Department of Radiation Oncology, Chi Mei Medical Center, Liouying, Tainan, Taiwan.
Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan.
Palliat Med. 2023 Jun;37(6):824-833. doi: 10.1177/02692163231152526. Epub 2023 Feb 15.
Palliative care has historically been under-utilized in patients with glioblastoma. Furthermore, literature on the utilization of healthcare and life-sustaining interventions during the late-stage of glioblastoma has been limited.
To identify and compare healthcare utilization and life-sustaining interventions between patients with glioblastoma who received palliative care and who did not based on patients identified retrospectively from Taiwan Cancer Registry between January 2007 and December 2017.
In this study, palliative care was defined on the basis of claims submitted to the National Health Insurance, which has a specific code for it. Variables included demographic characteristics, the utilization of healthcare services, and invasive life-sustaining interventions.
SETTING/PARTICIPANTS: Of the 1994 patients with glioblastoma identified, 1784 fulfilled the inclusion criteria, 613 (34%) of whom received palliative care.
The survival of patients with glioblastoma under palliative care was significantly longer than that of those without palliative care. Those without palliative care had significantly more frequent intensive care unit admissions and a longer cumulative length of intensive care unit stay. Regarding cardiopulmonary or respiratory treatments, patients without palliative care had significantly more invasive interventions than those with palliative care. Patients receiving palliative care had significantly lower odds than those without life-sustaining interventions.
Our retrospective analysis reveals that glioblastoma patients without palliative care had greater odds of receiving life-sustaining treatments within 1 year before their death, although no gains in survival as compared to those that received palliative care. These findings highlight the urgent need for palliative care in caring for patients with glioblastoma.
在胶质母细胞瘤患者中，姑息治疗的应用历史上一直不足。此外，关于胶质母细胞瘤晚期使用医疗保健和维持生命干预措施的文献也很有限。
根据 2007 年 1 月至 2017 年 12 月从台湾癌症登记处回顾性确定的患者，确定并比较接受姑息治疗和未接受姑息治疗的胶质母细胞瘤患者的医疗保健利用和维持生命的干预措施。
本研究中，姑息治疗是根据向国家健康保险提交的索赔来定义的，该保险有一个专门的代码。变量包括人口统计学特征、医疗保健服务的利用情况和侵入性维持生命的干预措施。
地点/参与者：在确定的 1994 例胶质母细胞瘤患者中，1784 例符合纳入标准，其中 613 例（34%）接受了姑息治疗。
接受姑息治疗的胶质母细胞瘤患者的生存时间明显长于未接受姑息治疗的患者。未接受姑息治疗的患者 ICU 入院次数明显更多，累积 ICU 住院时间也更长。关于心肺或呼吸治疗，未接受姑息治疗的患者比接受姑息治疗的患者有更多的侵入性干预措施。接受姑息治疗的患者比未接受维持生命治疗的患者接受维持生命治疗的可能性显著降低。
我们的回顾性分析表明，在死亡前 1 年内，未接受姑息治疗的胶质母细胞瘤患者接受维持生命治疗的可能性更大，尽管与接受姑息治疗的患者相比，他们的生存没有改善。这些发现强调了在照顾胶质母细胞瘤患者时急需姑息治疗。
