Background: Cholangiocarcinoma (CCA) has a poor prognosis and is a major cause of mortality and suffering in Thailand’s Northeastern (Isaan) Region. Methods: This prospective cohort study aimed to compare the health-related quality of life (HRQoL) among 72 newly diagnosed CCA patients; 42 patients who received cannabis treatment (CT) and 30 patients who received a standard palliative care treatment (ST). The study was carried out between 1st September 2019 to 31st October 2020. Data were collected from patients from oncology clinics of six hospitals in five provinces of northeast Thailand. The HRQoL was measured at baseline, and at 2 and 4 months after diagnosis by the European Organisation for Research and Treatment of Cancer (EORTC) Core Quality of Life questionnaires QLQ-C30, and QLQ-BIL21. The Mann-Whitney U-test was performed to compare quality of life scores between the two patient groups and Wilcoxon signed rank test was performed to compare within groups QoL scores at pre-treatment, and 2 and 4 month follow-ups. Results: Global health status and functional scales, for both groups were high at pre-treatment. At 2 and 4 month follow-up, CT group patients had consistent statistically significantly better Palliative Performance Scale (PPS), and QoL scores, and many symptom scores than the ST group. Conclusions: Medicinal cannabis may increase QoL for advanced CCA patients. Our findings support the importance of early access to palliative cannabis care clinic before the terminal and acceleration phase close to death.
Background: Cholangiocarcinoma (CCA) incidence in Northeastern Thailand is very high and a major cause of mortality. CCA patients typically have a poor prognosis and short-term survival rate due to late-stage diagnosis. Thailand is the first Southeast Asian country to approve medicinal cannabis treatment, especially for palliative care with advanced cancer patients. Methods: A retrospective cohort comparative study of survival rates among 491 newly diagnosed advanced CCA patients was carried out between September 1, 2019, and June 30, 2021. A total of 404 patients were in the standard palliative care pain management treatment group (ST), and 87 were in the medicinal cannabis treatment group (CT). Patients with CCA were recruited from four tertiary hospitals and two secondary hospitals in five provinces of Northeast Thailand. The cumulative survival rates were calculated by the Kaplan-Meier method, and independent prognostic factors were investigated using Cox regression. Results: For ST patients, there was a total follow-up time of 790 person-months, with a mortality rate of 48.35/100 person-months. For CT patients the total follow-up time was 476 person-months, with mortality rate of 10.9/ 100 person-months. The median survival time after registration at a palliative clinic was 0.83 months (95% CI: 0.71–0.95) for ST and 5.66 months (95% CI: 1.94–9.38) for CT. Multivariate analysis showed that CT treatment protocol was associated with a significantly better survival (P value <0.001; median time of CT, 5.66 months (95% CI: 1.94–9.38); median time of ST, 0.83 months (95% CI: 0.71–0.95). Therefore, CT had a reduced probability of dying from the disease (HRadj., 0.28 (95% CI: 0.20–0.37) Conclusions: The medical cannabis increased overall survival rates among CCA patients.
Introduction:Cholangiocarcinoma (CCA) incidence in Northeastern Thailand is very high, and a major cause of mortality CCA patients typically have a poor prognosis and short-term survival rate, due to late-stage diagnosis. . Thailand is , the first Southeast Asian country to approve medicinal cannabis treatment, especially for palliative care with advanced cancer patients..Patients and methods:A retrospectively cohort comparative study of , survival rates among 491 newly diagnosed advanced CCA patients was carried out between September 2019 and 30 July, 2021; (404 patients in a standard palliative care pain management treatment group (ST), and 87 in a medicinal cannabis treatment group (CT). CCA Patients were recruited from 4 tertiary hospitals and 2 secondary hospitals in five provinces of Northeast Thailand. The cumulative survival rates were calculated by the Kaplan-Meier method, and independent prognostic factors were investigated using Cox regression.Results:For ST patients there was a total follow-up time of 790 person-months, with a , mortality rate of 48.35/ 100 person-years. For CT patients the total follow-up time was 476 person-months, with mortality rate of 10.9./ 100 person-years. The median survival time after registration at a palliative clinic was 0.83 months (95%CI: 0.71-0.95) for ST and 5.66 months (95%CI: 1.94-9.38) for CT None of the demographic factors were significantly associated with survival time for either ST or CT. Comparing ST with CT, there was a difference statistically significant in age, sex, cancer treatment and period of diagnosis with advanced CCA,HCC to registration factors (p-value<0.05)Conclusions:The medicinal cannabis group had an increase post CCA diagnosis survival rate.. Our findings support the importance of early access to palliative cannabis clinic before caner’s terminal and accelerating phase close to death.
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