Kinahan Holly, Maiti Abhishek, Hess Kenneth, Dempsey Jennifer, Beatty Laura, Baldwin Sarah, Hong David S, Naing Aung, Fu Siqing, Tsimberidou Apostolia M, Piha-Paul Sarina, Janku Filip, Karp Daniel, Reddy Suresh, Yennu Sriram, Epner Daniel, Bruera Eduardo, Meric-Bernstam Funda, Falchook Gerald, Subbiah Vivek
Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Oncology. 2017;92(1):14-20. doi: 10.1159/000449505. Epub 2016 Nov 2.
Patients with advanced cancer who progress on standard therapy are potential candidates for phase I clinical trials. Due to their aggressive disease and complex comorbid conditions, these patients often need inpatient admission. This study assessed the outcomes of such patients after they were discharged to hospice care.
We performed a retrospective analysis of patients with solid tumor malignancies who were discharged to hospice care from the inpatient service.
One hundred thirty-three patients were included in the study cohort. All patients had metastatic disease and an Eastern Cooperative Oncology Group performance status ≥3. The median survival after discharge to hospice from an inpatient setting was 16 days, with a survival rate of 5% at 3 months after discharge. The median survival after the last cancer treatment was 46 days, with survival of 17% at 3 months, and 5% at 6 months. Patients with lactate dehydrogenase (LDH) >618 IU/L had a median post-discharge survival of 11 days versus 20 days for patients with LDH ≤618 IU/L.
Patients with metastatic cancer participating in phase I trials who have poor performance status and require inpatient admission have a very short survival after discharge to hospice. A high LDH level predicts an even shorter survival.
在标准治疗中病情进展的晚期癌症患者是I期临床试验的潜在候选人。由于其病情侵袭性强且合并症复杂，这些患者常需住院治疗。本研究评估了此类患者出院后接受临终关怀的结局。
我们对从住院部出院后接受临终关怀的实体瘤恶性肿瘤患者进行了回顾性分析。
133例患者纳入研究队列。所有患者均有转移性疾病，东部肿瘤协作组体能状态≥3。从住院环境出院至临终关怀后的中位生存期为16天，出院后3个月生存率为5%。最后一次癌症治疗后的中位生存期为46天，3个月生存率为17%，6个月生存率为5%。乳酸脱氢酶（LDH）>618 IU/L的患者出院后中位生存期为11天，而LDH≤618 IU/L的患者为20天。
参加I期试验、体能状态差且需住院治疗的转移性癌症患者出院后接受临终关怀的生存期非常短。高LDH水平预示生存期更短。
