Sirohi B, Powles R, Lawrence D, Treleaven J, Kulkarni S, Leary A, Rudin C, Horton C, Morgan G
Leukaemia and Myeloma Units, Royal Marsden NHS Trust, Surrey SM2 5PT and Clinical Trials and Statistics Unit, Institute of Cancer Research, UK.
Ann Oncol. 2007 Aug;18(8):1388-94. doi: 10.1093/annonc/mdm180.
To compare the effects of pegylated interferon-alpha2b (P-IFN) and interferon-alpha2b (IFN) on quality of life (QoL) and toxicity in patients with multiple myeloma maintained on a steady dose of IFN.
Consenting, eligible myeloma patients on IFN maintenance therapy for at least 6 weeks were randomly (1:1) allocated to receive P-IFN for 3 months followed by IFN for 3 months, or to continue with IFN for 3 months followed by P-IFN for 3 months (cross-over design). Patients were assessed for toxicity and QoL. Dose of P-IFN was equivalent to IFN.
The study enrolled 60 patients. At enrollment, 35 patients were in complete remission, 20 in partial remission and 5 were minimal responders. P-IFN was associated with significantly better global QoL score (mean difference 8.4; P = 0.0002). There was a significant improvement in functional scales--physical (P = 0.03), emotional (P = 0.04), social (P = 0.0008) with P-IFN. Fatigue (P = 0.0003), pain (P = 0.02) and appetite loss (P = 0.003) symptom scales were less in patients while on P-IFN. There were no statistically significant differences between treatment arms in QoL as measured by QLQ-MY24.
These data suggest that patients on P-IFN have a better QoL. Dose escalation studies are warranted to investigate potential impact on survival.
比较聚乙二醇化干扰素-α2b(P-IFN)和干扰素-α2b(IFN)对接受稳定剂量IFN维持治疗的多发性骨髓瘤患者生活质量(QoL)和毒性的影响。
同意参与且符合条件的接受IFN维持治疗至少6周的骨髓瘤患者被随机(1:1)分配,一组先接受3个月的P-IFN治疗,随后接受3个月的IFN治疗;另一组先继续接受3个月的IFN治疗,随后接受3个月的P-IFN治疗(交叉设计)。对患者进行毒性和QoL评估。P-IFN的剂量与IFN等效。
该研究纳入了60例患者。入组时,35例患者完全缓解,20例部分缓解,5例为微小反应者。P-IFN与显著更好的整体QoL评分相关(平均差异8.4;P = 0.0002)。使用P-IFN时,功能量表——身体(P = 0.03)、情绪(P = 0.04)、社会(P = 0.0008)方面有显著改善。使用P-IFN的患者疲劳(P = 0.0003)、疼痛(P = 0.02)和食欲减退(P = 0.003)症状量表得分更低。通过QLQ-MY24测量,各治疗组在QoL方面无统计学显著差异。
这些数据表明接受P-IFN治疗的患者生活质量更好。有必要进行剂量递增研究以调查对生存的潜在影响。