Wata Clinic, Junyuu-Kai Medical Corporation, Tokyo, Japan.
Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan.
Support Care Cancer. 2024 Oct 28;32(11):748. doi: 10.1007/s00520-024-08946-w.
Adolescents and young adults (AYA) with cancer require highly individualized, age-specific end-of-life care. This study identified the characteristics of AYA patients with cancer receiving home-based palliative care and explored their unique needs and challenges compared with other age groups.
This retrospective cohort study analyzed the medical records of AYA patients with cancer to compare home-based palliative care characteristics with those of older age groups. The study included 81 AYA patients with cancer aged 16-39 years who had received home palliative care at a single institution from 2013 to 2023. They were compared with 5,017 patients with cancer aged 40 years and older. Patient background, duration of home end-of-life care, sedation, and association with social factors were examined retrospectively from medical records.
The median age of AYA patients with cancer was 34 years; 65.4% were female. The primary cancer sites were gastrointestinal (34.6%) and thoracic (23.5%), with 80.0% at Stage IV. The median home care duration was 28.5 days, shorter than that for older patients (40 days) (p < 0.0001). Home care rates were similar between AYA and older patients (82.4% vs. 79.9%, p = 0.16). Sedation was more common in the 30-39 age group than in the 16-29 group (33.3% vs. 6.3%, p = 0.049).
AYA patients with cancer achieved a high rate of end-of-life care at home, although their duration of home care was shorter. The characteristics of home care varied depending on the primary site and age, highlighting the importance of creating highly individualized care plans.
青少年和年轻成人（AYA）癌症患者需要高度个体化、特定于年龄的临终关怀。本研究旨在确定接受居家姑息治疗的 AYA 癌症患者的特征，并与其他年龄组相比，探讨他们独特的需求和挑战。
本回顾性队列研究分析了癌症 AYA 患者的病历，以比较居家姑息治疗的特征与其他年龄组的特征。研究纳入了 2013 年至 2023 年期间在一家机构接受居家姑息治疗的 81 名年龄在 16-39 岁的 AYA 癌症患者，并与 5017 名年龄在 40 岁及以上的癌症患者进行了比较。从病历中回顾性地检查了患者背景、居家临终关怀持续时间、镇静以及与社会因素的关联。
癌症 AYA 患者的中位年龄为 34 岁，女性占 65.4%。主要癌症部位为胃肠道（34.6%）和胸部（23.5%），80.0%为 IV 期。中位居家护理时间为 28.5 天，短于老年患者（40 天）（p<0.0001）。AYA 患者与老年患者的居家护理率相似（82.4% vs. 79.9%，p=0.16）。30-39 岁年龄组的镇静发生率高于 16-29 岁年龄组（33.3% vs. 6.3%，p=0.049）。
尽管 AYA 癌症患者的居家护理时间较短，但他们在家中接受临终关怀的比例很高。居家护理的特点因原发部位和年龄而异，这突出了制定高度个体化护理计划的重要性。
