between the intervention and control groups a month later after adjusting the pre-test variable (p=0.092). After two months, the intervention group had a significantly lower average sleepiness score compared to the control group (p=0.004).

Distance education and support based on virtual social network can be an effective way to reduce the daily sleepiness of cancer patients undergoing chemotherapy.

Chemotherapy is one of the most common methods of cancer treatment, which leads to many side effects, including nausea and vomiting. One of the complementary treatments that is currently used to control nausea and vomiting in these patients; The use of ear acupressure. This study was conducted with the aim of systematically investigating the effect of ear acupressure on chemotherapy-induced nausea and vomiting in cancer patients.

In this review, all studies from 2010 to June 2023 in PubMed, SCOPUS and Web of Science databases ,Magiran,SID with the keywords "Auricular Acupuncture", "Nausea", "Vomiting", "Chemotherapy" and "Cancer" were examined. were included, the prepared articles were screened based on the inclusion criteria.

A total of 1061 articles were identified through the initial search, and finally 5 articles that met the inclusion criteria were examined. Most of the conducted studies confirmed the effect of ear acupressure on nausea, especially in the acute phase; While the results of the studies related to the impact of this intervention on vomiting and control of delayed phase symptoms were contradictory.

Auricular acupressure can be helpful in improving nausea and vomiting in patients undergoing chemotherapy; and be used as a complementary method. However, due to the limitations of the studies conducted in this field and the conflicting results, it is suggested to conduct more and more diverse researches in this field.

Cardiotoxicity caused by fluoropyrimidines is an uncommon but potentially fatal complication. Its frequency has been 1.6 to 19% in previous studies. But there are no accurate statistics in Iran. The aim of this study was to determine the rate of cardiac complications of 5-fluorouracil (5-FU) infusion.

This prospective study was conducted in patients with gastrointestinal cancers who underwent chemotherapy with regimens containing 24-hour infusion of 5-FU at Rohani Hospital of Babol. Patients with a history of radiation therapy to the chest or epigastrium or suffering from COVID-19 disease in the last 6 weeks were excluded from the study. Each patient was examined in 2 cycles of chemotherapy. In case of complications, cardiac examinations including examination, electrocardiogram, echocardiography and if necessary, coronary angiography were done. Data analysis was done with SPSS 26 software using descriptive indices and Fisher exact test (significance≤0.05).

 In sixty one patients, 122 courses of chemotherapy were evaluated. Underlying cancer was colorectal cancer in 32 patients, stomach cancer in people. Eight patients (13.11%) had cardiac complication, in eleven chemotherapy cycles, included 7 cases of chest pain and one case of each of complications of myocardial infarction, pulmonary edema and pericarditis. Four out of 8 patients suffered from complications only in the first round, one only in the second round and three patients in both rounds of chemotherapy (P=0.004).The incidence rate of complications in patients without a history of heart disease was 8.7% and in patients with a history of heart disease 26.7%(P=0.073), in non-smokers 10% and in smokers 30%(P=0.084). It was 10.6% in non-diabetic patients and 21.4% in diabetic patients (P=0.294).

 Cardiac complications are common in 24-hour injection of 5-fluorouracil. A patient who has a heart complication once, might have a higher probability of having a complication in the next cycles.

Practical Implications:

Due to the high prevalence of cardiac complications of 24-hour floururacil infusion, especially in patients with a history of heart disease, careful cardiac monitoring during hospitalization is recommended.