Klinik Araştırma
Yıl 2023,
Cilt: 6 Sayı: 2, 337 - 347, 30.09.2023
Öz
Bu çalışmada amacımız, kanserli hastaların anemi derecesi ile metastaz, performans, beslenme durumu gibi etkenleri karşılaştırarak prognoza etkisini araştırmaktır.Bu çalışmaya palyatif bakımda (PB) izlenen kanserli 189 hasta dahil edildi. Hastalar kanser tanılarına göre sınıflandırıldı, demografik özellikleri, anemi paneli, kemoterapi, metastaz, performans durumu, yatış süreleri ve çıkış durumları kayıt edilerek gruplar arasında karşılaştırıldı. PB’da izlediğimiz kanserli hastaların %85.7’sinde anemi ve %88.4’ ünde metastaz vardı. Anemisi şiddetli olanlarda Eastern Cooperative Oncology Group Scale (ECOG) performans değerleri düşük, C-reaktif protein (CRP) düzeyleri diğer gruplardan anlamlı derecede yüksek bulundu. (p=0,045, p=0,000). Anemisi olmayanların Glaskow Koma Skalaları (GKS), orta derecede anemisi olanlardan anlamlı derecede daha yüksek bulundu. (p=0,049) PB’da izlediğimiz ileri evre kanserli hastalarda, düşük ECOG, yüksek GKS ve CRP değerleri gibi kötü prognostik kriterler ile aneminin şiddeti arasında ilişki olduğunu gösterdik. Kanserli hastalarda, aneminin erken değerlerilmesi, yeterli beslenme ve demir tedavilerin verilmesi sağlanmalı, sağkalım ve prognoz üzerindeki etkileri daha geniş çaplı çalışmalarla araştırılmalıdır.
Anahtar Kelimeler
Destekleyen Kurum
yok
Kaynakça
- Arends, J., Bachmann, P., Baracos, V., Barthelemy, N., Bertz, H., Bozzetti, F., Fearon, K., Hütterer, E., Isenring, E., Kaasa, S., Krznaric, Z., Laird, B., Larsson, M., Laviano, A., Mühlebach, S., Muscaritoli, M., Oldervoll, L., Ravasco, P., Solheim, T., Strasser, F., Schueren, M., Preiser, JC. (2017). ESPEN guidelines on nutrition in cancer patients. Clin Nutr, 36, 11–48.
- Baldwin, C., Spiro, A., Ahern, R., Emery, PW. (2012). Oral nutritional interventions in malnourished patients with cancer: a systematic review and meta-analysis. J Natl Cancer Inst, 104(5), 371-85.
- Birgegard, G., Aapro, MS., Bokemeyer, C., Dicato, M., Drings, P., Hornedo, J., Krzakowski, M., Ludwig, H., Pecorelli, S., Schmoll, H., Schneider, M., Schrijvers, D., Shasha, D., Belle, SV. (2005). Cancer-related anemia: pathogenesis, prevalence and treatment. Oncology, 68, 3–11.
- Bojaxhiu, B., Shrestha, BK., Luterbacher, P., Elicin, O., Shelan, M., Macpherson, AJS., Heimgartner, B. , Giger, R., Aebersold, DM., Zaugg, K. (2020). Unplanned hospitalizations in patients with locoregionally advanced head and neck cancer treated with (chemo)radiotherapy with and without prophylactic percutaneous endoscopic gastrostomy, 15(1), 281.
- Brito, M., Laranjo, A., Nunes, G., Oliveira, C., Santos, CA., Fonseca, J. (2020). Anemia and Hematopoietic Factor Deficiencies in Patients after Endoscopic Gastrostomy: A Nine-Year and 472-Patient Study. Nutrients, 12(12), 3637.
- Clarke, H., Pallister, CJ. (2005). Impact of anemia on outcome in cancer. Clin Lab Haematol, 27, 1–13.
- Demetri, GD., Kris, M., Wade, J., Degos, L., Cella, D. (1998). Quality-of-life benefit in chemotherapy patients treated with epoetin alpha is independent of disease response or tumor type: results from a prospective community oncology study. J Clin Oncol, 16, 3412– 25.
- Dunn, A., Carter, J., Carter, H. (2003). Anemia at the end of life: prevalence, significance, and causes in patients receiving palliative care. J Pain Symptom Manag, 26(6), 1132–1139.
- Hashemi, SM., Mashhadi, MA., Mohammadi, M., Ebrahimi, M., Allahyari, A. (2017). Absolute and Functional Iron Deficiency Anemia among Different Tumors in Cancer Patients in South Part of Iran, 2014. Int J Hematol Oncol Stem Cell Res, 11(3), 192–198.
- Knight, K., Wade, S., Balducci, L. (2004). Prevalence and outcomes of anemia in cancer: a systematic review of the literature. Am J Med, 116, 11–26.
- Lind. ML., Rosas, MM., McFarland, L., Taylor, L., Olson, S., Pergam, SA. (2021). Limits of the Glasgow Coma Scale When Assessing for Sepsis in Allogeneic Hematopoietic Cell Transplant Recipients. Nurs Res, 70(5), 399–404.
- Ludwig, H., Müldür, E., Endler, G., Hübl, W. (2013). Prevalence of iron deficiency across different tumors and its association with poor performance status, disease status and anemia. Ann Oncol, 24(7), 1886–1892.
- Macciò, A., Madeddu, C., Gramignano, G., Mulas, C., Tanca, L., Cherchi, MC., Floris, C., Omoto, I., Barracca, A., Ganz, T. (2015). The role of inflammation, iron, and nutritional status in cancer-related anemia: results of a large, prospective, observationalstudy. Haematologica, 100, 124–132.
- Madeddu, C., Gramignano, G., Astara, G., Demontis, R., Sanna, E., Atzeni, V., Macciò, A. (2018). Pathogenesis and Treatment Options of Cancer Related Anemia: Perspective for a Targeted Mechanism-Based Approach. Front Physiol, 9, 1294.
- Mäkitie, AA., Alabi, RO., Orell, H., Youssef, O., Almangush, A., Homma, A., Takes, RP., López, F., Bree, R., Rodrigo, JP., Ferlito, A. (2022). Managing Cachexia in Head and Neck Cancer: a Systematic Scoping Review. Adv Ther, 39(4), 1502-1523.
- Natalucci, V., Virgili, E., Calcagnoli, F., Valli, G., Agostini, D., Zeppa, SD., Barbieri, E., Rita Emili, R. (2021). Cancer Related Anemia: An Integrated Multitarget Approach and Lifestyle Interventions. Nutrients, 13(2): 482.
- Neeman, E., Gresham, G., Ovasapians, N., Hendifar, A., Tuli, R., Figlin, R., Shinde, A. (2019). Comparing Physician and Nurse Eastern Cooperative Oncology Group Performance Status (ECOG‐PS) Ratings as Predictors of Clinical Outcomes in Patients with Cancer. Oncologist, 24(12), e1460–e1466.
- Neoh, K., Page, A., Chin-Yee, N., Doree, C., Bennett, MI. (2022). Practice review: Evidence-based and effective management of anaemia in palliative care patients. Palliat Med, 36(5), 783–794.
- Neoh, K., Stanworth, S., Pasricha, SR., Bennett, MI. (2016). Estimating prevalence of functional iron deficiency anaemia in advanced cancer. Support Care Cancer, 25(4), 1209–1214.
- Oh, TK., Song, IA., Jeon, YT. (2019). Impact of Glasgow Coma Scale scores on unplanned intensive care unit readmissions among surgical patients.Ann Transl Med, 7(20), 520.
- Oken, MM., Creech, RH., Tormey, DC., Horton, J., Davis, TE., McFadden, ET., Carbone, PP. (1982). Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol, 5(6), 649–655.
- Park, S., Jung, CW., Kim, K., Kim, SJ., Kim, WS., Jang, JH. (2015). Iron deficient erythropoiesis might play key role in development of anemia in cancer patients. Oncotarget, 6(40), 42803–42812.
- Teasdale, G., Jennett, B. (1974). Assessment of coma and impaired consciousness. A practical scale. Lancet (London, England), 2, 81-4.
- Verdon, F., Burnand, B., Stubi, CL., Bonard, C., Graff, M., Michaud, A., Bischoff, T., Vevey, M., Studer, JP., Herzig, L., Chapuis, C., Tissot, J., Pécoud, A., Favrat, B. (2003). Iron supplementation for unexplained fatigue in non-anaemic women: double blind randomised placebo controlled trial. BMJ, 326, 1124–1126.
- World Health Organisation (2011) Haemoglobin concentrations for the diagnosis and assessment of severity. [Online]. [Accessed 28 August 2013]. Available from: http://www.who. int/vmnis/indicators/haemoglobin.pdf
Yıl 2023,
Cilt: 6 Sayı: 2, 337 - 347, 30.09.2023
Öz
In this study, we aimed to investigate the effects of anemia on the prognosis by comparing the severity of anemia with several prognostic factors including metastases, functional performance, and the feeding status of cancer patients.This study included 189 cancer patients, who received treatment in the palliative care unit (PCU). Demographic characteristics of the patients, anemia test panel results, chemotherapy, the status of metastases, functional performance, the length of hospital stay, and the status at discharge were recorded and compared between the study groups. Of the cancer patients in PCU, 85.7% had anemia and 88.4% had metastases. In patients with severe anemia, the Eastern Cooperative Oncology Group Scale (ECOG) performance scores were lower and C-reactive protein (CRP) levels were significantly higher compared to the other patients in other groups (p=0.045, p=0.000). Glasgow Coma Scales (GCS) were found to be significantly lower in patients with moderate anemia than those without anemia. (p=0.049) We have shown that there is a correlation between the severity of anemia and poor prognostic criteria including low ECOG, GCS scores and high CRP levels in advanced cancer patients we treated in PCU. The early assessment of anemia and the adequate intake of nutrients along with iron supplements should be ensured in cancer patients during the disease course.
Anahtar Kelimeler
Kaynakça
- Arends, J., Bachmann, P., Baracos, V., Barthelemy, N., Bertz, H., Bozzetti, F., Fearon, K., Hütterer, E., Isenring, E., Kaasa, S., Krznaric, Z., Laird, B., Larsson, M., Laviano, A., Mühlebach, S., Muscaritoli, M., Oldervoll, L., Ravasco, P., Solheim, T., Strasser, F., Schueren, M., Preiser, JC. (2017). ESPEN guidelines on nutrition in cancer patients. Clin Nutr, 36, 11–48.
- Baldwin, C., Spiro, A., Ahern, R., Emery, PW. (2012). Oral nutritional interventions in malnourished patients with cancer: a systematic review and meta-analysis. J Natl Cancer Inst, 104(5), 371-85.
- Birgegard, G., Aapro, MS., Bokemeyer, C., Dicato, M., Drings, P., Hornedo, J., Krzakowski, M., Ludwig, H., Pecorelli, S., Schmoll, H., Schneider, M., Schrijvers, D., Shasha, D., Belle, SV. (2005). Cancer-related anemia: pathogenesis, prevalence and treatment. Oncology, 68, 3–11.
- Bojaxhiu, B., Shrestha, BK., Luterbacher, P., Elicin, O., Shelan, M., Macpherson, AJS., Heimgartner, B. , Giger, R., Aebersold, DM., Zaugg, K. (2020). Unplanned hospitalizations in patients with locoregionally advanced head and neck cancer treated with (chemo)radiotherapy with and without prophylactic percutaneous endoscopic gastrostomy, 15(1), 281.
- Brito, M., Laranjo, A., Nunes, G., Oliveira, C., Santos, CA., Fonseca, J. (2020). Anemia and Hematopoietic Factor Deficiencies in Patients after Endoscopic Gastrostomy: A Nine-Year and 472-Patient Study. Nutrients, 12(12), 3637.
- Clarke, H., Pallister, CJ. (2005). Impact of anemia on outcome in cancer. Clin Lab Haematol, 27, 1–13.
- Demetri, GD., Kris, M., Wade, J., Degos, L., Cella, D. (1998). Quality-of-life benefit in chemotherapy patients treated with epoetin alpha is independent of disease response or tumor type: results from a prospective community oncology study. J Clin Oncol, 16, 3412– 25.
- Dunn, A., Carter, J., Carter, H. (2003). Anemia at the end of life: prevalence, significance, and causes in patients receiving palliative care. J Pain Symptom Manag, 26(6), 1132–1139.
- Hashemi, SM., Mashhadi, MA., Mohammadi, M., Ebrahimi, M., Allahyari, A. (2017). Absolute and Functional Iron Deficiency Anemia among Different Tumors in Cancer Patients in South Part of Iran, 2014. Int J Hematol Oncol Stem Cell Res, 11(3), 192–198.
- Knight, K., Wade, S., Balducci, L. (2004). Prevalence and outcomes of anemia in cancer: a systematic review of the literature. Am J Med, 116, 11–26.
- Lind. ML., Rosas, MM., McFarland, L., Taylor, L., Olson, S., Pergam, SA. (2021). Limits of the Glasgow Coma Scale When Assessing for Sepsis in Allogeneic Hematopoietic Cell Transplant Recipients. Nurs Res, 70(5), 399–404.
- Ludwig, H., Müldür, E., Endler, G., Hübl, W. (2013). Prevalence of iron deficiency across different tumors and its association with poor performance status, disease status and anemia. Ann Oncol, 24(7), 1886–1892.
- Macciò, A., Madeddu, C., Gramignano, G., Mulas, C., Tanca, L., Cherchi, MC., Floris, C., Omoto, I., Barracca, A., Ganz, T. (2015). The role of inflammation, iron, and nutritional status in cancer-related anemia: results of a large, prospective, observationalstudy. Haematologica, 100, 124–132.
- Madeddu, C., Gramignano, G., Astara, G., Demontis, R., Sanna, E., Atzeni, V., Macciò, A. (2018). Pathogenesis and Treatment Options of Cancer Related Anemia: Perspective for a Targeted Mechanism-Based Approach. Front Physiol, 9, 1294.
- Mäkitie, AA., Alabi, RO., Orell, H., Youssef, O., Almangush, A., Homma, A., Takes, RP., López, F., Bree, R., Rodrigo, JP., Ferlito, A. (2022). Managing Cachexia in Head and Neck Cancer: a Systematic Scoping Review. Adv Ther, 39(4), 1502-1523.
- Natalucci, V., Virgili, E., Calcagnoli, F., Valli, G., Agostini, D., Zeppa, SD., Barbieri, E., Rita Emili, R. (2021). Cancer Related Anemia: An Integrated Multitarget Approach and Lifestyle Interventions. Nutrients, 13(2): 482.
- Neeman, E., Gresham, G., Ovasapians, N., Hendifar, A., Tuli, R., Figlin, R., Shinde, A. (2019). Comparing Physician and Nurse Eastern Cooperative Oncology Group Performance Status (ECOG‐PS) Ratings as Predictors of Clinical Outcomes in Patients with Cancer. Oncologist, 24(12), e1460–e1466.
- Neoh, K., Page, A., Chin-Yee, N., Doree, C., Bennett, MI. (2022). Practice review: Evidence-based and effective management of anaemia in palliative care patients. Palliat Med, 36(5), 783–794.
- Neoh, K., Stanworth, S., Pasricha, SR., Bennett, MI. (2016). Estimating prevalence of functional iron deficiency anaemia in advanced cancer. Support Care Cancer, 25(4), 1209–1214.
- Oh, TK., Song, IA., Jeon, YT. (2019). Impact of Glasgow Coma Scale scores on unplanned intensive care unit readmissions among surgical patients.Ann Transl Med, 7(20), 520.
- Oken, MM., Creech, RH., Tormey, DC., Horton, J., Davis, TE., McFadden, ET., Carbone, PP. (1982). Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol, 5(6), 649–655.
- Park, S., Jung, CW., Kim, K., Kim, SJ., Kim, WS., Jang, JH. (2015). Iron deficient erythropoiesis might play key role in development of anemia in cancer patients. Oncotarget, 6(40), 42803–42812.
- Teasdale, G., Jennett, B. (1974). Assessment of coma and impaired consciousness. A practical scale. Lancet (London, England), 2, 81-4.
- Verdon, F., Burnand, B., Stubi, CL., Bonard, C., Graff, M., Michaud, A., Bischoff, T., Vevey, M., Studer, JP., Herzig, L., Chapuis, C., Tissot, J., Pécoud, A., Favrat, B. (2003). Iron supplementation for unexplained fatigue in non-anaemic women: double blind randomised placebo controlled trial. BMJ, 326, 1124–1126.
- World Health Organisation (2011) Haemoglobin concentrations for the diagnosis and assessment of severity. [Online]. [Accessed 28 August 2013]. Available from: http://www.who. int/vmnis/indicators/haemoglobin.pdf
Toplam 25 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | İç Hastalıkları |
| Bölüm | Makaleler |
| Yazarlar | |
| Erken Görünüm Tarihi | 18 Eylül 2023 |
| Yayımlanma Tarihi | 30 Eylül 2023 |
| Gönderilme Tarihi | 5 Nisan 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 6 Sayı: 2 |
