Schonwetter Ronald S, Roscoe Lori A, Nwosu Martin, Zilka Brian, Kim Sehwan
LifePath Hospice and Palliative Care, Inc., University of South Florida, Tampa, Florida 33637, USA.
J Palliat Med. 2006 Jun;9(3):638-45. doi: 10.1089/jpm.2006.9.638.
The value of palliative chemotherapy for hospice patients is difficult to quantify and little is known about outcomes from these treatments. This study examined quality of life and symptom control in hospice patients with cancer receiving chemotherapy and in a control group of hospice patients with cancer who had not received chemotherapy for at least 3 months. Using a case-control study design matching patients by age, gender, race, and cancer diagnosis, patients receiving chemotherapy reported a similar number of symptoms as patients off chemotherapy. Global symptom distress was comparable in both groups as was quality of life. Patients in both groups were similar at the symptom-specific level, however, patients on chemotherapy had better symptom outcomes for urination problems (p=0.03), numbness/tingling (p=0.03), muscle weakness (p=0.07), and pain (p=0.09). Patients on chemotherapy had poorer symptom control involving change in taste (p=0.01) and cough (p=0.01). Patients on chemotherapy were more likely than those off chemotherapy to report that chemotherapy "made them feel better" (p=0.01) and "allowed better symptom control" (p=0.01), indicating that patients taking chemotherapy had more subjective benefit from chemotherapy when compared to those off chemotherapy. The two groups showed no difference in the rate of survival.
姑息性化疗对临终关怀患者的价值难以量化，人们对这些治疗的结果知之甚少。本研究调查了接受化疗的临终关怀癌症患者以及未接受化疗至少3个月的临终关怀癌症患者对照组的生活质量和症状控制情况。采用病例对照研究设计，根据年龄、性别、种族和癌症诊断对患者进行匹配，接受化疗的患者报告的症状数量与未接受化疗的患者相似。两组的总体症状困扰和生活质量相当。两组患者在特定症状水平上相似，然而，化疗患者在排尿问题（p=0.03）、麻木/刺痛（p=0.03）、肌肉无力（p=0.07）和疼痛（p=0.09）方面的症状改善更好。化疗患者在味觉改变（p=0.01）和咳嗽（p=0.01）方面的症状控制较差。与未接受化疗的患者相比，接受化疗的患者更有可能报告化疗“让他们感觉更好”（p=0.01）和“使症状得到更好控制”（p=0.01），这表明与未接受化疗的患者相比，接受化疗的患者从化疗中获得的主观益处更多。两组的生存率没有差异。
