DePuy Venita, Anstrom Kevin J, Castel Liana D, Schulman Kevin A, Weinfurt Kevin P, Saad Fred
Center for Clinical and Genetic Economics, Duke Clinical Research Institute, Duke University Medical Center, P.O. Box 17969, Durham, NC 27715, USA.
Support Care Cancer. 2007 Jul;15(7):869-76. doi: 10.1007/s00520-006-0203-x.
Patients with prostate cancer metastasized to bone frequently experience skeletal morbidities as a result of their disease. We sought to quantify the longitudinal effects on patient-reported outcomes of skeletal-related events (SREs) and to ascertain the declines in health-related quality of life (HRQOL) and pain experienced by patients who experienced SREs.
Data are from a clinical trial for the treatment of SREs associated with advanced prostate cancer metastatic to bone. Outcome measures included the Functional Assessment of Cancer Therapy-General (FACT-G) and the Brief Pain Inventory. Among patients who survived 6 months after randomization, patients with no SREs in the initial 6 months after randomization were matched via propensity scores with those experiencing one or more SREs. Similarly, patients with one SRE were matched with a subset of patients with two or more SREs.
Patients with SREs in the initial period had significantly worse survival and HRQOL than those with no SREs. Significant differences were found between the pain differences, FACT-G total scores, and FACT-G physical, emotional, and functional subscales. Comparisons of patients with single vs multiple SREs showed similar patterns.
The presence of SREs is significantly associated with worse survival and poorer HRQOL in this patient population. Increasing SRE intensity shows a pattern of increasingly decreased survival and poorer HRQOL.
前列腺癌骨转移患者常因疾病出现骨骼相关并发症。我们试图量化骨骼相关事件(SREs)对患者报告结局的纵向影响,并确定发生SREs的患者在健康相关生活质量(HRQOL)和疼痛方面的下降情况。
数据来自一项治疗与晚期前列腺癌骨转移相关的SREs的临床试验。结局指标包括癌症治疗功能评估通用版(FACT-G)和简明疼痛问卷。在随机分组后存活6个月的患者中,将随机分组后最初6个月内无SREs的患者通过倾向得分与发生一个或多个SREs的患者进行匹配。同样,将发生一次SRE的患者与发生两次或更多次SRE的患者子集进行匹配。
初始阶段发生SREs的患者的生存率和HRQOL显著低于无SREs的患者。在疼痛差异、FACT-G总分以及FACT-G身体、情感和功能子量表方面发现了显著差异。单次与多次SREs患者的比较显示出相似的模式。
在该患者群体中,SREs的存在与较差的生存率和较差的HRQOL显著相关。SRE强度增加呈现出生存率逐渐降低和HRQOL较差的模式。