Lindholm Elisabet, Daneryd Peter, Körner Ulla, Hyltander Anders, Fouladiun Marita, Lundholm Kent
Department of Surgery, Sahlgrenska University Hospital, Göteborg University, Göteborg, Sweden.
Clin Cancer Res. 2004 Oct 15;10(20):6855-64. doi: 10.1158/1078-0432.CCR-04-0373.
The purpose is to evaluate relationships between objectively assessed exercise capacity and subjectively assessed scoring of physical functioning and well-being after erythropoietin treatment in cancer patients on palliative care.
Unselected cancer patients (n = 108) who experienced progressive cachexia were randomized to receive either anti-inflammatory treatment alone (indomethacin) or recombinant erythropoietin plus indomethacin to prevent the appearance of disease-induced anemia and thereby protect patients' exercise capacity. Follow-up investigations of nutritional status, exercise capacity, and health-related quality of life assessed by SF-36 and the European Organization for Research and Treatment of Cancer QLQ-C30 were compared.
Effective treatment by erythropoietin on top of basal whole body anti-inflammatory treatment was confirmed and indicated by time course changes of biochemical, physiologic, and nutritional objectives, whereas individual self-reported scoring of physical functioning and general health did not indicate a clear-cut effectiveness, particularly at moderately subnormal hemoglobin levels.
Discrepancies between objective and subjective self-reported measures may be either fundamental or indicate scoring limitations for evaluation of therapeutic results. Present results demonstrate a clinical benefit of erythropoietin treatment in cancer patients with subnormal to normal hemoglobin levels, whereas the patients' own subjective scoring was insufficient to sense such improvements. The discrepancy may be either fundamental or methodological but emphasizes the importance to document therapeutic outcome in both subjective and objective perspectives in palliative care of cancer patients.
旨在评估姑息治疗的癌症患者接受促红细胞生成素治疗后，客观评估的运动能力与主观评估的身体功能及幸福感评分之间的关系。
将108例出现进行性恶病质的未选择癌症患者随机分组，分别单独接受抗炎治疗（吲哚美辛）或重组促红细胞生成素加吲哚美辛治疗，以预防疾病所致贫血的出现，从而保护患者的运动能力。比较通过SF-36和欧洲癌症研究与治疗组织QLQ-C30对营养状况、运动能力及健康相关生活质量进行的随访调查结果。
在基础全身抗炎治疗之上，促红细胞生成素的有效治疗得到证实，这通过生化、生理和营养指标的时间进程变化得以体现，而个体自我报告的身体功能和总体健康评分并未显示出明确的疗效，尤其是在血红蛋白水平中度低于正常时。
客观测量与主观自我报告测量之间的差异可能是根本性的，也可能表明评估治疗结果时评分存在局限性。目前的结果表明，促红细胞生成素治疗对血红蛋白水平低于正常至正常的癌症患者具有临床益处，而患者自身的主观评分不足以感知到这种改善。这种差异可能是根本性的，也可能是方法学上的，但强调了在癌症患者姑息治疗中从主观和客观两个角度记录治疗结果的重要性。
