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门诊姑息治疗咨询对晚期前列腺癌患者症状负担的影响。

The impact of an outpatient palliative care consultation on symptom burden in advanced prostate cancer patients.

机构信息

Department of Palliative Care and Rehabilitation Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.

出版信息

J Palliat Med. 2012 Jan;15(1):20-4. doi: 10.1089/jpm.2011.0219. Epub 2011 Dec 5.

Abstract

OBJECTIVES

There are limited studies characterizing cancer-related symptoms in outpatient advanced prostate cancer patients. The aim of this retrospective study was to describe the impact of an outpatient palliative care (PC) consultation on symptoms in patients with advanced prostate cancer.

METHODS

We retrospectively reviewed the medical records of 55 consecutive patients with advanced prostate cancer seen in our institution's outpatient PC center. Information regarding demographics, disease status, Edmonton Symptom Assessment System (ESAS) scores, Eastern Cooperative Oncology Group (ECOG) Performance Status, laboratory data, and pharmacological interventions were analyzed.

RESULTS

The median age of the study's patients was 66 years old, with 73% Caucasian ethnicity. All patients had metastatic disease and 96% had received prior cytotoxic chemotherapy. The most frequently occurring symptoms upon presentation were pain, fatigue, and drowsiness (>50%). Pain and fatigue were also the most severe symptoms, each having median ESAS scores of 7 (on a 0-10 scale). We instituted a median of 3 pharmacological interventions per patient, with a median of 15 days to follow-up assessment. At follow-up, patients reported significant symptom improvements in pain, drowsiness, fatigue, depression, sleep, sense of well-being, and anxiety.

CONCLUSIONS

Based on our preliminary data, we conclude that patients with advanced prostate cancer referred to PC experience severe and clinically significant symptoms. An outpatient PCconsultation is associated with significant symptom improvement in this subset of a distressed population. Future prospective studies are warranted to further describe symptom burden and the role for outpatient PC for advanced prostate cancer patients.

摘要

目的

目前针对门诊晚期前列腺癌患者的癌相关症状,相关研究较少。本回顾性研究旨在描述门诊姑息治疗(PC)咨询对晚期前列腺癌患者症状的影响。

方法

我们回顾性分析了在我院门诊 PC 中心就诊的 55 例连续晚期前列腺癌患者的病历资料。分析内容包括人口统计学、疾病状况、埃德蒙顿症状评估系统(ESAS)评分、东部合作肿瘤学组(ECOG)体能状态、实验室数据和药物干预情况。

结果

本研究患者的中位年龄为 66 岁,73%为白种人。所有患者均患有转移性疾病,96%的患者曾接受过细胞毒性化疗。就诊时最常见的症状是疼痛、疲劳和嗜睡(>50%)。疼痛和疲劳也是最严重的症状,ESAS 评分中位数均为 7(0-10 分)。我们为每位患者平均实施了 3 种药物干预措施,中位随访时间为 15 天。随访时,患者报告疼痛、嗜睡、疲劳、抑郁、睡眠、幸福感和焦虑感均有明显改善。

结论

根据我们的初步数据,我们得出结论,转至 PC 治疗的晚期前列腺癌患者会出现严重且具有临床意义的症状。门诊 PC 咨询可显著改善这部分患者的症状。未来有必要开展前瞻性研究,进一步描述晚期前列腺癌患者的症状负担以及门诊 PC 的作用。

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