Supportive Care in Cancer

, Volume 16, Issue 4, pp 359–370

The palliative prognostic score and survival in patients with advanced solid tumors receiving chemotherapy

  • Davide Tassinari
  • Luigi Montanari
  • Marco Maltoni
  • Michela Ballardini
  • Alessandra Piancastelli
  • Marco Musi
  • Giampiero Porzio
  • Vincenzo Minotti
  • Augusto Caraceni
  • Barbara Poggi
  • Anna Stella
  • Federica Aielli
  • Emanuela Scarpi
Original Article

DOI: 10.1007/s00520-007-0302-3

Cite this article as:
Tassinari, D., Montanari, L., Maltoni, M. et al. Support Care Cancer (2008) 16: 359. doi:10.1007/s00520-007-0302-3

Abstract

Purpose

To evaluate the accuracy of the Palliative Prognostic Score (PaP score) in selecting metastatic gastrointestinal or nonsmall-cell lung cancer patients candidate to palliative chemotherapy.

Materials and methods

The PaP score was calculated in 173 patients with advanced, pretreated gastrointestinal or nonsmall-cell lung cancer before starting a further line of chemotherapy with palliative aim. Symptom distress score was calculated using the Edmonton Symptom Assessment System (ESAS) before every course of chemotherapy. Univariate analysis of survival was performed using the logrank test; multivariate analysis was performed using the Cox regression model. Symptom distress scores were compared using multivariate analysis of variance test for repeated measures, and overall symptom distress score was compared using analysis of variance test for repeated measures.

Results

Overall median survival was 26 weeks; in PaP score class A it was 32 weeks, and in class B 8 weeks (p < 0.0001). No patient was classified in class C. The two-class PaP score resulted in an independent prognostic factor (p = 0.022), as well as Karnofsky performance status (p = 0.002) and colorectal cancer (p = 0.017). A trend towards worsening of symptom distress was observed in the entire population and in class A. The high number of missed data did not permit an adequate analysis in class B.

Conclusions

The PaP score seems to discriminate patients who could benefit by palliative chemotherapy from those who could better benefit by supportive and palliative approach. However, the data are insufficient to validate the use of the PaP score in patients to be treated with palliative chemotherapy, and further trials should be planned to assess its ability to improve the quality of care in oncology and the appropriateness in the choice of palliative chemotherapy.

Keywords

Palliative prognostic score Nonsmall-cell lung cancer Metastatic cancer 

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Davide Tassinari
    • 1
    • 9
  • Luigi Montanari
    • 2
  • Marco Maltoni
    • 3
  • Michela Ballardini
    • 4
  • Alessandra Piancastelli
    • 4
  • Marco Musi
    • 5
  • Giampiero Porzio
    • 6
  • Vincenzo Minotti
    • 7
  • Augusto Caraceni
    • 8
  • Barbara Poggi
    • 1
  • Anna Stella
    • 5
  • Federica Aielli
    • 6
  • Emanuela Scarpi
    • 4
  1. 1.Supportive and Palliative Care Unit, Department of OncologyCity HospitalRiminiItaly
  2. 2.Department of Medical OncologyUmberto I HospitalLugo di RomagnaItaly
  3. 3.Palliative Care UnitValerio Grassi HospiceForlimpopoliItaly
  4. 4.Unit of Biostatistic and Clinical TrialsIstituto Oncologico RomagnoloForlìItaly
  5. 5.Oncology UnitGeneral HospitalAostaItaly
  6. 6.Support Therapy and Rehabilitation Unit, Department of OncologyL’Aquila UniversityL’AquilaItaly
  7. 7.Medical OncologyMonteluce PolyclinicPerugiaItaly
  8. 8.Virgilio Floriani Hospice, Rehabilitation and Palliative Care UnitNational Cancer InstituteMilanItaly
  9. 9.Santarcangelo di RomagnaItaly