目的:恶性胸膜间皮瘤(MPM)是一种侵袭性癌,潜伏期长,预后差。最近发表了国际患者队列中MPM的真实世界治疗模式和人文负担。西班牙的数据目前缺乏,在这里报道。
方法:数据从三个来源收集:医生抽象的人口统计,MPM患者的临床和治疗特征;患者完成的治疗满意度问卷,症状,护理人员使用,和疾病的影响;以及护理人员填写的问卷,报告他们的活动及其对日常生活的影响。
结果:西班牙的241例患者主要是老年人(中位年龄:67岁),男性,退休/失业/长期病假,并在IV期诊断出不可切除的疾病。检测到接触石棉(54%,101/188)。一线治疗(1L)主要包括双重化疗(86%,207/241)。在102名在数据抽象时完成1L的患者中,67人接受维持治疗,最常见的单态化疗与培美曲塞。为29名患者提供了最佳的支持治疗,主要在1L后(86.2%,25/29).症状负担较高,与健康相关的生活质量较差,并且随着进展而下降:1L的平均(SD)EQ-5D评分和EQ-5D视觉模拟评分分别为0.615(0.285)和60.8(17.1),二线为0.497(0.370)和56.1(19.5)。总的来说,67%的患者(162/241)需要护理人员的日常帮助。报告了对他们心理健康的影响。
结论:西班牙的MPM患者根据当时的治疗指南进行总体治疗。然而,患者和护理人员报告了相当大的疾病负担.
OBJECTIVE: Malignant pleural mesothelioma (MPM) is an aggressive cancer with long latency and poor prognosis. The real-world treatment patterns and humanistic burden of MPM in an international cohort of patients were recently published. Spanish data are currently lacking and are reported here.
METHODS: Data were collected from three sources: physician-abstracted demographic, clinical and treatment characteristics of patients with MPM; patient-completed questionnaires on treatment satisfaction, symptoms, caregiver use, and impact of the disease; and caregiver-completed questionnaire reporting their activity and its impact on their daily life.
RESULTS: The 241 patients in Spain were primarily elderly (median age: 67 years), male, retired/unemployed/on long-term sick leave, and diagnosed at stage IV with unresectable disease. Exposure to asbestos was detected (54%, 101/188). First-line treatment (1L) consisted primarily of doublet chemotherapy (86%, 207/241). Of 102 patients who completed 1L at data abstraction, 67 were receiving maintenance therapy, most commonly singlet chemotherapy with pemetrexed. Best supportive care was given to 29 patients, primarily after 1L (86.2%, 25/29). Symptom burden was high and health-related quality of life was poor and declined with progression: mean (SD) EQ-5D score and EQ-5D visual analogue scale score were 0.615 (0.285) and 60.8 (17.1) in 1L and 0.497 (0.370) and 56.1 (19.5) in second line. Overall, 67% of patients (162/241) required daily assistance from their caregiver, who reported an impact on their psychological well-being.
CONCLUSIONS: Patients with MPM in Spain were overall treated according to treatment guidelines at the time. Nevertheless, a considerable burden of disease was reported by patients and caregivers.