Gonca ALTINIŞIK İNAN, İpek Pınar ARAL, Tarık KARGIOĞLU, Çağkan ERGİDEN, Yılmaz TEZCAN

Yoğun bakım yatışı sırasında radyoterapi endikasyonu konulan hastalarda tedavi sonuçlarımız

Amaç: Radyasyon onkolojisi kliniğinde yoğun bakım ünitesi (YBÜ) yatışı sırasında radyoterapi endikasyonu konulan hastaların tedavi tamamlama durumunu ve sağkalım sonuçlarını değerlendirmek amaçlanmıştır. Gereç ve Yöntem: Ankara Şehir Hastanesi Radyasyon Onkolojisi Kliniği’nde 01.01.2020-30.06.2022 tarihleri arasında RT uygulanmış hastaların verileri retrospektif olarak değerlendirilmiştir. Bu araştırmanın primer sonlanım noktası hastaların tedaviyi tamamlama durumudur ve sekonder sonlanım noktası genel sağkalımdır (GS). Veriler SPSS ver. 26 (İBM Corporation, Armonk, NY, USA) kullanılarak kaydedilmiştir ve analiz edilmiştir. Bulgular: Araştırmamızda Ankara Şehir Hastanesi Radyasyon Onkolojisi Kliniğinde 20.05.2020 - 30.06.2022 tarihleri arasında radyoterapi alan hastalardan, endikasyonu yoğun bakım yatışı sırasında konulmuş olan 11 hastanın verileri retrospektif incelenmiştir. RT başlangıcından itibaren medyan takip süresi 4.1 (range 1-9.8) aydır. Bu süre içinde 9 (81.8%) hasta ex, 2 (18.2%) hasta hayattadır. Hastaların median yaşı 55 (range 3-70); 4 (36.4%) kadın 7 (63.6%)’sı erkektir. Hastaların 7 (%63.6)’ si planlanan radyoterapi şemasını tamamlanmıştır ve 4 (36.4%)’ü ise tedaviyi tamamlayamamıştır. Tedaviyi tamamlayamama ile primer tanı (p=0.545) arasında anlamlı ilişki tespit edilememiştir. Hastaların median GS değeri 4.1 (range 1-9.8) aydır Ayrıca 1 aylık sağkalım 60.6 % ve 6 aylık sağkalım 20%’dır. GS ile yaş (p=0.401; correlation coefficient -282) ve primer tanı (p=0.638) arasında anlamlı ilişki yoktur. Kadınlarda median GS 5.3 (range 2.7-9.8) aydır; erkeklerde median GS 1 (range 1-5.5) aydır (p=0.059). Tedaviyi tamamlayanların median GS değeri 4.5 (aralık 1-9.8) ay iken; tedaviyi tamamlayamayanlar median GS 1.1 (range 1-4) aydır (p=0.037). Sonuç: YBÜ yatışı olup RT endikasyonu konulan hastaların yaklaşık %60’ı tedaviyi tamamlayabilmiştir. Planlanan RT şemasını tamamlayan hastalarda anlamlı olarak daha yüksek GS elde edilmiştir. Yoğun bakım yatışı olan kanser hastalarının radyoterapi endikasyonlarını belirlerken uygulanacak kriterlerin geliştirilmesi gerekmektedir.

Anahtar Kelimeler:

Radyoterapi, yoğun bakım ünitesi, palyatif

Treatment results of intensive care patients with cancer undergoing radiotherapy

Aim: This paper aims to evaluate the treatment completion status and survival outcomes of patients who were prescribed radiotherapy during intensive care unit (ICU) hospitalization in the radiation oncology clinic. Material and Method: Data on patients who underwent RT between January 1, 2020, and June 30, 2022, in the Radiation Oncology Clinic of Ankara City Hospital were retrospectively evaluated. The primary endpoint of this study is the patient status at the completion of the planned radiotherapy and the secondary endpoint is the overall survival (OS). The data were recorded and analyzed using SPSS version 26 (IBM Corporation, Armonk, NY, USA). Results: The data of 11 patients who were indicated for radiotherapy while hospitalized for intensive care between May 20, 2020, and June 30, 2022, in the Ankara City Hospital Radiation Oncology Clinic were retrospectively analyzed. The median follow-up period from the onset of RT was 4.1 months (range 1–9.8). During this period, nine (81.8%) patients had deceased, and two (18.2%) patients were surviving. The median age of the patients was 55 years (range 3–70); four (36.4%) were female and seven (63.6%) were male. Seven (63.6%) of the patients completed the planned radiotherapy scheme and four (36.4%) did not complete the treatment. There was no significant relationship between the inability to complete the treatment and gender (p=0.194) or primary diagnosis (p=0.545). The median OS value of the patients was 4.1 months (range 1–9.8). In addition, the 1-month survival was 60.6%, and the 6-month survival was 20%. There was no significant relationship between OS and age (p=0.401; correlation coefficient: ‑282) or primary diagnosis (p=0.638). The median OS in women was 5.3 (range 2.7–9.8) months; the median OS in men was 1 month (range 1–5.5; p=0.059). The median OS of those who completed treatment was 4.5 months (range 1–9.8), while that of those who did not complete the treatment was 1.1 months (range 1–4; p=0.037). Conclusion: Approximately 60% of the patients who were hospitalized in the ICU and indicated for RT were able to complete treatment. A significantly higher OS was achieved in patients who completed the RT protocol. Criteria must be developed when determining the indications for radiotherapy of cancer patients hospitalized in intensive care.

Keywords:

Radiotherapy, intensive care unit, palliative,

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