Jomar Rafael Tavares, Marques Jéssica Thaís Nascimento, Oliveira Livia Costa de, Mendes Gelcio Luiz Quintella, Cunha Daianny Arrais de Oliveira da, Guimarães Raphael Mendonça
Instituto Nacional de Câncer (INCA), Rio de Janeiro, RJ, Brazil.
Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.
Einstein (Sao Paulo). 2024 Sep 30;22:eAO0536. doi: 10.31744/einstein_journal/2024AO0536. eCollection 2024.
Jomar et al. demonstrated that death due to COVID-19 did not affect the time under exclusive palliative care among patients with advanced cancer, even during the first year of the pandemic caused by a hitherto little-known disease.
◼ Fatality due to COVID-19 does not alter the time under oncological palliative care.
◼ The retrospective design of this pioneering study allows causal inference.
◼ Access to oncological palliative care frequently approaches terminality of life.
This study aimed at investigating the extent to which COVID-19-induced fatalities affect the duration of palliative care among patients with advanced cancer.
A retrospective cohort study was conducted at the Palliative Care Unit of the Brazilian Instituto Nacional de Câncer in Rio de Janeiro, Brazil, on 1,104 advanced cancer patients who died under exclusive palliative care between March 11, 2020, and March 31, 2021. Wilcoxon rank-sum (Mann-Whitney U) and log-rank tests were performed to examine statistical differences between the medians of time, and the Kaplan-Meier estimator was used to graphically illustrate survival over time under exclusive palliative care contingent upon the underlying causes of death of the two experimental groups (cancer versus COVID-19).
A total of 133 (12.05%) patients succumbed to COVID-19. In both groups, the median time under exclusive palliative care was less than one month. The exclusive palliative care survival curves did not exhibit any statistically significant difference between the groups.
Death due to COVID-19 did not modify the duration of exclusive palliative care among patients with advanced cancer.
乔马尔等人证明，即使在由一种此前鲜为人知的疾病引发的大流行的第一年，因新冠病毒疾病（COVID-19）导致的死亡也未影响晚期癌症患者接受专门姑息治疗的时间。
◼ 因COVID-19导致的死亡并未改变肿瘤姑息治疗的时间。
◼ 这项开创性研究的回顾性设计允许进行因果推断。
◼ 获得肿瘤姑息治疗常常接近生命终末期。
本研究旨在调查COVID-19导致的死亡对晚期癌症患者姑息治疗持续时间的影响程度。
在巴西里约热内卢的巴西国家癌症研究所姑息治疗科，对2020年3月11日至2021年3月31日期间在专门姑息治疗下死亡的1104例晚期癌症患者进行了一项回顾性队列研究。采用威尔科克森秩和检验（曼-惠特尼U检验）和对数秩检验来检验时间中位数之间的统计学差异，并使用卡普兰-迈耶估计量来直观展示在专门姑息治疗下两组（癌症与COVID-19）基于潜在死亡原因的随时间的生存情况。
共有133例（12.05%）患者死于COVID-19。两组中，专门姑息治疗的中位时间均少于1个月。两组之间专门姑息治疗的生存曲线未显示出任何统计学上的显著差异。
因COVID-19导致的死亡并未改变晚期癌症患者专门姑息治疗的持续时间。
