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High End-of-Life Health Care Utilization in a Contemporary Cohort of Head and Neck Cancer Patients Treated with Immune Checkpoint Inhibitors.
Chalker, Cameron; Santana-Davila, Rafael; Voutsinas, Jenna M; Wu, Qian Vicky; Hwang, Victoria; Baik, Christina S; Lee, Sylvia; Barber, Brittany; Futran, Neal D; Houlton, Jeffrey J; Laramore, George E; Liao, Jay Justin; Parvathaneni, Upendra; Martins, Renato G; Eaton, Keith D; Rodriguez, Cristina P.
Afiliación
  • Chalker C; Department of Medicine and Department of Medicine, University of Washington, Seattle, Washington, USA.
  • Santana-Davila R; Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, Washington, USA.
  • Voutsinas JM; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
  • Wu QV; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
  • Hwang V; Department of Obstetrics and Gynecology, John Peter Smith Hospital, Fort Worth, Texas, USA.
  • Baik CS; Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, Washington, USA.
  • Lee S; Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, Washington, USA.
  • Barber B; Department of Otolaryngology Head and Neck Surgery and University of Washington, Seattle, Washington, USA.
  • Futran ND; Department of Otolaryngology Head and Neck Surgery and University of Washington, Seattle, Washington, USA.
  • Houlton JJ; Department of Otolaryngology Head and Neck Surgery and University of Washington, Seattle, Washington, USA.
  • Laramore GE; Department of Radiation Oncology, University of Washington, Seattle, Washington, USA.
  • Liao JJ; Department of Radiation Oncology, University of Washington, Seattle, Washington, USA.
  • Parvathaneni U; Department of Radiation Oncology, University of Washington, Seattle, Washington, USA.
  • Martins RG; Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, Washington, USA.
  • Eaton KD; Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, Washington, USA.
  • Rodriguez CP; Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, Washington, USA.
J Palliat Med ; 25(4): 614-619, 2022 04.
Article en En | MEDLINE | ID: mdl-34847733
Background/Objective: End-of-life health care utilization (EOLHCU) is largely uncharacterized among patients with recurrent/metastatic head and neck squamous cell carcinomas (RMHNSCC), particularly now that immune checkpoint inhibitors (ICI) have been introduced to the treatment landscape. We examined this in a single-institution, retrospective study. Design/Settings: We utilized a database of deceased, ICI-treated RMHNSCC patients to obtain demographic and EOLHCU data, the latter of which included advanced care plan documentation (ACPD) and systemic therapy or emergency room (ER)/hospital/intensive care unit (ICU) admission within 30 days of death (DOD). This was compared with a cohort of deceased thoracic malignancy (TM) patients in an exploratory analysis. Multivariate analysis was performed to examine for association between patient factors (such as age, Eastern Cooperative Oncology Group (ECOG) performance status, or smoking status) and overall survival (OS); associations between the said patient factors and EOLHCU were also evaluated. This study was conducted at an academic, tertiary center in the United States. Results: The RMHNSCC patients (n = 74) were more likely to have ACPD (p < 0.01), an emergency department visit (p < 0.01), and/or hospital admission (p < 0.01) within 30 DOD relative to the TM group. There was no difference in ICU admissions, ICU deaths, or systemic therapy at end of life (EOL). The OS declined in association with ECOG performance status (PS) and smoking. No association was observed between patient factors and any EOLHCU metric. Conclusions: At our center, patients with ICI-treated RMHNSCC have higher rates of both ACPD and EOLHCU, suggesting high symptom burden and representing opportunities for further study into supportive care augmentation.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Inhibidores de Puntos de Control Inmunológico / Neoplasias de Cabeza y Cuello Tipo de estudio: Guideline / Observational_studies / Risk_factors_studies Aspecto: Implementation_research Límite: Humans Idioma: En Revista: J Palliat Med Asunto de la revista: SERVICOS DE SAUDE Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Inhibidores de Puntos de Control Inmunológico / Neoplasias de Cabeza y Cuello Tipo de estudio: Guideline / Observational_studies / Risk_factors_studies Aspecto: Implementation_research Límite: Humans Idioma: En Revista: J Palliat Med Asunto de la revista: SERVICOS DE SAUDE Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos