在第三级护理中心检查点抑制剂诱导的免疫相关不良事件管理的实践变化
Malek Shatila1, Farzin Eshaghi2, Austin R Thomas3
1Department of Gastroenterology, Hepatology, and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Cancers
|January 23, 2024
概括
随着时间的推移,检查点抑制剂对免疫相关不良事件 (irAEs) 的管理发生了变化. 及时的专业咨询改善了胃肠道IRAE的结果,而肺部IRAE护理则出现了整体改善.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 临床医学 临床医学
背景情况:
- 免疫相关不良事件 (irAEs) 是免疫检查点抑制剂 (ICI) 治疗的常见并发症.
- 对IRAE的管理准则正在不断发展.
- 了解irAE管理中的时间实践变化对于优化患者护理至关重要.
研究的目的:
- 随着时间的推移,探索ICI诱导的胃肠道,肺,和心脏irAEs的管理变化.
- 确定在irAE管理策略中需要改进的具体领域.
- 评估管理变化对患者治疗结果的影响.
主要方法:
- 单中心回顾性研究.
- 包括在2019年或2021年7月至10月期间发生胃肠道,肺,或心脏irrAEs的患者.
- 在毒性后长达一年的时间内收集人口和临床数据.
主要成果:
- 胃肠道IRAE管理显示,在2019年至2021年期间,内镜评估和专科随访减少,症状持续时间缩短,类固醇缩小试验减少.
- 与2019年相比,2021年肺部IRAE管理得到改善,死亡率降低,住院/再住院,专科咨询增加.
- 在这两段时间内,心脏irAE的管理涉及到频繁且及时的心脏病专家咨询. 整体上,出院后的随访仍然很低 (<50%).
结论:
- 及时的专业咨询与胃肠道IRAE的改善结果有关.
- 观察到肺部IRAE管理的改善,这表明指导方针的成功实施.
- 有机会加强出院后的随访,并在不同类型的IRAE中标准化护理.
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