在晚期转移性膀癌患者中,患者与临床医生报告的症状协议
Soufyan Annakib1, Emma Di Méglio2, Yona Dibert-Bekoy2
1Medical Oncology Department, CHU Nîmes, Univ Montpellier, Nîmes, France.
Cancer medicine
|April 21, 2025
概括
晚期泌尿癌患者报告的症状明显比临床医生评估的症状严重,突出显示了护理的断开. 利用患者报告结果 (PRO) 对于准确的症状评估和改善患者体验至关重要.
科学领域:
- 在瘤学瘤学.
- 临床试验 临床试验
- 患者报告的结果
背景情况:
- 免疫检查点抑制剂 (ICI) 改善了局部晚期或转移性尿路细胞癌 (la/mUC) 的存活率.
- 在接受ICI的la/mUC患者中,患者报告的症状尚未得到研究.
- 这项研究旨在比较患者和临床医生报告的症状严重程度.
研究的目的:
- 为了比较患者和临床医生之间的症状严重程度和频率在la/mUC.
- 评估患者报告的结果 (PRO-CTCAE) 和临床医生评估的不良事件 (CTCAE) 之间的一致性.
- 评估ICI治疗期间症状报告中的纵向不一致.
主要方法:
- 对AMI临床试验的二次分析,该试验涉及用 pembrolizumab治疗的la/mUC患者.
- 从基线到12周期,PRO-CTCAE和CTCAE分别用于患者和临床医生的评估.
- 使用科恩卡帕测量了协议;使用威尔科克森测试比较了毒性指数和症状频率.
主要成果:
- 包括39名患者;PRO-CTCAE完成率为77.5%.
- 患者和临床医生之间对于症状严重程度的一致性很低 (kappa范围: -0.017至0.161).
- 与临床医生相比,患者报告的症状毒性指数 (p < 0.001) 和频率 (p < 0.009) 显著更高,疲劳和疼痛是最常见的.
结论:
- 患者报告的症状和临床医生对ICI的la/mUC患者的评估之间存在显著的不一致.
- 与患者相比,临床医生往往低于报告症状的频率和严重程度.
- 整合PRO对于全面了解患者体验和优化护理至关重要.
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