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Predictors of Symptom Severity and Response in Patients With Metastatic Cancer
Camilla Zimmermann, MD, MSc*,
Debika Burman, MSc,
Matthew Follwell, MD, MSc,
Kristina Wakimoto, MSc,
Dori Seccareccia, MD, MCISc,
John Bryson, MD,
Lisa W. Le, MSc,
and
Gary Rodin, MD
* To whom correspondence should be addressed. E-mail: camilla.zimmermann{at}uhn.on.ca.
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Abstract |
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We examined determinants of symptom severity and response to treatment among 150 patients with cancer participating in a phase II trial of a palliative care team intervention. Patients completed a modified Edmonton Symptom Assessment Scale (ESAS) at baseline and 1 week. Women had a worse baseline ESAS Distress Score (EDS; P = .003) and Total Distress Score (TDS; P = .005); differences were particularly marked for anxiety and appetite. Performance status was inversely associated with EDS, TDS, well-being, appetite, and fatigue (Kruskal-Wallis, all P < .005). Multivariate analysis of covariance (ANCOVA) showed that symptom improvement was independently predicted by worse baseline EDS score and female gender. Performance status, gender, and baseline symptom severity should be accounted for in trials of palliative care interventions; inclusion criteria based on symptom severity should also be considered.
First published on September 25, 2009, doi:10.1177/1049909109346307
This version was published on October
16, 2009
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