Fayers P M, Bleehen N M, Girling D J, Stephens R J
Cancer Trials Office, Cambridge, UK.
Br J Cancer. 1991 Aug;64(2):299-306. doi: 10.1038/bjc.1991.296.
Three hundred and sixty-nine patients in an MRC study of combination chemotherapy and radiotherapy for small-cell lung cancer of limited extent were asked to complete a Daily Diary Card which enabled an assessment of their quality of life to be made during and after treatment. The information derived from the card suggests that although cytotoxic chemotherapy has an adverse effect upon quality of life, this impairment only affects the first 2 or 3 days following each course of treatment, although there is also a small deterioration which may be associated with the 'nadir' effect of the blood counts about 10 days after each course. These results should assist physicians in counselling patients about the likely effects of treatment. Just over half of the patients (196) were subsequently randomised to either a further six courses of maintenance chemotherapy or no further chemotherapy, and it is also shown that the patients allocated to no maintenance chemotherapy experienced a gradually deteriorating quality of life, as opposed to the brief but more severe adverse effects which occurred following each course in the maintenance chemotherapy group; this supports the hypothesis of a palliative effect in this latter group. The findings demonstrate that the Daily Diary Card is a sensitive instrument capable of yielding useful information.
在医学研究委员会（MRC）针对局限期小细胞肺癌进行的联合化疗与放疗研究中，369名患者被要求填写一份日常日记卡，以便在治疗期间及治疗后对他们的生活质量进行评估。从该卡片获得的信息表明，尽管细胞毒性化疗会对生活质量产生不利影响，但这种损害仅影响每个疗程后的头2至3天，不过在每个疗程约10天后，还会出现与血细胞计数“最低点”效应相关的轻微恶化。这些结果应有助于医生向患者提供有关治疗可能产生的影响的咨询。随后，略多于一半的患者（196名）被随机分配接受另外六个疗程的维持化疗或不接受进一步化疗，并且还表明，分配到不进行维持化疗的患者生活质量逐渐恶化，而维持化疗组每个疗程后出现的是短暂但更严重的不良反应；这支持了后一组具有姑息作用的假设。研究结果表明，日常日记卡是一种能够产生有用信息的敏感工具。
