Pancreatic Cancer Action Network, Manhattan Beach, CA.
Cancer Research and Biostatistics, Seattle, WA.
Pancreas. 2019 Jul;48(6):780-786. doi: 10.1097/MPA.0000000000001330.
Pancreatic cancer (PC) and its treatments can result in pancreatic exocrine insufficiency that requires pancreatic enzyme replacement therapy (PERT). Appropriate PERT usage is during meals and snacks. The aim was to determine the frequency of appropriate use of PERT and its impact on symptom alleviation in PC through a patient-reported outcomes online platform.
Users in the Pancreatic Cancer Action Network's Patient Registry were prompted to answer a standalone questionnaire about their experience with PERT.
Two hundred sixty-two users completed the PERT questionnaire (January 2016-January 2018). Patients who reported taking PERT with meals had higher alleviation of symptoms compared with those taking PERT prior to or after meals. Specifically, "feeling of indigestion," "light-colored or orange stools," and "visible food particles in stool" were significantly decreased. Patients taking PERT with meals reported weight gain and less weight loss.
Of the 89% of PC patients prescribed PERT, 65% were prescribed PERT appropriately with all meals and snacks. Overall compliance with PERT administration guidelines was low (50% [105/208]). Improvement in symptoms significantly correlated with appropriate use of PERT. Increase in PC patient and provider education about appropriate PERT usage and administration is warranted.
胰腺癌（PC）及其治疗方法可导致胰腺外分泌功能不全，需要胰酶替代治疗（PERT）。PERT 的适当使用是在进餐和小吃期间。本研究旨在通过患者报告的在线平台来确定 PERT 的适当使用频率及其对 PC 症状缓解的影响。
胰腺癌行动网络（Pancreatic Cancer Action Network）患者登记处的用户被提示回答一个关于其 PERT 经验的独立问卷。
262 名用户完成了 PERT 问卷（2016 年 1 月至 2018 年 1 月）。与在用餐前后服用 PERT 的患者相比，报告在用餐时服用 PERT 的患者症状缓解程度更高。具体而言，“消化不良感”、“浅色或橙色粪便”和“粪便中可见食物颗粒”明显减少。在用餐时服用 PERT 的患者报告体重增加和体重减轻较少。
在 89%的接受 PERT 治疗的 PC 患者中，65%的患者接受了适当的治疗，包括所有的餐食和小吃。PERT 管理指南的总体依从性较低（50%[105/208]）。症状的改善与 PERT 的适当使用显著相关。需要增加对 PC 患者和提供者关于适当的 PERT 使用和管理的教育。
