Purpose: This study sought to investigate changes in quality of life (QoL) and symptom burden among palliative care patients undergoing one week of inpatient care in a specialized palliative care unit (PCU). The patient population was stratified into two groups, with one group pretreated from pre-admission palliative care (PC) provided by an outpatient multidisciplinary PC team, while the other group did not receive such support prior to admission. Although the average duration of treatment at a PCU in Germany is 1–2 weeks, the question also arises as to whether a significant improvement in symptom burden and QoL can be expected after just one week of PC in a PCU. Methods: PC patients with various cancer entities were prospectively included in a non-randomized study. Patients in group 1 received outpatient specialized PC prior to admission, while patients in group 2 did not. Over an 8-month period, we gathered data from one academic cancer center, utilizing the EORTC QLQ-C30, one of the most widely used patient-reported outcome (PRO) instruments to assess health-related QoL in cancer patients. Patients completed the QLQ-C30 at T0 (admission or one day later) and T1 (one week later), enabling the assessment of potential changes in their QoL and symptom burden over time. Results: A total of 103 patients (51.5% male) were enrolled (group 1: 42%, group 2: 58%). At T0, there were no significant differences regarding QLQ-C30 scores between groups 1 and 2, except from global health/QoL (group 1 mean 20.7, group 2 mean 25.6,p= 0.026). Over the course of one week several significant and clinically relevant changes were found: Emotional functioning demonstrated an uplift in both groups (group 1: mean 41.5 IQR 33 vs. 53.1 IQR 50,p= 0.014, group 2: mean 48.2 IQR 46 vs. 56.8 IQR 58,p= 0.029), as did the global health status (group 1: M 20.7 IQR 17 vs. 36.2 IQR 33,p< 0.001, group 2: M 25.6 IQR 25 vs. 35.3 IQR 33,p< 0.001). Nausea and vomiting showed a reduction (group 1: M 29.9 IQR 17 vs. 6.8 IQR 0,p< 0.001, group 2: M 22.6 IQR 17 vs. 8.2 IQR 0,p< 0.001), along with a notable decline in pain (group 1: M 67.4 IQR 67 vs. 25.3 IQR 17,p< 0.001, group 2: M 73.1 IQR 83 vs. 29.7 IQR 17,p< 0.001). A decrease was observed in insomnia (group 1: M 63.6 IQR 67 vs. 27.6 IQR 33,p< 0.001, group 2: M 60.1 IQR 67 vs. 27.6 IQR 33,p< 0.001). There were no significant differences between groups 1 and 2 in the extent of improvement in the various symptom scales from T0 to T1. Conclusion: The findings of our study demonstrate that QoL and several symptoms prevalent in cancer patients cared for in the PCU experienced significant enhancement over the span of just one week. Both groups, patients receiving specialized outpatient PC prior to admission and those without, equally benefited from inpatient PC. All mentioned changes from T0 to T1 are considered not only significant but clinically relevant.
目的：本研究旨在探讨在专科姑息治疗病房接受一周住院治疗的姑息治疗患者生活质量与症状负担的变化。患者群体分为两组，其中一组在入院前接受过多学科门诊姑息治疗团队的预处理，另一组则在入院前未获得此类支持。尽管德国姑息治疗病房的平均治疗时长为1-2周，但本研究同时探讨在姑息治疗病房仅接受一周治疗后，患者的症状负担与生活质量是否可能获得显著改善。方法：本研究采用非随机前瞻性设计，纳入患有不同癌症类型的姑息治疗患者。第一组患者在入院前接受过专科门诊姑息治疗，第二组患者则未接受。在为期8个月的研究中，我们收集了某学术癌症中心的数据，采用癌症患者生活质量测定量表EORTC QLQ-C30（该量表是评估癌症患者健康相关生活质量最广泛使用的患者报告结局工具之一）。患者在T0（入院时或入院后一天）和T1（一周后）分别完成QLQ-C30量表，以评估其生活质量和症状负担随时间变化的潜在趋势。结果：共纳入103例患者（男性占51.5%），其中第一组42%，第二组58%。在T0时点，除总体健康状况/生活质量维度（第一组均值20.7，第二组均值25.6，p=0.026）外，两组患者的QLQ-C30评分无显著差异。经过一周治疗，多项指标呈现具有临床意义的显著变化：情绪功能在两组均显著改善（第一组：均值41.5 IQR 33 vs. 53.1 IQR 50，p=0.014；第二组：均值48.2 IQR 46 vs. 56.8 IQR 58，p=0.029），总体健康状况亦同步提升（第一组：均值20.7 IQR 17 vs. 36.2 IQR 33，p<0.001；第二组：均值25.6 IQR 25 vs. 35.3 IQR 33，p<0.001）。恶心呕吐症状显著减轻（第一组：均值29.9 IQR 17 vs. 6.8 IQR 0，p<0.001；第二组：均值22.6 IQR 17 vs. 8.2 IQR 0，p<0.001），疼痛程度明显下降（第一组：均值67.4 IQR 67 vs. 25.3 IQR 17，p<0.001；第二组：均值73.1 IQR 83 vs. 29.7 IQR 17，p<0.001）。失眠症状亦呈现下降趋势（第一组：均值63.6 IQR 67 vs. 27.6 IQR 33，p<0.001；第二组：均值60.1 IQR 67 vs. 27.6 IQR 33，p<0.001）。从T0到T1期间，两组患者在各症状量表改善程度上均无显著差异。结论：本研究结果表明，在姑息治疗病房接受治疗仅一周后，癌症患者的生活质量及多项常见症状均获得显著改善。无论入院前是否接受过专科门诊姑息治疗，两组患者均从住院姑息治疗中同等获益。所有从T0到T1观察到的变化不仅具有统计学显著性，更具备临床相关性。
肿瘤(癌症)患者之家