Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Department of Medical Informatics and Clinical Epidemiology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Cancer Control. 2024 Jan-Dec;31:10732748241305234. doi: 10.1177/10732748241305234.
This study aimed to describe the course of patients with lung cancer from treatment initiation to end-of-life.
This retrospective cohort study used Claims Data from the National Health Insurance and Advanced Elderly Medical Service System. We analyzed data from patients newly diagnosed with lung cancer between April 2013 and March 2021 who had been hospitalized at our University Hospital in urban area. We evaluated (1) treatment courses of these patients, and (2) end-of-life care and clinical factors related to end-of-life care.
A total of 818 patients who were diagnosed with lung cancer and received lung cancer treatment were included, of whom 200 were assessed for end-of-life. During the study period, 464 patients underwent surgery, while 308 received chemotherapy without undergoing surgery. The patients generally received lung cancer treatment within 2 years. The median time from initial treatment to death was 13 months for deceased patients. Patients in the palliative care unit (PCU) constituted 9% at 30 days before death, 25% at 7 days before death, and 40.5% on the day of death, whereas only 15% died at home. The prevalence of end-of-life care in the home/PCU was elevated among patients receiving molecular targeted drugs and in the female group.
This study highlighted the patterns of end-of-life care following lung cancer treatment by using Claims Data. PCU utilization was concentrated in the period shortly before death, with fewer patients passing away at home. End-of-life care may be influenced by clinical factors, including the type of lung cancer treatment received, which may change the place of care.
本研究旨在描述肺癌患者从治疗开始到临终的病程。
这是一项回顾性队列研究，使用了全民健康保险和高级老年医疗服务系统的理赔数据。我们分析了 2013 年 4 月至 2021 年 3 月期间在我们大学附属医院新诊断为肺癌且住院的患者的数据。我们评估了（1）这些患者的治疗过程，以及（2）临终关怀和与临终关怀相关的临床因素。
共纳入 818 例诊断为肺癌并接受肺癌治疗的患者，其中 200 例评估为临终。在研究期间，464 例患者接受了手术，308 例患者接受了化疗但未接受手术。患者通常在 2 年内接受肺癌治疗。死亡患者从初始治疗到死亡的中位时间为 13 个月。在死亡前 30 天，9%的患者在姑息治疗病房（PCU），死亡前 7 天为 25%，死亡当天为 40.5%，而只有 15%的患者在家中死亡。接受分子靶向药物治疗和女性患者的家庭/PCU 临终关怀比例较高。
本研究利用理赔数据强调了肺癌治疗后临终关怀的模式。PCU 的使用集中在死亡前的短时间内，在家中死亡的患者较少。临终关怀可能受到临床因素的影响，包括所接受的肺癌治疗类型，这可能会改变护理地点。
