Department of Investigational Cancer Therapeutics, Unit 0455, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA.
J Clin Oncol. 2011 Sep 10;29(26):3547-52. doi: 10.1200/JCO.2010.33.3823. Epub 2011 Aug 15.
This study assessed outcomes of individuals with advanced cancer who required admission to an intensive care unit (ICU) after referral for an early clinical trial because they did not respond to conventional therapy.
Outcome analyses were conducted for 212 consecutive patients admitted to The University of Texas MD Anderson Cancer Center ICU after being seen in the phase I clinic starting on May 1, 2007. All data were obtained by a review of electronic medical records of patients.
The median survival of 212 patients with advanced cancer referred to phase I care after the initial ICU admission was 3.2 weeks (95% CI, 2.5 to 4.9 weeks). Patients who underwent cardiopulmonary resuscitation (CPR) succumbed within a median survival of 1 day (75% and 25% estimated survival of 1 and 3 days, respectively). Patients admitted for a postsurgical intervention did better than patients admitted for a nonsurgical intervention (median survival, 21.5 versus 2.1 weeks; P < .0001). The multivariate analysis revealed that a nonsurgical intervention, hypoalbuminemia, and higher Acute Physiology and Chronic Health Evaluation II scores were associated with poor overall survival.
The outcome of patients in a phase I clinic after initial ICU admission was poor, particularly when admission was for a nonsurgical intervention and/or when CPR was needed.
本研究评估了因常规治疗无效而被转介至早期临床试验后入住重症监护病房（ICU）的晚期癌症患者的预后。
对 2007 年 5 月 1 日开始在 I 期临床诊所就诊的 212 例连续患者在入住德克萨斯大学 MD 安德森癌症中心 ICU 后的结局进行了分析。所有数据均通过回顾患者的电子病历获得。
212 例初始 ICU 入院后被转介至 I 期治疗的晚期癌症患者的中位生存期为 3.2 周（95%CI，2.5 至 4.9 周）。接受心肺复苏（CPR）的患者中位生存期为 1 天（分别为 75%和 25%的估计生存时间为 1 天和 3 天）。接受手术后干预的患者比接受非手术干预的患者生存更好（中位生存期分别为 21.5 周和 2.1 周；P<.0001）。多变量分析显示，非手术干预、低白蛋白血症和更高的急性生理学和慢性健康评估 II 评分与总体生存不良相关。
初始 ICU 入院后在 I 期临床诊所的患者预后较差，特别是在接受非手术干预和/或需要 CPR 的情况下。
