BACKGROUND We evaluated symptom trajectories and predictors of reporting severe symptoms in the last 6 months of life among non-resected pancreatic adenocarcinoma (PAC) decedents. METHODS A retrospective cohort study of non-resected PAC decedents receiving care at regional cancer centres between January 2007 and December 2015. Symptoms were measured using the Edmonton Symptom Assessment System (ESAS). We described the proportion of patients reporting severe (score ≥7) symptoms by 2-week intervals during the six months prior to death. Multivariable modified Poisson regression models identified predictors of reporting severe symptom scores in the last 6 months of life. RESULTS 2538 non-resected PAC decedents treated at regional cancer centres had ≥1 symptom ESAS record in the last six months of life, totaling 10,893 unique symptom assessments. Tiredness was the most commonly reported symptom (59% reporting ≥1 severe score), followed by lack of appetite (57%), impaired-wellbeing (49%) and drowsiness (42%). All symptoms increased closer to death. Older age, female sex, higher comorbidity status, survival less than 6 months, and urban residence were associated with a significantly higher risk of reporting severe symptoms. CONCLUSION Non-resected PAC patients experience significant symptom burden nearing death. Patient subsets may benefit from personalized supportive care interventions.

中文翻译：

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生命周期结束时胰腺腺癌的症状轨迹和严重症状的预测因子：基于人群的2,538例患者的分析。

背景我们评估了未切除的胰腺腺癌（PAC）后遗症患者生命中最后6个月的症状轨迹和报告严重症状的预测因子。方法对2007年1月至2015年12月在区域癌症中心接受治疗的未切除PAC后遗症患者进行回顾性队列研究。使用埃德蒙顿症状评估系统（ESAS）对症状进行测量。我们描述了死亡前六个月内每两周报告一次严重（分数≥7）症状的患者比例。多变量改进的Poisson回归模型确定了生命中最后6个月报告严重症状评分的预测因素。结果在区域癌症中心接受治疗的2538名未切除的PAC后遗症患者在生命的最后六个月中有≥1种症状ESAS记录，总共进行了10,893次独特的症状评估。疲倦是最常见的症状（59％表示≥1严重分数），其次是食欲不振（57％），健康受损（49％）和嗜睡（42％）。所有症状越来越接近死亡。年龄较大，女性，合并症程度较高，生存期少于6个月以及在城市居住与报告严重症状的风险显着相关。结论未切除的PAC患者在临近死亡时会出现明显的症状负担。患者子集可能会受益于个性化支持治疗干预措施。和城市居民与报告严重症状的风险显着相关。结论未切除的PAC患者在临近死亡时会出现明显的症状负担。患者子集可能会受益于个性化支持治疗干预措施。和城市居民与报告严重症状的风险显着相关。结论未切除的PAC患者在临近死亡时会出现明显的症状负担。患者子集可能会受益于个性化支持治疗干预措施。