Goksu Sema Sezgin, Gunduz Seyda, Unal Dilek, Uysal Mukremin, Arslan Deniz, Tatli Ali Murat, Bozcuk Hakan, Ozdogan Mustafa, Coskun Hasan Senol
Department of Medical Oncology, Kayseri State Hospital of Research and Education, Kayseri, Turkey E-mail :
Asian Pac J Cancer Prev. 2014;15(10):4251-4. doi: 10.7314/apjcp.2014.15.10.4251.
Treatment of anemia is an important issue in the palliative care setting. Blood transfusion is generally used for this purpose in supportive care. However the place of blood transfusion in terminally ill cancer cases is less far established.
We aimed to outline the use of transfusions and to find the impact of blood transfusion on survival in patients with advanced cancer and very near to death.
Patients dying in 2010-2011 with advanced cancer were included in the study. We retrospectively collected the data including age, type of cancer, the duration of last hospitalisation, ECOG performance status, Hb levels, transfusion history of erythrocytes and platelets, cause and the amount of transfusion. The anaemic patients who had transfusion at admission were compared with the group who were not transfused. Survival was defined as the time between the admission of last hospitalisation period and death.
Three hundred and ninety eight people with solid tumours died in 2010-2011 in our clinic. Ninety percent of the patients had anemia at the time of last hospitalisation. One hundred fifty three patients had erythrocyte transfusion at admission during the last hospitalisation period (38.4%). In the anaemic population the duration of last hospitalisation was longer in patients who had erythrocyte transfusion (15 days vs 8 days, p<0.001).
Patients who had blood transfusion at the end of life lived significantly longer than the anaemic patients who were not transfused. This study remarks that blood transfusions should not be withheld from terminal cancer patients in palliative care.
贫血的治疗是姑息治疗中的一个重要问题。在支持性治疗中，输血通常用于此目的。然而，输血在晚期癌症患者中的地位尚未完全确立。
我们旨在概述输血的使用情况，并探讨输血对晚期癌症且濒临死亡患者生存的影响。
本研究纳入了2010 - 2011年死于晚期癌症的患者。我们回顾性收集了包括年龄、癌症类型、最后一次住院时间、东部肿瘤协作组（ECOG）体能状态、血红蛋白水平、红细胞和血小板输血史、输血原因及输血量等数据。将入院时接受输血的贫血患者与未输血的患者组进行比较。生存时间定义为最后一次住院入院至死亡的时间。
2010 - 2011年，我们诊所共有398例实体瘤患者死亡。90%的患者在最后一次住院时患有贫血。153例患者在最后一次住院期间入院时接受了红细胞输血（38.4%）。在贫血人群中，接受红细胞输血的患者最后一次住院时间更长（15天对8天，p<0.001）。
临终时接受输血的患者比未输血的贫血患者存活时间显著更长。本研究表明，在姑息治疗中，不应拒绝为晚期癌症患者输血。
