在姑息治疗下的头颈部鳞状细胞癌患者中，格拉斯哥预后评分和姑息预后指数的效用。
The Utility of Glasgow Prognostic Score and Palliative Prognostic Index in Patients With Head and Neck Squamous Cell Carcinoma Under Palliative Care.
机构信息
Department of Otolaryngology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Division of Head and Neck and Thyroid Oncology, National Hospital Organization Shikoku Cancer Center, Ehime, Japan.
出版信息
Ear Nose Throat J. 2023 Jun;102(6):379-384. doi: 10.1177/01455613211005114. Epub 2021 Mar 26.
OBJECTIVES
Palliative care patients with head and neck squamous cell carcinoma (HNSCC) often experience dysphagia and airway trouble; thus, each patient requires a specific palliative care plan based on their prognostication. However, no established specific prognostic tool performed on the day of starting end-of-life care is available for such patients. We assessed the accuracy of Glasgow prognostic score (GPS) and palliative prognostic index (PPI) and their combination to establish a specified prognostic tool for patients with HNSCC in end-of-life setting.
METHODS
A retrospective clinical chart review was undertaken on patients with HNSCC in end-of life setting who were decided in Kagawa University Hospital and National Hospital Organization Shikoku Cancer Center between April 2011 and March 2019. The patients were divided into 2 categories according to GPS (0-1 and 2) and PPI (groups A-B and C). These were combined into 4 categories (PPI group A-B and GPS score 0-1: good; PPI group A-B and GPS score 2: intermediate; PPI group C and GPS score 2: poor; and PPI group C and GPS score 0-1: others). The survival curves were compared for the former 3 categories.
RESULTS
The median survival of the scores 0-1 and 2 on GPS were 114 (72-148) and 39 (25-52) days, respectively ( < .01). These of groups A-B and C on PPI were 79 (64-99) and 16 (9-29) days, respectively ( < .01). The median survival of the good, intermediate, and poor categories was 127 (73-149), 64 (44-80), and 15 (9-27) days, respectively ( < .01 among all categories).
CONCLUSIONS
In this study, the survival of terminally ill patients with HNSCC can be predicted by the GPS, PPI, and their combination with sufficient probability.
目的
头颈部鳞状细胞癌（HNSCC）的姑息治疗患者常出现吞咽困难和气道问题；因此，每位患者都需要根据其预后制定特定的姑息治疗计划。然而，目前尚无针对此类患者在临终关怀开始时进行的既定特定预后工具。我们评估了格拉斯哥预后评分（GPS）和姑息预后指数（PPI）及其组合在确定 HNSCC 终末期患者特定预后工具方面的准确性。
方法
对 2011 年 4 月至 2019 年 3 月在香川县立医科大学医院和日本国立癌症中心组织志古癌症中心接受治疗的 HNSCC 临终患者进行回顾性临床病历回顾。根据 GPS（0-1 和 2）和 PPI（A-B 和 C 组）将患者分为 2 类。将这些组合成 4 类（PPI 组 A-B 和 GPS 评分 0-1：良好；PPI 组 A-B 和 GPS 评分 2：中等；PPI 组 C 和 GPS 评分 2：差；和 PPI 组 C 和 GPS 评分 0-1：其他）。比较了前 3 类的生存曲线。
结果
GPS 评分 0-1 和 2 的中位生存时间分别为 114（72-148）和 39（25-52）天（<0.01）。PPI 的 A-B 和 C 组分别为 79（64-99）和 16（9-29）天（<0.01）。良好、中等和差的中位生存时间分别为 127（73-149）、64（44-80）和 15（9-27）天（所有类别之间均<0.01）。
结论
在这项研究中，通过 GPS、PPI 及其组合可以以足够的概率预测晚期 HNSCC 患者的生存情况。
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