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帕博利珠单抗联合以铂类为基础的化疗治疗非小细胞肺癌合并稳定性脑转移患者的结局:KEYNOTE-021、-189和-407研究的汇总分析 被引量:7
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作者 周清(翻译校对) Steven F Powell +14 位作者 Delvys Rodríguez-Abreu Corey J Langer Ali Tafreshi Luis Paz-Ares Hans-Georg Kopp Jeronimo Rodríguez-Cid Dariusz M Kowalski Ying Cheng Takayasu Kurata Mark M Awad Jinaxin Lin Bin Zhao M Catherine Pietanza Bilal Piperdi Marina C Garassino 《中国肺癌杂志》 CAS CSCD 北大核心 2022年第1期I0007-I0018,共12页
背景与目的此项探索性分析回顾评价了晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者的结局,旨在确定基线时合并脑转移是否会影响一线应用帕博利珠单抗联合化疗(pembrolizumab plus chemotherapy,PC)比对单用化疗的疗效。患... 背景与目的此项探索性分析回顾评价了晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者的结局,旨在确定基线时合并脑转移是否会影响一线应用帕博利珠单抗联合化疗(pembrolizumab plus chemotherapy,PC)比对单用化疗的疗效。患者和方法对KEYNOTE-021队列G(非鳞癌)、KEYNOTE-189(非鳞癌)和KEYNOTE-407(鳞癌)三项研究晚期NSCLC患者的数据进行汇总分析。患者接受含铂两药化疗和/或35个周期帕博利珠单抗治疗(每3周200 mg)。所有研究均纳入了经治或初治的稳定性脑转移患者(KEYNOTE-189与KEYNOTE-407研究纳入初治脑转移患者)。经治的脑转移患者已处于病情稳定的状态≥2周(KEYNOTE-021队列G患者≥4周),无新发或脑转移病灶扩大的证据且入组前至少3天以上未使用激素。初治的无症状脑转移患者需定期接受脑部影像学检查。结果共纳入1298例患者,其中171例有基线脑转移,1127例无脑转移。两组的中位随访时间(范围)在数据截止时分别为10.9(0.1-35.1)个月和11.0(0.1-34.9)个月。合并脑转移和无脑转移患者的总生存期[0.48(95%CI:0.32-0.70)和0.63(95%CI:0.53-0.75)]和无进展生存期[0.44(95%CI:0.31-0.62)和0.55(95%CI:0.48-0.63)]的风险比(PC/化疗)相似。合并脑转移的患者中,PC组和单用化疗组患者的中位总生存期分别为18.8个月和7.6个月,中位无进展生存期分别为6.9个月和4.1个月。无论是否合并脑转移,PC组患者的客观缓解率都高于单用化疗组,且缓解持续时间有显著延长。合并脑转移的患者中,PC组与单用化疗组的治疗相关不良事件发生率分别为88.2%和82.8%;而无脑转移的患者中,两组治疗相关不良事件的发生率分别为94.5%和90.6%。结论无论是否合并脑转移,与单用化疗相比,帕博利珠单抗联合以铂类为基础的组织学特异性化疗可改善所有PD-L1亚组的临床结局,其中包括PD-L1肿瘤比例评分<1%的患者,并且在晚期NSCLC患者中安全性良好。该方案是晚期NSCLC初治患者的标准方案,并可用于合并稳定性脑转移的患者。 展开更多
关键词 帕博利珠单抗 脑转移 化疗 非小细胞肺癌 PD-L1
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Nurses’perception on competency requirement and training demand for intensive care nurses 被引量:4
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作者 Yeray Gabriel Santana-Padilla María Desamparados Bernat-Adell Luciano Santana-Cabrera 《International Journal of Nursing Sciences》 CSCD 2022年第3期350-356,I0004,共8页
Objectives Various authors have explored the combination of competencies necessary for ensuring safe and quality care carried out by nurses in Intensive Care Units(ICUs).Nurses’perception of training is an element th... Objectives Various authors have explored the combination of competencies necessary for ensuring safe and quality care carried out by nurses in Intensive Care Units(ICUs).Nurses’perception of training is an element that must be studied in order to adopt appropriate educational measures.This study aimed to evaluate nurses’perception of the importance of intensive care training in Spain.Methods A descriptive,cross-sectional,multicentre study was conducted on a national level in Spain.Totally 85 ICUs took part in the study.The questionnaire used was developed using the Delphi method and had 66 items to investigate nurses’perception on competency requirements and training needs.The evaluation was conducted by a 10-point Likert scale.Results The sample was 568 Spanish nurses.Significant differences were found on an academic level,in terms of gender and hospital type,and in the professional experience of the nurse when it comes to evaluating the different training items;the differences in overall questionnaire scores among these groups were statistically significant(P<0.05).The nurses analyzed believe that previous training and professional experience in other care services are necessary before starting work in an ICU.Conclusion Implementation of training programs tailored to the needs of critical nurses had benefits for nurses and the health system.Nurses benefited from training focused on the skills and knowledge of each moment of their working life.Nurses have a different evaluation of their training needs throughout their professional cycle.Therefore,their training must be adapted to the professional stage of each nurse. 展开更多
关键词 Competency-based education Critical care nursing Nursing education Nursing staff Staff development Surveys and questionnaires
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