進行がん患者における生物学的予後スコアBiological Prognostic Score の開発と外的妥当性の前向き検証―Palliative Prognostic Index との比較
【目的】進行がん患者の血液検査値のみを用いる生物学的予後スコアを開発し，妥当性を確かめた．【方法】緩和ケア病棟の患者（開発群）を対象に血液検査値，年齢，性別，がん種を独立変数，死亡を従属変数とするパラメトリック生存時間解析を行い生物学的予後スコアBiological Prognostic Score（BPS）を開発した．次に，異施設の積極的がん治療を終了または差し控えた患者（検証群）で前向きにBPS とPalliative Prognostic Index（PPI）の精度を検証した．【結果】開発群122 例よりコリンエステラーゼ，血中尿素窒素，総鉄結合能から成るBPS を得た．検証群195例で...
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| Published in | Palliative Care Research Vol. 10; no. 4; pp. 251 - 258 |
|---|---|
| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本緩和医療学会
2015
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1880-5302 |
| DOI | 10.2512/jspm.10.251 |
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| Abstract | 【目的】進行がん患者の血液検査値のみを用いる生物学的予後スコアを開発し，妥当性を確かめた．【方法】緩和ケア病棟の患者（開発群）を対象に血液検査値，年齢，性別，がん種を独立変数，死亡を従属変数とするパラメトリック生存時間解析を行い生物学的予後スコアBiological Prognostic Score（BPS）を開発した．次に，異施設の積極的がん治療を終了または差し控えた患者（検証群）で前向きにBPS とPalliative Prognostic Index（PPI）の精度を検証した．【結果】開発群122 例よりコリンエステラーゼ，血中尿素窒素，総鉄結合能から成るBPS を得た．検証群195例で1-9 週生存予測のROC 曲線下面積はBPS＝0.76-0.86，PPI＝0.69-0.73 であった．【考察】BPS の妥当性が示唆された．今後，多施設での検証とTIBC に代わる一般的な項目の探索が必要である． |
|---|---|
| AbstractList | 【目的】進行がん患者の血液検査値のみを用いる生物学的予後スコアを開発し，妥当性を確かめた．【方法】緩和ケア病棟の患者（開発群）を対象に血液検査値，年齢，性別，がん種を独立変数，死亡を従属変数とするパラメトリック生存時間解析を行い生物学的予後スコアBiological Prognostic Score（BPS）を開発した．次に，異施設の積極的がん治療を終了または差し控えた患者（検証群）で前向きにBPS とPalliative Prognostic Index（PPI）の精度を検証した．【結果】開発群122 例よりコリンエステラーゼ，血中尿素窒素，総鉄結合能から成るBPS を得た．検証群195例で1-9 週生存予測のROC 曲線下面積はBPS＝0.76-0.86，PPI＝0.69-0.73 であった．【考察】BPS の妥当性が示唆された．今後，多施設での検証とTIBC に代わる一般的な項目の探索が必要である． |
| Author | 大道, 雅英 佐藤, 裕信 村上, 真基 杉本, 典夫 山本, 直樹 成田, 昌広 宗像, 康博 青沼, 架佐賜 森田, 達也 髙橋, 陽 |
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| References | 13) Sonoda H, Yamaguchi T, Matsumoto M, et al. Validation of the Palliative Prognostic Index and Palliative Prognostic Score in a palliative care consultation team setting for patients with advanced cancers in an acute care hospital in Japan. Am J Hosp Palliat Care 2013; 00: 1-5. 7) Krishnan M, Temel JS, Wright AA, et al. Predicting life expectancy in patients with advanced incurable cancer: a review. J Support Oncol 2013; 11: 68-74. 12) Kim AS, Youn CH, Ko HJ, et al. The survival time of terminal cancer patients: prediction based on clinical parameters and simple prognostic scores. J Palliat Care 2014; 30: 24-31. 21) Hamano J, Maeno T, Kizawa Y, et al. Usefulness of Palliative Prognostic Index for patient with advanced cancer in home care setting. Am J Hosp Palliat Care 2012; 30: 264-7. 4) Maltoni M, Caraceni A, Brunelli C, et al. Prognostic factors in advanced cancer patients: Evidence-based clinical recommendations — a study by the steering committee of the European association for palliative care. J Clin Oncol 2005; 23: 6240-8. 9) Morita T, Tsunoda J, Inoue S, et al. The Palliative Prognostic Index: a scoring system for survival prediction of terminally ill cancer patients. Support Care Cancer 1999; 7: 128-33. 5) Lau F, Cloutier-Fisher D, Kuziemsky C, et al. A systematic review of prognostic tools for estimating survival time in palliative care. J Palliat Care 2007; 23: 93-112. 8) Maltoni M, Nanni O, Pirovano M, et al. Successful validation of the palliative prognostic score in terminally ill cancer patients. Italian Multicenter Study Group on Palliative Care. J Pain Symptom Manage 1999; 17: 240-7. 11) Maltoni M, Scarpi E, Pittureri C, et al. Prospective comparison of prognostic scores in palliative care cancer populations. Oncologist 2012; 17: 446-54. 15) Pourhoseingholi MA, Hajizadeh E, Moghimi Dehkordi B, et al. Comparing Cox regression and parametric models for survival of patients with gastric carcinoma. Asian Pac J Cancer Prev 2007; 8: 412-6. 20) Yoon SJ, Jung JG, Kim JS, et al. Comparison of accuracy among prognostic scores for predicting life expectancy in Korean patients with cancer with weeks of survival. Am J Hosp Palliat Care 2013; 00: 1-8. 18) Subramaniam S, Thorns A, Ridout M, et al. Accuracy of prognosis prediction by PPI in hospice inpatients with cancer: A multi-centre prospective study. BMJ Support Palliat Care 2013; 3: 324-9. 16) Stone CA, Tiernan E, Dooley BA. Prospective validation of the palliative prognostic index in patients with cancer. J Pain Symptom Manage 2008; 35: 617-22. 24) Lau F, Downing M, Lesperance M, et al. Using the Palliative Performance Scale to provide meaningful survival estimates. J Pain Symptom Manage 2009; 38: 134-44. 23) Anderson F, Downing GM, Hill J, et al. Palliative performance scale （PPS）: A new tool. J Palliat Care 1996; 12: 5-11. 25) Feliu J, Jiménez-Gordo AM, Madero R, et al. Development and validation of a prognostic nomogram for terminally ill cancer patients. J Natl Cancer Inst 2011; 103: 1613-20. 26) Gwilliam B1, Keeley V, Todd C, et al. Development of prognosis in palliative care study （PiPS） predictor models to improve prognostication in advanced cancer: Prospective cohort study. BMJ 2011; 343: d4920 28) Ohde S, Hayashi A, Takahasi O, et al. A 2-week prognostic prediction model for terminal cancer patients in a palliative care unit at a Japanese general hospital. Palliat Med 2011; 25: 170-6. 27) Chiang JK, Cheng YH, Koo M, et al. A computer-assisted model for predicting probability of dying within 7 days of hospice admission in patients with terminal cancer. Jpn J Clin Oncol 2010; 40: 449-55. 2) 日本緩和医療学会緩和医療ガイドライン作成委員会編．終末期がん患者の輸液療法に関するガイドライン2013年版．金原出版，東京，2013; 2-8, 26-33, 46-52. 22) Hamano J, Kizawa Y, Maeno T, et al. Prospective clarification of the utility of the Palliative Prognostic Index for patients with advanced cancer in the home care setting. Am J Hosp Palliat Care 2013; 00: 1-5. 14) Pandharipande P, Cotton BA, Shintani A, et al. Motoric subtypes of delirium in mechanically ventilated surgical and trauma intensive care unit patients. Intensive Care Med 2007; 33: 1726-31. 19) Stiel S, Bertram L, Neuhaus S, et al. Evaluation and comparison of two prognostic scores and the physicians’ estimate of survival in terminally ill patients. Support Care Cancer 2010; 18: 43-9. 10) Tarumi Y, Watanabe SM, Lau F, et al. Evaluation of the Palliative Prognostic Score （PaP） and routinely collected clinical data in prognostication of survival for patients referred to a palliative care consultation service in an acute care hospital. J Pain Symptom Manage 2011; 42: 419-31. 1) Glare P, Sinclair C, Downing M, et al. Predicting survival in patients with advanced disease. In Hanks G, Cherny N, Christakis N, Fallon M, Kaasa S, Portenoy R eds. Oxford Textbook of Palliative Medicine, 4th ed. Oxford University Press, Oxford, 2009; 81-110. 6) Stone PC, Lund S. Predicting prognosis in patients with advanced cancer. Ann Oncol 2007; 18: 971-6. 3) 日本緩和医療学会緩和医療ガイドライン作成委員会編．苦痛緩和のための鎮静に関するガイドライン2010年版．金原出版，東京，2010; 27-31, 46. 17) Cheng WH, Kao CY, Hung YS, et al. Validation of a palliative prognostic index to predict life expectancy for terminally ill cancer patients in a hospice consultation setting in Taiwan. Asian Pac J Cancer Prev 2012; 13: 2861-6. |
| References_xml | – reference: 11) Maltoni M, Scarpi E, Pittureri C, et al. Prospective comparison of prognostic scores in palliative care cancer populations. Oncologist 2012; 17: 446-54. – reference: 24) Lau F, Downing M, Lesperance M, et al. Using the Palliative Performance Scale to provide meaningful survival estimates. J Pain Symptom Manage 2009; 38: 134-44. – reference: 6) Stone PC, Lund S. Predicting prognosis in patients with advanced cancer. Ann Oncol 2007; 18: 971-6. – reference: 28) Ohde S, Hayashi A, Takahasi O, et al. A 2-week prognostic prediction model for terminal cancer patients in a palliative care unit at a Japanese general hospital. Palliat Med 2011; 25: 170-6. – reference: 1) Glare P, Sinclair C, Downing M, et al. Predicting survival in patients with advanced disease. In Hanks G, Cherny N, Christakis N, Fallon M, Kaasa S, Portenoy R eds. Oxford Textbook of Palliative Medicine, 4th ed. Oxford University Press, Oxford, 2009; 81-110. – reference: 9) Morita T, Tsunoda J, Inoue S, et al. The Palliative Prognostic Index: a scoring system for survival prediction of terminally ill cancer patients. Support Care Cancer 1999; 7: 128-33. – reference: 7) Krishnan M, Temel JS, Wright AA, et al. Predicting life expectancy in patients with advanced incurable cancer: a review. J Support Oncol 2013; 11: 68-74. – reference: 16) Stone CA, Tiernan E, Dooley BA. Prospective validation of the palliative prognostic index in patients with cancer. J Pain Symptom Manage 2008; 35: 617-22. – reference: 12) Kim AS, Youn CH, Ko HJ, et al. The survival time of terminal cancer patients: prediction based on clinical parameters and simple prognostic scores. J Palliat Care 2014; 30: 24-31. – reference: 8) Maltoni M, Nanni O, Pirovano M, et al. Successful validation of the palliative prognostic score in terminally ill cancer patients. Italian Multicenter Study Group on Palliative Care. J Pain Symptom Manage 1999; 17: 240-7. – reference: 22) Hamano J, Kizawa Y, Maeno T, et al. Prospective clarification of the utility of the Palliative Prognostic Index for patients with advanced cancer in the home care setting. Am J Hosp Palliat Care 2013; 00: 1-5. – reference: 13) Sonoda H, Yamaguchi T, Matsumoto M, et al. Validation of the Palliative Prognostic Index and Palliative Prognostic Score in a palliative care consultation team setting for patients with advanced cancers in an acute care hospital in Japan. Am J Hosp Palliat Care 2013; 00: 1-5. – reference: 14) Pandharipande P, Cotton BA, Shintani A, et al. Motoric subtypes of delirium in mechanically ventilated surgical and trauma intensive care unit patients. Intensive Care Med 2007; 33: 1726-31. – reference: 26) Gwilliam B1, Keeley V, Todd C, et al. Development of prognosis in palliative care study （PiPS） predictor models to improve prognostication in advanced cancer: Prospective cohort study. BMJ 2011; 343: d4920 – reference: 10) Tarumi Y, Watanabe SM, Lau F, et al. Evaluation of the Palliative Prognostic Score （PaP） and routinely collected clinical data in prognostication of survival for patients referred to a palliative care consultation service in an acute care hospital. J Pain Symptom Manage 2011; 42: 419-31. – reference: 18) Subramaniam S, Thorns A, Ridout M, et al. Accuracy of prognosis prediction by PPI in hospice inpatients with cancer: A multi-centre prospective study. BMJ Support Palliat Care 2013; 3: 324-9. – reference: 4) Maltoni M, Caraceni A, Brunelli C, et al. Prognostic factors in advanced cancer patients: Evidence-based clinical recommendations — a study by the steering committee of the European association for palliative care. J Clin Oncol 2005; 23: 6240-8. – reference: 27) Chiang JK, Cheng YH, Koo M, et al. A computer-assisted model for predicting probability of dying within 7 days of hospice admission in patients with terminal cancer. Jpn J Clin Oncol 2010; 40: 449-55. – reference: 25) Feliu J, Jiménez-Gordo AM, Madero R, et al. Development and validation of a prognostic nomogram for terminally ill cancer patients. J Natl Cancer Inst 2011; 103: 1613-20. – reference: 21) Hamano J, Maeno T, Kizawa Y, et al. Usefulness of Palliative Prognostic Index for patient with advanced cancer in home care setting. Am J Hosp Palliat Care 2012; 30: 264-7. – reference: 17) Cheng WH, Kao CY, Hung YS, et al. Validation of a palliative prognostic index to predict life expectancy for terminally ill cancer patients in a hospice consultation setting in Taiwan. Asian Pac J Cancer Prev 2012; 13: 2861-6. – reference: 15) Pourhoseingholi MA, Hajizadeh E, Moghimi Dehkordi B, et al. Comparing Cox regression and parametric models for survival of patients with gastric carcinoma. Asian Pac J Cancer Prev 2007; 8: 412-6. – reference: 23) Anderson F, Downing GM, Hill J, et al. Palliative performance scale （PPS）: A new tool. J Palliat Care 1996; 12: 5-11. – reference: 3) 日本緩和医療学会緩和医療ガイドライン作成委員会編．苦痛緩和のための鎮静に関するガイドライン2010年版．金原出版，東京，2010; 27-31, 46. – reference: 19) Stiel S, Bertram L, Neuhaus S, et al. Evaluation and comparison of two prognostic scores and the physicians’ estimate of survival in terminally ill patients. Support Care Cancer 2010; 18: 43-9. – reference: 20) Yoon SJ, Jung JG, Kim JS, et al. Comparison of accuracy among prognostic scores for predicting life expectancy in Korean patients with cancer with weeks of survival. Am J Hosp Palliat Care 2013; 00: 1-8. – reference: 2) 日本緩和医療学会緩和医療ガイドライン作成委員会編．終末期がん患者の輸液療法に関するガイドライン2013年版．金原出版，東京，2013; 2-8, 26-33, 46-52. – reference: 5) Lau F, Cloutier-Fisher D, Kuziemsky C, et al. A systematic review of prognostic tools for estimating survival time in palliative care. J Palliat Care 2007; 23: 93-112. |
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| Snippet | 【目的】進行がん患者の血液検査値のみを用いる生物学的予後スコアを開発し，妥当性を確かめた．【方法】緩和ケア病棟の患者（開発群）を対象に血液検査値，年齢，性別，がん種を独立変数，死亡を従属変数とするパラメトリック生存時間解析を行い生物学的予後スコアBiological Prognostic... |
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| SubjectTerms | Palliative Prognostic Index 予後予測 外的妥当性 緩和ケア 進行がん |
| Title | 進行がん患者における生物学的予後スコアBiological Prognostic Score の開発と外的妥当性の前向き検証―Palliative Prognostic Index との比較 |
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