Clinical validation of a prognostic tool in a population of outpatients treated for incurable cancer undergoing anticancer therapy: PRONOPALL study

被引：38

作者：

Bourgeois, H. ^{[1
,2
]}

Grude, F. ^{[2
]}

Solal-Celigny, P. ^{[1
]}

Dupuis, O. ^{[1
]}

Voog, E. ^{[1
]}

Ganem, G. ^{[1
]}

Denis, F. ^{[1
]}

Zinger, M. ^{[1
]}

Juhel-Voog, L. ^{[1
]}

Lafond, C. ^{[1
]}

Maillart, P. ^{[3
]}

Capitain, O. ^{[3
]}

Delva, R. ^{[3
]}

Soulie, P. ^{[3
]}

Abadie-Lacourtoisie, S. ^{[3
]}

Guerin-Meyer, V. ^{[3
]}

Morin-Meschin, M. E. ^{[3
]}

Commer, J. M. ^{[3
]}

Gangler, A. ^{[3
]}

d'Aillieres, B. ^{[3
]}

Zannetti, A. ^{[3
]}

Bourbouloux, E. ^{[4
]}

Berton-Rigault, D. ^{[4
]}

Lebouvier-Sadot, S. ^{[4
]}

Kaassis, M. ^{[5
]}

Baudon, J. ^{[5
]}

Lam, Y. H. ^{[5
]}

Bizieux, A. ^{[6
]}

Marcq, M. ^{[6
]}

Edeline, J. ^{[7
]}

Le Du, F. ^{[7
]}

Lefeuvre, C. ^{[7
]}

Deguiral, P. ^{[8
]}

Delecroix, V. ^{[8
]}

Blot, E. ^{[9
]}

Egreteau, J. ^{[10
]}

Goudier, M. J. ^{[10
]}

Lamy, R. ^{[10
]}

Ferec, M. ^{[11
]}

Artignan, X. ^{[12
]}

Corbinais, S. ^{[13
]}

Morel, H. ^{[13
]}

Hardy-Bessard, A. C. ^{[14
]}

Alleaume, C. ^{[15
]}

Naudeix, E. ^{[16
]}

Cojocarasu, O. ^{[17
]}

Metges, J. P. ^{[2
]}

Riche, C. ^{[2
]}

Gamelin, E. ^{[18
]}

Deniel-Lagadec, D. ^{[2
]}

机构：

[1] Clin Victor Hugo, Ctr Jean Bernard, Med Oncol Dept, 18 Rue Victor Hugo, F-72000 Le Mans, France

[2] Siege Med Inst Cancerol Ouest, Observ Canc Bretagne Pays Loire, Site Paul Papin, Angers, France

[3] Inst Cancerol Ouest, Med Oncol Dept, Site Paul Papin, Angers, France

[4] Inst Cancerol Ouest, Med Oncol Dept, Site Rene Gauducheau, St Herblain, France

[5] CH Cholet, Med Oncol Dept, Cholet, France

[6] CHD Vendee, Med Oncol Dept, La Roche Sur Yon, France

[7] CRLCC Eugene Marquis, Med Oncol Dept, Rennes, France

[8] Clin Mutualiste Estuaire, Med Oncol Dept, St Nazaire, France

[9] Hop Prive Oceane, Oncol Ctr St Yves, Vannes, France

[10] CHBS, Med Oncol Dept, Lorient, France

[11] CH Morlaix, Med Oncol Dept, Morlaix, France

[12] CHP, Dept Med Oncol & Radiotherapy, St Gregoire, France

[13] CH Broussais, Med Oncol Dept, St Malo, France

[14] Ctr Cario HPCA, Med Oncol Dept, Plerin Sur Mer, France

[15] CH Yves le Foll, Med Oncol Dept, St Brieuc, France

[16] CH Fougeres, Med Oncol Dept, Fougeres, France

[17] CH Le Mans, Med Oncol Dept, Le Mans, France

[18] Siege Med Inst Cancerol Ouest, Observ Canc Bretagne Pays Loire, Site Paul Papin, Angers, France

[19] CHU, Fac Med & Pharm, INSERM CIC 1402, Poitiers, France

[20] Univ Poitiers, Poitiers, France

来源：

ANNALS OF ONCOLOGY | 2017年 / 28卷 / 07期

关键词：

prognostic tool; palliative care; lactate dehydrogenase; serum albumin; Performance Status (PS ECOG); survival at 2 months; RANDOMIZED CONTROLLED-TRIAL; EARLY PALLIATIVE CARE; ADVANCED SOLID TUMORS; HOSPITALIZED-PATIENTS; LIFE CARE; CHEMOTHERAPY; END; SURVIVAL; DEATH; SCORE;

D O I：

10.1093/annonc/mdx172

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: In 2008, a study of the characteristics of hospitalised patients led to the development of a prognostic tool that distinguished three populations with significantly different 2-month survival rates. The goal of our study aimed at validating prospectively this prognostic tool in outpatients treated for cancer in terminal stage, based on four factors: performance status (ECOG) (PS), number of metastatic sites, serum albumin and lactate dehydrogenase. Patients and methods: PRONOPALL is a multicentre study of current care. About 302 adult patients who met one or more of the following criteria: life expectancy under 6 months, performance status >= 2 and disease progression during the previous chemotherapy regimen were included across 16 institutions between October 2009 and October 2010. Afterwards, in order to validate the prognostic tool, the score was ciphered and correlated to patient survival. Results: Totally 262 patients (87%) were evaluable (27 patients excluded and 13 unknown score). Median age was 66 years [3788], and women accounted for 59%. ECOG PS 0-1 (46%), PS 2 (37%) and PS 3-4 (17%). The primary tumours were: breast (29%), colorectal (28%), lung (13%), pancreas (12%), ovary (11%) and other (8%). About 32% of patients presented one metastatic site, 35% had two and 31% had more than two. The median lactate dehydrogenase level was 398 IU/l [118-4314]; median serum albumin was 35 g/l [13-54]. According to the PRONOPALL prognostic tool, the 2-month survival rate was 92% and the median survival rate was 301 days [209-348] for the 130 patients in population C, 66% and 79 days [71-114] for the 111 patients in population B, and 24% and 35 days for [14-56] the 21 patients in population A. These three populations survival were statistically different (P<0.0001). Conclusion: PRONOPALL study confirms the three prognostic profiles defined by the combination of four factors. This PRONOPALL score is a useful decision-making tool in daily practice.

引用

页码：1612 / 1617

页数：6

共 18 条

[1] Multivariable analysis of prognostic factors for toxicity and survival for patients enrolled in phase I clinical trials [J].

Bachelot, T ;

Ray-Coquard, I ;

Catimel, G ;

Ardiet, C ;

Guastalla, JP ;

Dumortier, A ;

Chauvin, F ;

Droz, JP ;

Philip, T ;

Clavel, M .

ANNALS OF ONCOLOGY, 2000, 11 (02) :151-156

[2] Effects of a Palliative Care Intervention on Clinical Outcomes in Patients With Advanced Cancer The Project ENABLE II Randomized Controlled Trial [J].

Bakitas, Marie ;

Lyons, Kathleen Doyle ;

Hegel, Mark T. ;

Balan, Stefan ;

Brokaw, Frances C. ;

Seville, Janette ;

Hull, Jay G. ;

Li, Zhongze ;

Tosteson, Tor D. ;

Byock, Ira R. ;

Ahles, Tim A. .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2009, 302 (07) :741-749

[3] Assessing 2-month clinical prognosis in hospitalized patients with advanced solid tumors [J].

Barbot, Anne-Claire ;

Mussault, Pascale ;

Ingrand, Pierre ;

Tourani, Jean-Marc .

JOURNAL OF CLINICAL ONCOLOGY, 2008, 26 (15) :2538-2543

[4] Chemotherapy Near the End of Life First-and Third and Fourth (Line)-Do No Harm [J].

Blanke, Charles D. ;

Fromme, Erik K. .

JAMA ONCOLOGY, 2015, 1 (06) :785-786

[5]

Bouleuc C, 2007, REFLEXIONS MED ONCOL, V10, P79

[6] Effect of integrated palliative care on the quality of end-of-life care: retrospective analysis of 521 cancer patients [J].

Colombet, Isabelle ;

Montheil, Vincent ;

Durand, Jean-Philippe ;

Gillaizeau, Florence ;

Niarra, Ralph ;

Jaeger, Cecile ;

Alexandre, Jerome ;

Goldwasser, Francois ;

Vinant, Pascale .

BMJ SUPPORTIVE & PALLIATIVE CARE, 2012, 2 (03) :239-247

[7] Conversion of Karnofsky Performance Status (KPS) and Eastern Cooperative Oncology Group Performance Status (ECOG) to Palliative Performance Scale (PPS), and the Interchangeability of PPS and KPS in Prognostic Tools [J].

de Kock, Ingrid ;

Mirhosseini, Mehrnoush ;

Lau, Francis ;

Thai, Vincent ;

Downing, Michael ;

Quan, Hue ;

Lesperance, Mary ;

Yang, Ju .

JOURNAL OF PALLIATIVE CARE, 2013, 29 (03) :163-169

[8] Diagnostic accuracy of the palliative prognostic score in hospitalized patients with advanced cancer [J].

Glare, PA ;

Eychmueller, S ;

McMahon, P .

JOURNAL OF CLINICAL ONCOLOGY, 2004, 22 (23) :4823-4828

[9]

Golwasser F., 2006, GUIDE DISPOSITIF DAN

[10] Use of chemotherapy at the end of life in a Portuguese oncology center [J].

Goncalves, Jose Ferraz ;

Goyanes, Carmen .

SUPPORTIVE CARE IN CANCER, 2008, 16 (04) :321-327

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