Department of Hematology, Oncology, and Tumor Immunology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany.
Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Centre for Musculoskeletal Surgery, Campus Virchow-Klinikum, Berlin, Germany.
BMC Palliat Care. 2021 Jan 14;20(1):16. doi: 10.1186/s12904-020-00702-1.
Soft tissue sarcomas (STS) account for less than 1% of all malignancies. Approximately 50% of the patients develop metastases with limited survival in the course of their disease. For those patients, palliative treatment aiming at symptom relief and improvement of quality of life is most important. However, data on symptom burden and palliative intervention are limited in STS patients.
Our study evaluates the effectiveness of a palliative care intervention on symptom relief and quality of life in STS patients.
DESIGN/SETTING: We retrospectively analysed 53 inpatient visits of 34 patients with advanced STS, admitted to our palliative care unit between 2012 and 2018. Symptom burden was measured with a standardised base assessment questionnaire at admission and discharge.
Median disease duration before admission was 24 months, 85% of patients had metastases. The predominant indication for admission was pain, weakness and fatigue. Palliative care intervention led to a significant reduction of pain: median NRS for acute pain was reduced from 3 to 1 (p < 0.001), pain within the last 24 h from 5 to 2 (p < 0.001) and of the median MIDOS symptom score: 18 to 13 (p < 0.001). Also, the median stress level, according to the distress thermometer, was reduced significantly: 7.5 to 5 (p = 0.027).
Our data underline that specialised palliative care intervention leads to significant symptom relief in patients with advanced STS. Further efforts should aim for an early integration of palliative care in these patients focusing primarily on the identification of subjects at high risk for severe symptomatic disease.
软组织肉瘤（STS）占所有恶性肿瘤的不到 1%。大约 50%的患者在疾病过程中发生转移，生存时间有限。对于这些患者，以缓解症状和提高生活质量为目标的姑息治疗最为重要。然而，STS 患者的症状负担和姑息干预数据有限。
我们的研究评估了姑息治疗干预对晚期 STS 患者症状缓解和生活质量的影响。
设计/设置：我们回顾性分析了 2012 年至 2018 年间我院姑息治疗科收治的 34 例晚期 STS 患者的 53 例住院患者的资料。入院和出院时采用标准化基础评估问卷测量症状负担。
入院前疾病持续时间中位数为 24 个月，85%的患者有转移。入院的主要指征是疼痛、虚弱和疲劳。姑息治疗干预导致疼痛显著减轻：急性疼痛的中位数 NRS 从 3 降至 1（p<0.001），过去 24 小时内疼痛从 5 降至 2（p<0.001），以及中位数 MIDOS 症状评分从 18 降至 13（p<0.001）。此外，根据痛苦温度计，中位数应激水平显著降低：从 7.5 降至 5（p=0.027）。
我们的数据表明，专业的姑息治疗干预可显著缓解晚期 STS 患者的症状。应进一步努力，将姑息治疗尽早纳入这些患者，重点关注识别有严重症状疾病高风险的患者。
