The role of breast cancer-related arm lymphedema in physical functioning and physical activity participation among long-term African American breast cancer survivors.
African American
Breast cancer
Cancer survivorship
Lymphedema
Minority health
Physical health
Journal
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
ISSN: 1433-7339
Titre abrégé: Support Care Cancer
Pays: Germany
ID NLM: 9302957
Informations de publication
Date de publication:
20 Jun 2024
20 Jun 2024
Historique:
received:
14
02
2024
accepted:
10
06
2024
medline:
20
6
2024
pubmed:
20
6
2024
entrez:
20
6
2024
Statut:
epublish
Résumé
Breast cancer-related arm lymphedema (BCRL) is a common chronic and debilitating condition that involves accumulation of lymphatic fluid in the arm or hand. Limited data are available on BCRL in African American women. Lack of physical activity (PA) and poor physical functioning (PF) are both associated with increased morbidity and mortality among breast cancer survivors. We examined the association of BCRL with PA and PF among African American breast cancer survivors. 323 African American women who previously participated in a case-only study in three states (TN, GA, SC) completed a survivorship-focused questionnaire (mean: 4.2 years post-diagnosis) in 2015-2016. Validated measures were used to determine BCRL, PF, and PA. Adjusted binary logistic regression models estimated ORs and 95% CIs for the association of BCRL and meeting PA guidelines (≥ 150 min/week), while multinomial logistic regression was used for PF and PA (minutes/week) categorized based on tertiles. Approximately 32% reported BCRL since diagnosis; 25.4% reported BCRL in the last 12-months. About 26% and 50% reported that BCRL interfered with exercise and ability to do daily activities, respectively. The mean PF among those with BCRL was 51.0(SD:29.0) vs. 68.5(SD:30.1) among those without BCRL. BCRL was associated with lower PF (adjusted-OR for tertile 2: 2.12(95% CI:1.03-4.36) and adjusted-OR for tertile 1: 2.93(95% CI:1.44-5.96)). BCRL was associated with lower PF among long-term African American breast cancer survivors. Continued monitoring by health care professionals and increased education and behavioral interventions to support PA and improved PF among survivors living with BCRL are warranted.
Identifiants
pubmed: 38900224
doi: 10.1007/s00520-024-08648-3
pii: 10.1007/s00520-024-08648-3
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
446Subventions
Organisme : NIH HHS
ID : K07CA184257
Pays : United States
Organisme : NIH HHS
ID : R03CA192214
Pays : United States
Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Norman SA, Miller LT, Erikson HB, Norman MF, McCorkle R (2001) Development and validation of a telephone questionnaire to characterize lymphedema in women treated for breast cancer. Phys Ther 81(6):1192–1205
doi: 10.1093/ptj/81.6.1192
pubmed: 11380275
Gillespie TC, Sayegh HE, Brunelle CL, Daniell KM, Taghian AG (2018) Breast cancer-related lymphedema: risk factors, precautionary measures, and treatments. Gland Surg. 7(4):379–403. https://doi.org/10.21037/gs.2017.11.04
doi: 10.21037/gs.2017.11.04
pubmed: 30175055
pmcid: 6107585
Meeske KA, Sullivan-Halley J, Smith AW, McTiernan A, Baumgartner KB, Harlan LC et al (2009) Risk factors for arm lymphedema following breast cancer diagnosis in Black women and White women. Breast Cancer Res Treat 113(2):383–391. https://doi.org/10.1007/s10549-008-9940-5
doi: 10.1007/s10549-008-9940-5
pubmed: 18297429
Bar AdV, Dutta PR, Solin LJ, Hwang WT, Tan KS, Both S et al (2012) Time-course of arm lymphedema and potential risk factors for progression of lymphedema after breast conservation treatment for early stage breast cancer. Breast J. 18(3):219–25. https://doi.org/10.1111/j.1524-4741.2012.01229.x
doi: 10.1111/j.1524-4741.2012.01229.x
Black DM, Jiang J, Kuerer HM, Buchholz TA, Smith BD (2014) Racial disparities in adoption of axillary sentinel lymph node biopsy and lymphedema risk in women with breast cancer. JAMA Surg 149(8):788–796. https://doi.org/10.1001/jamasurg.2014.23
doi: 10.1001/jamasurg.2014.23
pubmed: 25073831
pmcid: 5853102
DiSipio T, Rye S, Newman B, Hayes S (2013) Incidence of unilateral arm lymphoedema after breast cancer: a systematic review and meta-analysis. Lancet Oncol 14(6):500–515. https://doi.org/10.1016/S1470-2045(13)70076-7
doi: 10.1016/S1470-2045(13)70076-7
pubmed: 23540561
Togawa K, Ma HY, Sullivan-Halley J, Neuhouser ML, Imayama I, Baumgartner KB et al (2014) Risk factors for self-reported arm lymphedema among female breast cancer survivors: a prospective cohort study. Breast Cancer Res. 16(4):414. https://doi.org/10.1186/S13058-014-0414-X
doi: 10.1186/S13058-014-0414-X
pubmed: 25145603
pmcid: 4189147
Taghian NR, Miller CL, Jamrnallo LS, O’Toole J, Skolny MN (2014) Lymphedema following breast cancer treatment and impact on quality of life: A review. Crit Rev Oncol Hemat 92(3):227–234. https://doi.org/10.1016/j.critrevonc.2014.06.004
doi: 10.1016/j.critrevonc.2014.06.004
Gonzalez BD, Eisel SL, Qin B, Llanos AAM, Savard J, Hoogland AI et al (2021) Prevalence, risk factors, and trajectories of sleep disturbance in a cohort of African-American breast cancer survivors. Support Care Cancer 29(5):2761–70. https://doi.org/10.1007/s00520-020-05786-2
doi: 10.1007/s00520-020-05786-2
pubmed: 32995999
He L, Qu H, Wu Q, Song Y (2020) Lymphedema in survivors of breast cancer. Oncol Lett. 19(3):2085–96. https://doi.org/10.3892/ol.2020.11307
doi: 10.3892/ol.2020.11307
pubmed: 32194706
pmcid: 7039097
Paskett ED, Naughton MJ, Mccoy TP, Case LD, Abbott JM (2007) The epidemiology of arm and hand swelling in premenopausal breast cancer survivors. Cancer Epidem Biomar 16(4):775–782. https://doi.org/10.1158/1055-9965.EPI-06-0168
doi: 10.1158/1055-9965.EPI-06-0168
Kwan ML, Darbinian J, Schmitz KH, Citron R, Partee P, Kutner SE et al (2010) Risk factors for lymphedema in a prospective breast cancer survivorship study: the pathways study. Arch Surg 145(11):1055–1063. https://doi.org/10.1001/archsurg.2010.231
doi: 10.1001/archsurg.2010.231
pubmed: 21079093
pmcid: 2997775
Norman SA, Localio AR, Kallan MJ, Weber AL, Torpey HAS, Potashnik SL et al (2010) Risk Factors for Lymphedema after Breast Cancer Treatment. Cancer Epidem Biomar 19(11):2734–2746. https://doi.org/10.1158/1055-9965.EPI-09-1245
doi: 10.1158/1055-9965.EPI-09-1245
Paskett ED, Dean JA, Oliveri JM, Harrop JP (2012) Cancer-related lymphedema risk factors, diagnosis, treatment, and impact: a review. J Clin Oncol 30(30):3726–3733. https://doi.org/10.1200/JCO.2012.41.8574
doi: 10.1200/JCO.2012.41.8574
pubmed: 23008299
Dominick SA, Madlensky L, Natarajan L, Pierce JP (2013) Risk factors associated with breast cancer-related lymphedema in the WHEL Study. J Cancer Surviv 7(1):115–123. https://doi.org/10.1007/s11764-012-0251-9
doi: 10.1007/s11764-012-0251-9
pubmed: 23212606
Showalter SL, Brown JC, Cheville AL, Fisher CS, Sataloff D, Schmitz KH (2013) Lifestyle Risk Factors Associated with Arm Swelling Among Women with Breast Cancer. Ann Surg Oncol 20(3):842–849. https://doi.org/10.1245/s10434-012-2631-9
doi: 10.1245/s10434-012-2631-9
pubmed: 23054109
Warren LEG, Miller CL, Horick N, Skolny MN, Jammallo LS, Sadek BT et al (2014) The impact of radiation therapy on the risk of lymphedema after treatment for breast cancer: a prospective cohort study. Int J Radiat Oncol 88(3):565–571. https://doi.org/10.1016/j.ijrobp.2013.11.232
doi: 10.1016/j.ijrobp.2013.11.232
Cariati M, Bains SK, Grootendorst MR, Suyoi A, Peters AM, Mortimer P et al (2015) Adjuvant taxanes and the development of breast cancer-related arm lymphoedema. Brit J Surg 102(9):1071–1078. https://doi.org/10.1002/bjs.9846
doi: 10.1002/bjs.9846
pubmed: 26040263
Ridner SH, Sinclair V, Deng J, Bonner CM, Kidd N, Dietrich MS (2012) Breast cancer survivors with lymphedema: glimpses of their daily lives. Clin J Oncol Nurs 16(6):609–14. https://doi.org/10.1188/12.CJON.609-614
doi: 10.1188/12.CJON.609-614
pubmed: 23178353
Ahmed RL, Prizment A, Lazovich D, Schmitz KH, Folsom AR (2008) Lymphedema and quality of life in breast cancer survivors: the Iowa Women’s Health Study. J Clin Oncol 26(35):5689–96. https://doi.org/10.1200/JCO.2008.16.4731
doi: 10.1200/JCO.2008.16.4731
pubmed: 19001331
pmcid: 2600601
Ridner SH, Bonner CM, Deng J, Sinclair VG (2012) Voices from the shadows: living with lymphedema. Cancer nursing 35(1):E18-26. https://doi.org/10.1097/NCC.0b013e31821404c0
doi: 10.1097/NCC.0b013e31821404c0
pubmed: 21558848
pmcid: 3172392
Vassard D, Olsen MH, Zinckernagel L, Vibe-Petersen J, Dalton SO, Johansen C (2010) Psychological consequences of lymphoedema associated with breast cancer: a prospective cohort study. Eur J Cancer 46(18):3211–8. https://doi.org/10.1016/j.ejca.2010.07.041
doi: 10.1016/j.ejca.2010.07.041
pubmed: 20797846
Rupp J, Hadamitzky C, Henkenberens C, Christiansen H, Steinmann D, Bruns F (2019) Frequency and risk factors for arm lymphedema after multimodal breast-conserving treatment of nodal positive breast Cancer - a long-term observation. Radiation Oncol (London, England). 14(1):39. https://doi.org/10.1186/s13014-019-1243-y
doi: 10.1186/s13014-019-1243-y
pmcid: 6407279
Eaton LH, Narkthong N, Hulett JM (2020) Psychosocial Issues Associated with Breast Cancer-Related Lymphedema: a Literature Review. Curr Breast Cancer Rep 12(4):216–24. https://doi.org/10.1007/s12609-020-00376-x
doi: 10.1007/s12609-020-00376-x
pubmed: 32864036
pmcid: 7445072
Clough-Gorr KM, Ganz PA, Silliman RA (2010) Older breast cancer survivors: factors associated with self-reported symptoms of persistent lymphedema over 7 years of follow-up. Breast J 16(2):147–55. https://doi.org/10.1111/j.1524-4741.2009.00878.x
doi: 10.1111/j.1524-4741.2009.00878.x
pubmed: 19968661
Pusic AL, Cemal Y, Albornoz C, Klassen A, Cano S, Sulimanoff I et al (2013) Quality of life among breast cancer patients with lymphedema: a systematic review of patient-reported outcome instruments and outcomes. J Cancer Surviv 7(1):83–92. https://doi.org/10.1007/s11764-012-0247-5
doi: 10.1007/s11764-012-0247-5
pubmed: 23212603
Das N, Baumgartner RN, Riley EC, Pinkston CM, Yang D, Baumgartner KB (2015) Treatment-related risk factors for arm lymphedema among long-term breast cancer survivors. J Cancer Surviv 9(3):422–30. https://doi.org/10.1007/s11764-014-0416-9
doi: 10.1007/s11764-014-0416-9
pubmed: 25913877
Jorgensen MG, Toyserkani NM, Hansen FG, Bygum A, Sorensen JA (2021) The impact of lymphedema on health-related quality of life up to 10 years after breast cancer treatment. NPJ Breast Cancer 7(1):70. https://doi.org/10.1038/s41523-021-00276-y
doi: 10.1038/s41523-021-00276-y
pubmed: 34075045
pmcid: 8169644
Montagna G, Zhang J, Sevilimedu V, Charyn J, Abbate K, Gomez EA et al (2022) Risk Factors and Racial and Ethnic Disparities in Patients With Breast Cancer-Related Lymphedema. JAMA Oncol 8(8):1195–200. https://doi.org/10.1001/jamaoncol.2022.1628
doi: 10.1001/jamaoncol.2022.1628
pubmed: 35679026
pmcid: 9185510
Ren Y, Kebede MA, Ogunleye AA, Emerson MA, Evenson KR, Carey LA et al (2022) Burden of lymphedema in long-term breast cancer survivors by race and age. Cancer 128(23):4119–28. https://doi.org/10.1002/cncr.34489
doi: 10.1002/cncr.34489
pubmed: 36223240
Jette AM (2006) Toward a common language for function, disability, and health. Phys Ther 86(5):726–734
doi: 10.1093/ptj/86.5.726
pubmed: 16649895
Kroenke CH, Rosner B, Chen WY, Kawachi I, Colditz GA, Holmes MD (2004) Functional impact of breast cancer by age at diagnosis. J Clin Oncol 22(10):1849–1856. https://doi.org/10.1200/Jco.2004.04.173
doi: 10.1200/Jco.2004.04.173
pubmed: 15143077
Sweeney C, Schmitz KH, Lazovich D, Virnig BA, Wallace RB, Folsom AR (2006) Functional limitations in elderly female cancer survivors. J Natl Cancer Inst 98(8):521–529. https://doi.org/10.1093/jnci/djj130
doi: 10.1093/jnci/djj130
pubmed: 16622121
Pruitt SL, McQueen A, Deshpande AD, Jeffe DB, Schootman M (2012) Mediators of the effect of neighborhood poverty on physical functioning among breast cancer survivors: a longitudinal study. Cancer Causes Control 23(9):1529–1540. https://doi.org/10.1007/s10552-012-0030-y
doi: 10.1007/s10552-012-0030-y
pubmed: 22833236
pmcid: 3425435
Braithwaite D, Satariano WA, Sternfeld B, Hiatt RA, Ganz PA, Kerlikowske K et al (2010) Long-term prognostic role of functional limitations among women with breast cancer. J Natl Cancer Inst 102(19):1468–1477. https://doi.org/10.1093/jnci/djq344
doi: 10.1093/jnci/djq344
pubmed: 20861456
pmcid: 2950169
Sehl M, Lu X, Silliman R, Ganz PA (2013) Decline in physical functioning in first 2 years after breast cancer diagnosis predicts 10-year survival in older women. Journal of Cancer Survivorship-Research and Practice 7(1):20–31. https://doi.org/10.1007/s11764-012-0239-5
doi: 10.1007/s11764-012-0239-5
pubmed: 23232922
Paskett ED, Alfano CM, Davidson MA, Andersen BL, Naughton MJ, Sherman A et al (2008) Breast cancer survivors’ health-related quality of life : racial differences and comparisons with noncancer controls. Cancer 113(11):3222–3230. https://doi.org/10.1002/cncr.23891
doi: 10.1002/cncr.23891
pubmed: 18973178
Paxton RJ, Phillips KL, Jones LA, Chang S, Taylor WC, Courneya KS et al (2012) Associations among physical activity, body mass index, and health-related quality of life by race/ethnicity in a diverse sample of breast cancer survivors. Cancer 118(16):4024–4031. https://doi.org/10.1002/Cncr.27389
doi: 10.1002/Cncr.27389
pubmed: 22252966
Bradley CJ, Wilk A (2014) Racial differences in quality of life and employment outcomes in insured women with breast cancer. J Cancer Surviv 8(1):49–59. https://doi.org/10.1007/s11764-013-0316-4
doi: 10.1007/s11764-013-0316-4
pubmed: 24130067
Maly RC, Liu Y, Liang LJ, Ganz PA (2015) Quality of life over 5 years after a breast cancer diagnosis among low-income women: effects of race/ethnicity and patient-physician communication. Cancer 121(6):916–926. https://doi.org/10.1002/cncr.29150
doi: 10.1002/cncr.29150
pubmed: 25411008
Kwan ML, Cohn JC, Armer JM, Stewart BR, Cormier JN (2011) Exercise in patients with lymphedema: a systematic review of the contemporary literature. J Cancer Surviv 5(4):320–36. https://doi.org/10.1007/s11764-011-0203-9
doi: 10.1007/s11764-011-0203-9
pubmed: 22002586
Hasenoehrl T, Palma S, Ramazanova D, Kolbl H, Dorner TE, Keilani M et al (2020) Resistance exercise and breast cancer-related lymphedema-a systematic review update and meta-analysis. Support Care Cancer 28(8):3593–603. https://doi.org/10.1007/s00520-020-05521-x
doi: 10.1007/s00520-020-05521-x
pubmed: 32415386
pmcid: 7316683
Joaquim A, Leao I, Antunes P, Capela A, Viamonte S, Alves AJ et al (2022) Impact of physical exercise programs in breast cancer survivors on health-related quality of life, physical fitness, and body composition: Evidence from systematic reviews and meta-analyses. Front Oncol 12:955505. https://doi.org/10.3389/fonc.2022.955505
doi: 10.3389/fonc.2022.955505
pubmed: 36568235
pmcid: 9782413
McTiernan A, Friedenreich CM, Katzmarzyk PT, Powell KE, Macko R, Buchner D et al (2019) Physical Activity in Cancer Prevention and Survival: A Systematic Review. Med Sci Sports Exerc 51(6):1252–61. https://doi.org/10.1249/MSS.0000000000001937
doi: 10.1249/MSS.0000000000001937
pubmed: 31095082
pmcid: 6527123
Thompson CL, Owusu C, Nock NL, Li L, Berger NA (2014) Race, age, and obesity disparities in adult physical activity levels in breast cancer patients and controls. Front Public Health 2:150. https://doi.org/10.3389/fpubh.2014.00150
doi: 10.3389/fpubh.2014.00150
pubmed: 25285306
pmcid: 4168674
Alcaraz KI, Wiedt TL, Daniels EC, Yabroff KR, Guerra CE, Wender RC (2020) Understanding and addressing social determinants to advance cancer health equity in the United States: A blueprint for practice, research, and policy. CA Cancer J Clin 70(1):31–46. https://doi.org/10.3322/caac.21586
doi: 10.3322/caac.21586
pubmed: 31661164
Busen K, Sanderson M, Banks AD, Wallace H, Nechuta S. Patterns of Physical Activity and the Role of Obesity and Comorbidities Among Long-term African American Breast Cancer Survivors. J Racial Ethn Health Disparities. 2022 https://doi.org/10.1007/s40615-022-01405-4
Sanderson M, Pal T, Beeghly-Fadiel A, Fadden MK, Dujon SA, Clinton C et al (2021) A Pooled Case-only Analysis of Reproductive Risk Factors and Breast Cancer Subtype Among Black Women in the Southeastern United States. Cancer Epidemiol Biomarkers Prev 30(7):1416–23. https://doi.org/10.1158/1055-9965.EPI-20-1784
doi: 10.1158/1055-9965.EPI-20-1784
pubmed: 33947654
pmcid: 8254754
Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG (2009) Research electronic data capture (REDCap)-A metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 42(2):377–381. https://doi.org/10.1016/j.jbi.2008.08.010
doi: 10.1016/j.jbi.2008.08.010
pubmed: 18929686
Russell C, Palmer JR, Adams-Campbell LL, Rosenberg L (2001) Follow-up of a large cohort of Black women. Am J Epidemiol 154(9):845–853
doi: 10.1093/aje/154.9.845
pubmed: 11682367
Carter-Nolan PL, Adams-Campbell LL, Makambi K, Lewis S, Palmer JR, Rosenberg L (2006) Validation of physical activity instruments: Black Women’s Health Study. Ethn Dis 16(4):943–947
pubmed: 17061751
Holmes MD, Chen WY, Feskanich D, Kroenke CH, Colditz GA (2005) Physical activity and survival after breast cancer diagnosis. Jama 293(20):2479–86. https://doi.org/10.1001/jama.293.20.2479
doi: 10.1001/jama.293.20.2479
pubmed: 15914748
Signorello LB, Hargreaves MK, Steinwandel MD, Zheng W, Cai Q, Schlundt DG et al (2005) Southern community cohort study: establishing a cohort to investigate health disparities. J Natl Med Assoc 97(7):972–9
pubmed: 16080667
pmcid: 2569308
Caan B, Sternfeld B, Gunderson E, Coates A, Quesenberry C, Slattery ML (2005) Life After Cancer Epidemiology (LACE) study: A cohort of early stage breast cancer survivors (United states). Cancer Cause Control 16(5):545–556. https://doi.org/10.1007/s10552-004-8340-3
doi: 10.1007/s10552-004-8340-3
Kwan M, Ambrosone C, Lee M, Barlow J, Krathwohl S, Ergas I et al (2008) The Pathways Study: a prospective study of breast cancer survivorship within Kaiser Permanente Northern California. Cancer Cause Control 19(10):1065–1076. https://doi.org/10.1007/s10552-008-9170-5
doi: 10.1007/s10552-008-9170-5
RAND Corporation. 36-Item short form survey (SF-36) scoring instructions. https://www.rand.org/health-care/surveys_tools/mos/36-item-short-form/scoring.html . Accessed 15 Dec 2023
Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30(6):473–83
doi: 10.1097/00005650-199206000-00002
pubmed: 1593914
Ashing-Giwa K, Rosales M (2013) A cross-cultural validation of patient-reported outcomes measures: a study of breast cancers survivors. Qual Life Res 22(2):295–308. https://doi.org/10.1007/s11136-012-0140-8
doi: 10.1007/s11136-012-0140-8
pubmed: 22367682
Treanor C, Donnelly M (2015) A methodological review of the Short Form Health Survey 36 (SF-36) and its derivatives among breast cancer survivors. Qual Life Res 24(2):339–362. https://doi.org/10.1007/s11136-014-0785-6
doi: 10.1007/s11136-014-0785-6
pubmed: 25139502
Togawa K, Ma H, Smith AW, Neuhouser ML, George SM, Baumgartner KB et al (2021) Self-reported symptoms of arm lymphedema and health-related quality of life among female breast cancer survivors. Sci Rep 11(1):10701. https://doi.org/10.1038/s41598-021-89055-0
doi: 10.1038/s41598-021-89055-0
pubmed: 34021179
pmcid: 8139966
Zhang X, McLaughlin EM, Krok-Schoen JL, Naughton M, Bernardo BM, Cheville A et al (2022) Association of Lower Extremity Lymphedema With Physical Functioning and Activities of Daily Living Among Older Survivors of Colorectal, Endometrial, and Ovarian Cancer. JAMA Netw Open. 5(3):e221671. https://doi.org/10.1001/jamanetworkopen.2022.1671
doi: 10.1001/jamanetworkopen.2022.1671
pubmed: 35262713
pmcid: 8908072
U.S. Department of Health and Human Services (2018) Physical Activity Guidelines for Americans, 2nd edn. Washington, DC: U.S. https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf . Accessed 15 Dec 2023
Rock CL, Thomson CA, Sullivan KR, Howe CL, Kushi LH, Caan BJ et al (2022) American Cancer Society nutrition and physical activity guideline for cancer survivors. CA Cancer J Clin 72(3):230–62. https://doi.org/10.3322/caac.21719
doi: 10.3322/caac.21719
pubmed: 35294043
Collins-Bohler D (2019) The Lived Experiences of African American Women with Lymphedema Annals of Breast. Cancer Therapy 3(1):32–39
Yildiz Kabak V, Gursen C, Aytar A, Akbayrak T, Duger T (2021) Physical activity level, exercise behavior, barriers, and preferences of patients with breast cancer-related lymphedema. Support Care Cancer 29(7):3593–602. https://doi.org/10.1007/s00520-020-05858-3
doi: 10.1007/s00520-020-05858-3
pubmed: 33170403