在患有癌症的青少年和年轻成年人中,专门的息治疗和症状严重性和控制
Sumit Gupta1,2,3,4, Qing Li3, Alisha Kassam1,2,5
1Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada.
JAMA network open
|October 20, 2023
概括
报告严重症状的患有癌症的青少年和年轻人 (AYA) 更有可能接受特殊息治疗 (SPC). 虽然SPC改善了疼痛,但其他症状没有受到影响,这凸显了需要新的干预措施的需要.
科学领域:
- 在瘤学瘤学.
- 抚慰性护理是一种缓解性护理.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 患有癌症的青少年和年轻人 (AYA) 面临着严重的症状负担.
- 推为这些患者提供特殊的息治疗 (SPC),但往往缺乏及时参与.
研究的目的:
- 调查症状严重程度和随后SPC参与AYA与癌症之间的关联.
- 为了确定SPC是否改善了这个人群的症状管理.
主要方法:
- 在加拿大安大略省 (2010-2018) 诊断出癌症的AYA (15-29岁) 的队列研究.
- 利用医疗保健数据库,包括埃德蒙顿症状评估系统 (ESAS) 评分,将症状严重程度与SPC参与联系起来.
- 采用差异差异方法对5年内死亡的患者进行匹配病例控制分析.
主要成果:
- 中度至严重的症状评分 (ESAS) 与SPC参与的可能性增加有关 (严重疼痛的HR:7.7).
- 在5年内死亡的AYA中,84.9%的人在死亡前获得了SPC.
- SPC参与与疼痛轨迹的改善有关 (P=.003),但没有影响其他症状.
结论:
- 报告中度或严重症状的癌症AYA更有可能获得SPC.
- SPC与疼痛严重程度的减少有关,但不会影响其他症状轨迹.
- 需要新的干预措施来解决癌症治疗和终身护理期间的其他症状.
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