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Medline ® Abstracts for References 3-6

of '进展期胰腺外分泌癌的化疗'

3
TI
Depression and carcinoma of the pancreas.
AU
Joffe RT, Rubinow DR, Denicoff KD, Maher M, Sindelar WF
SO
Gen Hosp Psychiatry. 1986;8(4):241.
 
A systematic psychiatric evaluation of 21 subjects with intraabdominal malignancy (pancreatic or gastric carcinoma) was performed. Depression was frequently associated with and often the presenting symptom complex of patients with carcinoma of the pancreas. This finding was not observed in patients with gastric carcinoma. Clinical and theoretical implications of these findings are discussed.
AD
PMID
4
TI
Comparative psychological disturbance in patients with pancreatic and gastric cancer.
AU
Holland JC, Korzun AH, Tross S, Silberfarb P, Perry M, Comis R, Oster M
SO
Am J Psychiatry. 1986;143(8):982.
 
One hundred and seven patients with advanced pancreatic cancer and 111 patients with advanced gastric cancer, stratified for key medical and sociodemographic variables, were assessed with the Profile of Mood States before beginning combination chemotherapy in a national cancer clinical trials group. The pancreatic cancer patients had significantly higher self-ratings of depression, tension-anxiety, fatigue, confusion-bewilderment, and total mood disturbance; no difference was found in vigor or anger-hostility. These data support prior observations that patients with advanced pancreatic cancer experience significantly greater general psychological disturbance than patients with another type of advanced abdominal neoplasm.
AD
PMID
5
TI
Pain and depression in patients with newly diagnosed pancreas cancer.
AU
Kelsen DP, Portenoy RK, Thaler HT, Niedzwiecki D, Passik SD, Tao Y, Banks W, Brennan MF, Foley KM
SO
J Clin Oncol. 1995;13(3):748.
 
PURPOSE: To evaluate the prevalence of pain and depression, their correlation, and their effect on quality of life in patients with recently diagnosed adenocarcinoma of the pancreas (PC).
MATERIALS AND METHODS: Cross-sectional pain and psychosocial distress were assessed using validated instruments, including the Memorial Pain Assessment Card (MPAC), Beck Depression Inventory (BDI), Hopelessness Scale (BHS), and Functional Living Index-Cancer (FLIC). Patients were evaluated before their first operation for PC or first treatment with chemotherapy at a large tertiary-care cancer center.
RESULTS: One hundred thirty patients with proven PC were studied: 83 before their operation and 47 before their first chemotherapy treatment. At the time of study entrance, 37% of patients had no pain and an additional 34% had pain that was mild or less severe. Only 29% of patients had moderate, strong, or severe pain. Chemotherapy patients reported significantly more intense pain than did preoperative patients (P = .02). Symptoms of depression were assessed using the BDI and BHS scales. A substantial minority of patients (38%) had BDI scores>or = 15, which suggests high levels of depressive symptoms. There was a significant correlation between increasing pain and depressive symptoms among those who experienced pain. Quality of life was assessed using the Weekly Activity Checklist (WAC) and the FLIC. Compared with patients who had no pain or mild pain, patients with moderate or greater pain had significantly impaired functional activity (P = .03) and poorer quality-of-life scores (P = .02) when compared with those with lesser degrees of pain. There were significant correlations between increasing pain and depression and between pain and depressive symptoms and impaired quality of life and function.
CONCLUSION: Our results indicate that moderate or severe pain and symptoms of depression are not as prevalent in recently diagnosed PC patients as is generally believed. However, one third have inadequate pain control despite the use of oral analgesics. These patients can be identified by the use of a simple self-report instrument (the MPAC card). Quality of life and function are adversely affected by moderate or greater levels of perceived pain intensity. A simple and rapid assessment is possible and can identify high-risk patients in need of intervention that may improve quality of life.
AD
Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
PMID
6
TI
Palliative and supportive care of patients with pancreatic cancer.
AU
Alter CL
SO
Semin Oncol. 1996;23(2):229.
 
Pancreatic cancer tends to be diagnosed at a relatively late stage of disease and often secondary to significant complaints of pain. In addition there is evidence of higher rates of depressive symptoms at diagnosis in pancreatic cancer than in other forms of cancer. These factors, along with the specific tumor anatomy and pathophysiology of pancreatic cancer make palliative considerations central to the care of patients with the disease. The palliative and supportive approach must first include an aggressive evaluation of pain, mood, and emotional symptoms. Attention should be paid to the specific nature of pain complaints and attempts made to make accurate clinicopathological correlates for the pain. Assessment should be complete and ongoing. Pain treatments include pharmacotherapy, invasive anesthetic and surgical procedures, and supportive attention to side effects and other symptoms of disease and treatment. Depression often appears at higher rates than documented in other cancer patients and can be independent of pain complaints and other symptoms present in the preterminal phases of illness. Depression should be treated with pharmacotherapy and supportive psychotherapy as indicated. Hospice should be considered early on in the treatment relationship and can provide pain and symptom management services as well as play an important role in providing emotional support to the patient and family. Attention to pain, mood, psychological distress, and other quality of life issues can often allow for successful treatment of symptoms and improvement in functioning even in the setting of late stage pancreatic cancer.
AD
Temple University Cancer Center, Philadelphia, PA 19140, USA.
PMID