Sun Virginia, Cooke Liz, Chung Vincent, Uman Gwen, Smith Thomas J, Ferrell Betty
1 Division of Nursing Research and Education , Department of Population Sciences, City of Hope, Duarte, California.
J Palliat Med. 2014 Dec;17(12):1365-8. doi: 10.1089/jpm.2014.0108.
Cancer patients with advanced disease who have exhausted most treatment options are often offered participation in Phase I clinical trials. To date, studies that assess the benefits of palliative care provided concurrently in Phase I clinical trial settings are lacking. The overall purpose of this study was to test the feasibility of a palliative care intervention administered concurrently to cancer patients receiving treatment in a Phase I clinical trial.
Cancer patients enrolling in a Phase I clinical trial were invited to participate in this study. Patients completed baseline questionnaires prior to treatment initiation that assessed quality of life (QOL), symptom distress, psychological distress, and satisfaction with care. Patients then received the palliative care intervention (PCI), which consisted of comprehensive QOL assessment, care planning for the patient during an interdisciplinary team meeting, and two patient education sessions. Patients were surveyed again at 1 and 2 months following treatment initiation.
A total of 14 patients were accrued to the pilot over a 3-month time period, representing 70% of eligible patients. Patient retention was high at 1 month (75%), and had declined at 2 months (50%). Patient outcome measure scores, including symptom distress, psychological distress, and satisfaction with care, were relatively stable over time, except for overall QOL, which declined over time.
Concurrent palliative care is feasible for cancer patients treated in Phase I clinical trial settings. A large, multisite randomized controlled trial based on this pilot will be launched to test the efficacy of the intervention in this understudied cancer population.
患有晚期疾病且已用尽大多数治疗方案的癌症患者通常会被邀请参与I期临床试验。迄今为止,缺乏评估在I期临床试验环境中同时提供姑息治疗益处的研究。本研究的总体目的是测试在I期临床试验中同时对接受治疗的癌症患者实施姑息治疗干预措施的可行性。
邀请参加I期临床试验的癌症患者参与本研究。患者在开始治疗前完成基线问卷调查,评估生活质量(QOL)、症状困扰、心理困扰和护理满意度。然后患者接受姑息治疗干预(PCI),包括全面的生活质量评估、在跨学科团队会议期间为患者制定护理计划以及两次患者教育课程。在开始治疗后的1个月和2个月再次对患者进行调查。
在3个月的时间内,共有14名患者被纳入该试点研究,占符合条件患者的70%。1个月时患者留存率较高(75%),2个月时有所下降(50%)。患者结局测量分数,包括症状困扰、心理困扰和护理满意度,随时间相对稳定,除了总体生活质量随时间下降。
在I期临床试验环境中接受治疗的癌症患者同时接受姑息治疗是可行的。将基于该试点开展一项大型、多中心随机对照试验,以测试该干预措施在这个研究不足的癌症人群中的疗效。