Matei Daniela, Miller Anna M, Monahan Patrick, Gershenson David, Zhao Qianqian, Cella David, Champion Victoria L, Williams Stephen D
Indiana University Melvin and Bren Simon Cancer Center, 535 Barnhill Drive RT-473, Indianapolis, IN 46202, USA.
J Clin Oncol. 2009 Sep 1;27(25):4142-9. doi: 10.1200/JCO.2008.20.9189. Epub 2009 Jul 27.
This study compares late effects of treatment on physical well-being and utilization of health care resources between ovarian germ cell tumor (OGCT) survivors and age/race/education-matched controls.
Eligible patients had OGCT treated with surgery and chemotherapy and were disease-free for at least 2 years at time of enrollment. The matched control group was selected from acquaintances recommended by survivors. Symptoms and function were measured using previously validated scales. Health care utilization was assessed by questions regarding health insurance coverage and health services utilization.
One hundred thirty-two survivors and 137 controls completed the study. Survivors were significantly more likely to report a diagnosis of hypertension (17% v 8%, P = .02), and marginally hypercholesterolemia (9.8% v 4.4%, P = .09), and hearing loss (5.3% v 1.5%, P = .09) compared with controls. There were no significant differences in the rates of self-reported arthritis, heart, pulmonary or kidney disease, diabetes, non-OGCT malignancies, anxiety, hearing loss, or eating disorders between groups. Among chronic functional problems, numbness, tinnitus, nausea elicited by reminders of chemotherapy (v general nausea triggers for controls), and Raynaud's symptoms were reported more frequently by survivors. Patients who received vincristine, dactinomycin, and cyclophosphamide in addition to cisplatin therapy had increased functional complaints, particularly numbness and nausea. Health care utilization was similar, but 15.9% of survivors reported being denied health insurance versus 4.4% of controls (P < .001).
Although a few sequelae of treatment persist, in general, OGCT survivors enjoy a healthy life comparable to that of controls.
本研究比较了卵巢生殖细胞肿瘤（OGCT）幸存者与年龄、种族、教育程度相匹配的对照组在治疗对身体健康和医疗资源利用方面的远期影响。
符合条件的患者接受了手术和化疗治疗OGCT，入组时无疾病状态至少持续2年。匹配的对照组从幸存者推荐的熟人中选取。使用先前验证过的量表测量症状和功能。通过关于健康保险覆盖范围和医疗服务利用的问题评估医疗资源利用情况。
132名幸存者和137名对照完成了研究。与对照组相比，幸存者更有可能报告患有高血压（17%对8%，P = 0.02）、边缘性高胆固醇血症（9.8%对4.4%，P = 0.09）和听力损失（5.3%对1.5%，P = 0.09）。两组间自我报告的关节炎、心脏、肺部或肾脏疾病、糖尿病、非OGCT恶性肿瘤、焦虑、听力损失或饮食失调的发生率无显著差异。在慢性功能问题方面，幸存者更频繁地报告麻木、耳鸣、化疗提示引起的恶心（相对于对照组的一般恶心诱因）和雷诺氏症状。除顺铂治疗外还接受长春新碱、放线菌素D和环磷酰胺治疗的患者功能抱怨增加，尤其是麻木和恶心。医疗资源利用情况相似，但15.9%的幸存者报告被拒绝健康保险，而对照组为4.4%（P < 0.001）。
尽管治疗的一些后遗症仍然存在，但总体而言，OGCT幸存者享有与对照组相当的健康生活。
