Early Interdisciplinary Supportive Care in Patients With Previously Untreated Metastatic Esophagogastric Cancer: A Phase III Randomized Controlled Trial
| Autor: | Xi Jiao, Xiaotian Zhang, Lili Tang, Xicheng Wang, Yu Fang, Yi He, Jun Zhou, Yanshuo Cao, Xiaowei Xin, Zhihao Lu, Lin Shen, Jian Li, Ying Pang, Chang Liu, Tianqi Sun, Jifang Gong, Yanli Wang, Changsong Qi |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
0301 basic medicine China Cancer Research medicine.medical_specialty Time Factors Esophageal Neoplasms Psychological intervention MEDLINE Nutritional Status Antineoplastic Agents law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Stomach Neoplasms law Esophagogastric cancer Internal medicine medicine Humans In patient Prospective Studies Neoplasm Metastasis Aged Patient Care Team Nutritional Support business.industry Middle Aged Combined Modality Therapy Progression-Free Survival Psychotherapy Mental Health 030104 developmental biology Oncology 030220 oncology & carcinogenesis Disease Progression Female business |
| Zdroj: | Journal of Clinical Oncology. 39:748-756 |
| ISSN: | 1527-7755 0732-183X |
| Popis: | PURPOSEEffective interventions to improve prognosis in metastatic esophagogastric cancer (EGC) are urgently needed. We assessed the effect of the early integration of interdisciplinary supportive care for patients with metastatic EGC on overall survival (OS).PATIENTS AND METHODSAn open-label, phase III, randomized, controlled trial was conducted at Peking University Cancer Hospital & Institute. Patients with previously untreated metastatic EGC were enrolled. Patients were randomly assigned (2:1) to either early interdisciplinary supportive care (ESC) integrated into standard oncologic care or standard care (SC). ESC was provided by a team of GI medical oncologists, oncology nurse specialists, dietitians, and psychologists; patients in the SC group received standard oncologic care alone. The primary end point was OS in the intention-to-treat population.RESULTSBetween April 16, 2015, and December 29, 2017, 328 patients were enrolled: 214 in the ESC group and 114 in the SC group. At the data cutoff date of January 26, 2019, 15 (5%) patients were lost to follow-up. The median number of cycles of first-line chemotherapy was five (interquartile range [IQR], 4-7) in the ESC group and four (IQR, 2-6) in the SC group. The median OS was 14.8 months (95% CI, 13.3 to 16.3) in the ESC group and 11.9 months (95% CI, 9.6 to 13.6) in the SC group (hazard ratio, 0.68; 95% CI, 0.51 to 0.9; P = .021).CONCLUSIONThe early integration of interdisciplinary supportive care is an effective intervention with survival benefits for patients with metastatic EGC. Further optimization and standardization are warranted. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|