早期姑息治疗可改善淋巴瘤患者的总生存率：单中心回顾性研究。
Early Palliative Care Improves Overall Survival in Patients With Lymphoma: A Single-institution Retrospective Study.
机构信息
Department of Clinical Pharmacy, Fujita Health University, Toyoake, Japan.
Department of Pharmacy, Fujita Health University Hospital, Toyoake, Japan.
出版信息
In Vivo. 2022 Nov-Dec;36(6):2910-2917. doi: 10.21873/invivo.13032.
BACKGROUND/AIM: Early palliative care (EPC) intervention in patients with solid tumors can provide many benefits. However, studies on patients with hematological malignancies are limited, and there is no data on patients with lymphoma. We conducted a preliminary retrospective survey of palliative care (PC) intervention in patients with lymphoma to clarify the effect of EPC on overall survival (OS).
PATIENTS AND METHODS
The first palliative care consultation (PC1) was retrospectively reviewed from medical records in Japan. Patients with lymphoma requiring inpatient PC at our institution from January 2012 to December 2018 were recruited. We conducted receiver operating characteristic (ROC) analysis; patients were divided into two groups (early and delayed), and the survival periods and palliative care team (PCT) referral details were compared.
RESULTS
The analysis included 77 patients with lymphoma [median age, 71 (64-79)] years. The median period to PC1 from the initial diagnosis was 395 (180-1,086) days. ROC analysis revealed an optimal PC intervention timing of 140 days. OS was significantly longer in the early group than that in the delayed group. The most common counseling details for the PCT were symptom relief and palliative care transfer (36.8% and 35.2%, respectively).
CONCLUSION
This real-world evaluation of PC intervention for inpatients with lymphoma revealed that PC intervention was provided at approximately 13 months following initial diagnosis. EPC intervention from diagnosis to 140 days may improve OS in patients with lymphoma; however further large-scale studies are required to verify this finding.
背景/目的：早期姑息治疗（EPC）干预实体瘤患者可以带来许多益处。然而，血液恶性肿瘤患者的相关研究有限，并且尚无淋巴瘤患者的相关数据。我们对淋巴瘤患者的姑息治疗（PC）干预进行了初步回顾性调查，以明确 EPC 对总生存期（OS）的影响。
患者和方法
从日本的病历中回顾性地审查了第一次姑息治疗咨询（PC1）。我们招募了在 2012 年 1 月至 2018 年 12 月期间在我院因淋巴瘤需要住院 PC 的患者。我们进行了接收者操作特征（ROC）分析；将患者分为两组（早期和延迟），比较了生存期和姑息治疗团队（PCT）转介详情。
结果
分析包括 77 例淋巴瘤患者[中位年龄，71（64-79）]岁。从初诊到 PC1 的中位时间为 395（180-1086）天。ROC 分析显示，最佳的 PC 干预时机为 140 天。早期组的 OS 明显长于延迟组。PCT 最常见的咨询细节是症状缓解和姑息治疗转介（分别为 36.8%和 35.2%）。
结论
本研究对住院淋巴瘤患者的 PC 干预进行了真实世界的评估，结果表明，在初始诊断后大约 13 个月开始进行 PC 干预。从诊断到 140 天进行 EPC 干预可能会改善淋巴瘤患者的 OS；然而，需要进一步的大规模研究来验证这一发现。
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