Sun Charlotte C, Bodurka Diane C, Weaver Candice B, Rasu Rafia, Wolf Judith K, Bevers Michael W, Smith Judith A, Wharton J Taylor, Rubenstein Edward B
Department of Gynecologic Oncology, The University of Texas M. D. Anderson Cancer Center, Unit 440, 1515 Holcombe Boulevard, Houston, Texas, 77030, USA.
Support Care Cancer. 2005 Apr;13(4):219-27. doi: 10.1007/s00520-004-0710-6. Epub 2004 Nov 9.
Although many patients with ovarian cancer achieve favorable responses to primary chemotherapy, the majority of women will experience recurrence of their cancer. Selection of second- or third-line chemotherapy ultimately depends on patient preferences for different side effects. To better understand this process, we evaluated preferences and symptom distress in patients with ovarian cancer.
A total of 70 women with ovarian cancer who had previously received at least three cycles of platinum-based chemotherapy and currently undergoing chemotherapy for newly diagnosed or recurrent disease were interviewed in an outpatient chemotherapy clinic. The patients were asked to rank order 27 health states using a modified visual analog scale and to complete the Memorial Symptom Assessment Scale (MSAS).
Most favorable health states included perfect health, clinical remission and complete control of chemotherapy-induced nausea and vomiting (CINV). Least favorable health states included more severe CINV health states and death. Patients on first-line chemotherapy had less symptom distress, and rated sexual dysfunction, fatigue and memory loss more favorably than patients on second- or third-line chemotherapy (P<0.05). Married patients generally had less symptom distress compared to patients who were not married, but married patients indicated more distress with sexual dysfunction (P=0.04). Married patients rated alopecia less favorably than unmarried patients (P=0.03), but married patients viewed certain CINV health states more favorably (P=0.02-0.04).
CINV remains one of the most dreaded side effects of chemotherapy. Separate preference profiles exist for patients with newly diagnosed and recurrent disease, as well as for married versus unmarried patients. While MSAS scores and VAS rankings showed consistency across some health states, this was not true for CINV, suggesting that current symptom status may only influence patient preferences for selected side effects.
尽管许多卵巢癌患者对一线化疗有良好反应，但大多数女性会经历癌症复发。二线或三线化疗的选择最终取决于患者对不同副作用的偏好。为了更好地理解这一过程，我们评估了卵巢癌患者的偏好和症状困扰。
在门诊化疗诊所对70名卵巢癌女性进行了访谈，这些女性此前至少接受过三个周期的铂类化疗，目前正在接受新诊断或复发性疾病的化疗。要求患者使用改良的视觉模拟量表对27种健康状态进行排序，并完成纪念症状评估量表（MSAS）。
最有利的健康状态包括完美健康、临床缓解以及化疗引起的恶心和呕吐（CINV）得到完全控制。最不利的健康状态包括更严重的CINV健康状态和死亡。一线化疗患者的症状困扰较少，与二线或三线化疗患者相比，对性功能障碍、疲劳和记忆力减退的评价更有利（P<0.05）。与未婚患者相比，已婚患者的症状困扰通常较少，但已婚患者表示性功能障碍带来的困扰更多（P=0.04）。已婚患者对脱发的评价不如未婚患者有利（P=0.03），但已婚患者对某些CINV健康状态的评价更有利（P=0.02 - 0.04）。
CINV仍然是化疗最可怕的副作用之一。新诊断和复发性疾病的患者以及已婚与未婚患者存在不同的偏好概况。虽然MSAS评分和VAS排名在某些健康状态下显示出一致性，但CINV并非如此，这表明当前的症状状态可能仅影响患者对特定副作用的偏好。
