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卵巢癌患者参与随机对照试验的毒性和生活质量结局。

Toxicity and quality of life outcomes in ovarian cancer patients participating in randomized controlled trials.

机构信息

Department of Obstetrics and Gynecology, Medical University Graz, Auenbruggerplatz 14, 8036, Graz, Austria.

出版信息

Support Care Cancer. 2011 Sep;19(9):1421-7. doi: 10.1007/s00520-010-0969-8. Epub 2010 Aug 6.


DOI:10.1007/s00520-010-0969-8
PMID:20694564
Abstract

MAIN PURPOSE: The objective of this study was to determine the relationship between clinician-graded symptoms based on the common toxicity criteria (CTC) and patient-reported quality of life (QoL). We hypothesized that toxicity symptoms that are objective or observable would have a higher correlation with QoL than subjective data. MATERIAL AND METHODS: A retrospective analyses of data from three closed randomized chemotherapy trials was performed. A total of 2,110 patients with ovarian cancer (stage IIB-IV) who had complete toxicity and QoL data at cycles 3 and 6 were included. Toxicities were graded according to the National Cancer Institute Common Toxicity Criteria. Quality of life was assessed every other cycle by using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). MAIN RESULTS: Correlations between CTC grading and the QLQ-C30 functioning scales were weak (<0.30); correlation coefficients between CTC ratings and the QLQ-C30 symptom scales including nausea, vomiting, constipation, pain, and dyspnea ranged from 0.32 to 0.49 except for constipation (0.55). On a symptom level exact agreement between clinician and patient reporting ranged from 54.2% (pain) to 80.8% (emesis/vomiting). When symptom grading differed, patients reported greater severity for pain, constipation, and dyspnea, whereas clinicians graded emesis/vomiting and nausea as more severe than the grading by patients. CONCLUSION: Patient experience is not routinely captured by CTC toxicity scales. Therefore, clinicians should not entirely rely on the CTC grading but consider patient-reported outcomes as well.

摘要

主要目的:本研究旨在确定基于通用毒性标准(CTC)的临床医生分级症状与患者报告的生活质量(QoL)之间的关系。我们假设,客观或可观察到的毒性症状与 QoL 的相关性将高于主观数据。 材料和方法:对三项封闭随机化疗试验的数据进行了回顾性分析。共有 2110 名患有卵巢癌(IIB-IV 期)的患者完成了 3 期和 6 期的完整毒性和 QoL 数据,包括在内。毒性根据美国国立癌症研究所通用毒性标准进行分级。使用欧洲癌症研究与治疗组织生活质量问卷(EORTC QLQ-C30)每隔一个周期评估生活质量。 主要结果:CTC 分级与 QLQ-C30 功能量表之间的相关性较弱(<0.30);除便秘(0.55)外,CTC 评分与 QLQ-C30 症状量表(包括恶心、呕吐、便秘、疼痛和呼吸困难)之间的相关系数范围为 0.32 至 0.49。在症状水平上,临床医生和患者报告的完全一致性从疼痛(54.2%)到呕吐/恶心(80.8%)不等。当症状分级不同时,患者报告的疼痛、便秘和呼吸困难更为严重,而临床医生对呕吐/恶心和恶心的分级比患者更为严重。 结论:患者体验通常不会被 CTC 毒性量表捕获。因此,临床医生不应完全依赖 CTC 分级,而应同时考虑患者报告的结果。

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本文引用的文献

[1]
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J Natl Cancer Inst. 2009-12-2

[2]
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J Natl Cancer Inst. 2006-8-2

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Assessing health-related quality of life in palliative care: comparing patient and physician assessments.

Eur J Cancer. 2006-5

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Addition of epirubicin as a third drug to carboplatin-paclitaxel in first-line treatment of advanced ovarian cancer: a prospectively randomized gynecologic cancer intergroup trial by the Arbeitsgemeinschaft Gynaekologische Onkologie Ovarian Cancer Study Group and the Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens.

J Clin Oncol. 2006-3-1

[10]
Randomized study of the Arbeitsgemeinschaft Gynaekologische Onkologie Ovarian Cancer Study Group comparing quality of life in patients with ovarian cancer treated with cisplatin/paclitaxel versus carboplatin/paclitaxel.

J Clin Oncol. 2006-2-1

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