5803Memorial Sloan Kettering Cancer Center, New York, NY, USA.
J Intensive Care Med. 2022 Oct;37(10):1305-1311. doi: 10.1177/08850666211065993. Epub 2021 Dec 13.
To investigate the intent of, and reason for, administration of oncologic therapies in the intensive care unit (ICU).
Single center, retrospective, cohort study of patients with cancer who received oncologic therapies at a tertiary cancer center ICU between April 1, 2019 and March 31, 2020. Oncologic therapies included traditional cytotoxic chemotherapy, targeted therapy, immunotherapy, hormonal or biologic therapy directed at a malignancy and were characterized as initiation (initial administration) or continuation (part of an ongoing regimen).
84 unique patients (6.8% of total ICU admissions) received oncologic therapies in the ICU; 43 (51%) had hematologic malignancies and 41 (49%) had solid tumors. The intent of oncologic therapy was palliative in 63% and curative in 27%. Twenty-two (26%) patients received initiation and 62 (74%) received continuation oncologic therapies. The intent of oncologic therapy was significantly different by regimen type (initiation vs. continuation, p = <0.0001). Initiation therapy was more commonly prescribed with curative intent and continuation therapy was more commonly administered with palliative intent (p = <0.0001). Oncologic therapies were given in the ICU mainly for an oncologic emergency (56%) and because the patients happened to be in the ICU for a non-oncologic critical illness when their oncologic therapy was due (34.5%).
Our study provides intensivists with a better understanding of the context and intent of oncologic therapies and why these therapies are administered in the ICU.
调查在重症监护病房（ICU）中给予肿瘤治疗的意图和原因。
这是一项单中心、回顾性队列研究，纳入 2019 年 4 月 1 日至 2020 年 3 月 31 日期间在一家三级癌症中心 ICU 接受肿瘤治疗的癌症患者。肿瘤治疗包括传统细胞毒性化疗、靶向治疗、免疫治疗、针对恶性肿瘤的激素或生物治疗，其特征为起始（初始给药）或继续（正在进行的治疗方案的一部分）。
84 例（占 ICU 总入院人数的 6.8%）患者在 ICU 接受了肿瘤治疗；43 例（51%）患有血液系统恶性肿瘤，41 例（49%）患有实体瘤。肿瘤治疗的目的是姑息性的占 63%，根治性的占 27%。22 例（26%）患者接受起始治疗，62 例（74%）接受继续肿瘤治疗。治疗方案类型（起始治疗与继续治疗）显著影响治疗目的（p<0.0001）。起始治疗更常用于根治性目的，而继续治疗更常用于姑息性目的（p<0.0001）。在 ICU 中给予肿瘤治疗主要是因为肿瘤急症（56%），以及当患者因非肿瘤性急危重症而入住 ICU 时，其肿瘤治疗即将进行（34.5%）。
本研究使重症监护医生更好地了解 ICU 中肿瘤治疗的背景和目的，以及为何在 ICU 中给予这些治疗。
