Osoba David, Slamon Dennis J, Burchmore Michael, Murphy Maureen
Quality of Life Consulting, West Vancouver, British Columbia, Canada.
J Clin Oncol. 2002 Jul 15;20(14):3106-13. doi: 10.1200/JCO.2002.03.090.
The study was designed to compare the effects of treatment with a combination of trastuzumab (Herceptin; Genentech, Inc, South San Francisco, CA) and chemotherapy versus chemotherapy alone on health-related quality of life (HRQL) in patients with HER-2/neu overexpressing, metastatic breast cancer.
A sample of 400 patients, not previously treated for metastatic disease and randomized to receive either trastuzumab plus chemotherapy (208 patients) or chemotherapy alone (192 patients), completed the European Organization for Research and Treatment Care Quality of Life Questionnaire at baseline and on at least one subsequent occasion at 8, 20, 32, 44, and 56 weeks. HRQL improvement or worsening was defined as a >or= 10-point change (range, 0 to 100 points) in the scores of six preselected domains (global quality of life [QOL], physical, role, social, and emotional functioning, and fatigue). Stable HRQL was defined as a change of less than 10. A Bonferroni correction was applied for multiple testing.
After completion of chemotherapy, patients treated with trastuzumab and chemotherapy reported significant improvement in fatigue (P <.05) as compared with their baseline scores. Higher proportions of patients receiving the combined therapy achieved improvement in global QOL (P <.05) than did patients treated with chemotherapy alone. Higher proportions of the combined therapy group also achieved improvement in physical and role functioning and in fatigue as compared with the chemotherapy group, but the differences were not statistically significant. There were no differences in the proportions of patients in the two groups that reported worsening.
Statistically significantly higher proportions of patients treated with a combination of trastuzumab and chemotherapy reported improved global QOL than did patients treated by chemotherapy alone.
本研究旨在比较曲妥珠单抗(赫赛汀;基因泰克公司,加利福尼亚州南旧金山)联合化疗与单纯化疗对HER-2/neu过表达转移性乳腺癌患者健康相关生活质量(HRQL)的影响。
选取400例未曾接受过转移性疾病治疗的患者,随机分为接受曲妥珠单抗联合化疗组(208例患者)和单纯化疗组(192例患者),患者在基线时以及随后至少一次在第8、20、32、44和56周完成欧洲癌症研究与治疗组织生活质量调查问卷。HRQL改善或恶化定义为六个预选领域(总体生活质量[QOL]、身体、角色、社会和情感功能以及疲劳)得分变化≥10分(范围为0至100分)。稳定的HRQL定义为变化小于10分。采用Bonferroni校正进行多重检验。
化疗完成后,与基线得分相比,接受曲妥珠单抗联合化疗的患者报告疲劳有显著改善(P<.05)。接受联合治疗的患者中,总体QOL改善的比例高于单纯化疗患者(P<.05)。联合治疗组在身体和角色功能以及疲劳方面改善的患者比例也高于化疗组,但差异无统计学意义。两组中报告病情恶化的患者比例没有差异。
与单纯化疗的患者相比,接受曲妥珠单抗联合化疗的患者中,报告总体QOL改善的比例在统计学上显著更高。