生命末期的抗癌疗法:一项回顾性队列研究
Johnny Singh1, Andreas Stensvold2, Martin Turzer2
1Østfold Hospital Trust, Department of Oncology, Graalum, Norway; Oslo Metropolitan University, Faculty of Health Sciences, Institute of Nursing and Health Promotion, Oslo, Norway. Johnny.Joginder.Singh@so-hf.no.
Acta oncologica (Stockholm, Sweden)
|May 8, 2024
概括
系统性抗癌疗法 (SACT) 临终期 (EOL) 给了15%的无法治愈的癌症患者. 从诊断到死亡的时间较短和表现不佳的状态预测了SACT的使用,突出了护理质量的问题.
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:
- 患有不可治愈癌症的患者中有很大一部分接受全身抗癌疗法 (SACT) 接近生命终点 (EOL).
- 在这个阶段,SACT具有可疑的益处,但通常被视为EOL护理的质量指标.
- 这项研究调查了生命最后30天的SACT率,预测因素和相关因素.
研究的目的:
- 为了确定非治愈癌症患者在生命的最后30天内 (DOL) 施用SACT的比率.
- 为了确定在最后30个DOL中接收SACT的潜在预测因素.
- 评估东部合作瘤集团 (ECOG) 绩效状况和修改格拉斯哥预后得分 (mGPS) 在EOL护理决策中的有用性.
主要方法:
- 在2018年7月至2019年12月期间死亡的383名无法治愈的癌症患者的回顾性队列研究.
- 对医疗记录的分析,以确定在过去30 DOL内SACT的管理.
- 用描述性统计,奇二次测试和回归分析来确定相关因素.
主要成果:
- 15% (57/383) 的患者在过去的30个月内接受了SACT.
- 在过去的30个DOL中,SACT与从诊断到死亡的时间缩短有关 (中位数为234天与482天),ECOG得分<3 (p=0.001).
- 接受SACT治疗的患者更有可能住院并在医院环境中死亡. ECOG和mGPS的文档是有限的.
结论:
- 最近被诊断的患者更有可能在最后30天接受SACT.
- 修改后的格拉斯哥预后得分 (mGPS) 显示,作为决策工具的实用性不大.
- 关于终身癌症护理的绩效状况的文档显著缺乏.
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