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化疗后癌症幸存者潜在并发症的检测及区域护理网络的建立:PASCA可行性研究

Detection of potential complications in cancer survivors after chemotherapy and development of a regional care network: the PASCA feasibility study.

作者信息

Buono Romain, Pérol Olivia, Djebali Meyssane, Borja Mélodie, Abadie Alicia, Morisset Stéphane, Michallet Anne-Sophie, Fléchon Aude, Boyle Helen, Nicolas-Virelizier Emmanuelle, Rey Philippe, Guillermin Yann, Assaad Souad, Belhabri Amine, Lebras Laure, Blay Jean-Yves, Fervers Béatrice, Michallet Mauricette

机构信息

Department of Prevention, Cancer and Environment, Léon Bérard Cancer Center, Lyon, France.

Department of Medical Oncology, Léon Bérard Cancer Center, Lyon, France.

出版信息

Front Med (Lausanne). 2025 Mar 4;12:1469930. doi: 10.3389/fmed.2025.1469930. eCollection 2025.

Abstract

Complications are often poorly identified and managed in cancer survivors after treatment and restoring their initial quality of life remains a challenge, particularly in a context of unequal access to care nationwide. The PASCA "Parcours de Santé au cours du Cancer [in English: healthcare pathways with cancer]" feasibility study was conducted in the Léon Bérard Comprehensive Cancer Center (Lyon, France) to assess the feasibility of a complications detection program, in cancer survivors who have received intensive chemotherapy. An initial network of physicians and healthcare professionals was also set up to facilitate medical referrals after detection. The study had a high recruitment rate (83.8%) and an adherence rate of 43%. In our analysis population ( = 98), 8% presented dermatological, cardiological, and pneumological complications. Of these, 42 completed all program visits. Among them, the number of patients who developed a ≥ grade 2 complication increased between the first and last visits in: nephrology (+13.9%), overweight/obesity (+12.5%), endocrinology (+8.3%) and cardiology (+5.6%). Patient satisfaction was high (68%). The results supported the feasibility of a complication detection program and highlighted the presence of complications at the first visit, as well as an increase in the number of patients developing complication in four areas between the first and last visit. In the future, after-treatment programs could be improved by increasing the motivation of the referring oncologists and patients, improving communication and by adapting the follow-up visits to take into consideration the constraints and profiles of the cancer survivors.

摘要

在癌症幸存者接受治疗后,并发症往往难以被识别和处理,恢复他们最初的生活质量仍然是一项挑战,尤其是在全国医疗服务获取不平等的背景下。PASCA(法语“Parcours de Santé au cours du Cancer”,英语“healthcare pathways with cancer”,即“癌症治疗期间的健康路径”)可行性研究在法国里昂的莱昂·贝拉尔综合癌症中心开展,旨在评估针对接受强化化疗的癌症幸存者的并发症检测项目的可行性。还建立了一个由医生和医疗保健专业人员组成的初始网络,以便在检测到并发症后促进医疗转诊。该研究的招募率很高(83.8%),依从率为43%。在我们的分析人群(n = 98)中,8%出现了皮肤、心脏和肺部并发症。其中,42人完成了项目的所有访视。在这些人中,在第一次和最后一次访视之间,出现≥2级并发症的患者数量在以下科室有所增加:肾病科(+13.9%)、超重/肥胖(+12.5%)、内分泌科(+8.3%)和心脏科(+5.6%)。患者满意度较高(68%)。研究结果支持了并发症检测项目的可行性,并突出了首次访视时并发症的存在,以及在第一次和最后一次访视之间四个领域出现并发症的患者数量有所增加。未来,后续治疗项目可以通过提高转诊肿瘤学家和患者的积极性、改善沟通以及调整随访访视以考虑癌症幸存者的限制因素和特征来加以改进。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c48b/11914117/4f7674944217/fmed-12-1469930-g001.jpg

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