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.
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Acknowledgments
The authors would like to thank Britt Roudnas and Stefania Nicoletti of the Supportive and Palliative Care Unit, Department of Oncology, City Hospital, Rimini, Italy; Sergio Sartori of the Department of Internal Medicine, Arcispedale S.Anna, Ferrara, Italy; Alessandro Passardi and Sebastiano Calpona of the Department of Oncology, Morgagni-Pierantoni Hospital, Forlì, Italy; Elena Ravaioli and Oriana Nanni of the Unit of Biostatistic and Clinical Trials, Istituto Oncologico Romagnolo, Forlì, Italy; Maura Betti of Medical Oncology, Monteluce Polyclinic, Perugia, Italy; Ernesto Zecca and Cinzia Martini of the Neurology Unit, National Cancer Institute, Milano, Italy; and Alberto Bagnulo and Alessandra Zoboli of the Department of Oncology, S.Sebastiano Hospital, Correggio, Italy.
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Tassinari, D., Montanari, L., Maltoni, M. et al. The palliative prognostic score and survival in patients with advanced solid tumors receiving chemotherapy. Support Care Cancer 16, 359–370 (2008). https://doi.org/10.1007/s00520-007-0302-3
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DOI: https://doi.org/10.1007/s00520-007-0302-3