Department of Medicine V, University of Heidelberg, Heidelberg, Germany.
Leuk Lymphoma. 2010 Nov;51(11):2012-20. doi: 10.3109/10428194.2010.513749. Epub 2010 Sep 21.
In this study, we investigated the quality of life (QoL) of long-term survivors with Hodgkin lymphoma who received high-dose chemotherapy (HDCT) followed by peripheral blood stem cell transplantation (PBSCT). QoL of this group was compared with QoL of patients who were treated with conventional chemotherapy and with QoL of the healthy German population. Two standardized questionnaires, the EORTC QLQ-C30 and the EQ-5D, including the visual analogue scale (VAS) were applied. A total of 98 patients were included in the study, all of them treated in our institution. Thirty-seven patients who received HDCT with PBSCT between 1986 and 2007 were compared with 61 patients treated with conventional chemotherapy and supplementary radiation between 1998 and 2009. The median follow-up for the HDCT group was 11 years. Statistical analysis with the one-sample t-test shows a reduced QoL of both groups of patients compared to the healthy population. Compared to the group of patients who received conventional chemotherapy, there is a tendency towards reduced QoL in patients with HDCT in all of the three main categories of the EORTC-QLQ-C30. However, these differences were not statistically significant, with the exception of the subcategory of dyspnoea, which was worse in the group that was treated with BCNU containing high-dose protocols. We conclude that the negative impact of both HDCT and conventional therapy on the QoL of long-term survivors with Hodgkin lymphoma should not be underestimated and should lead to the development of less toxic therapy strategies.
在这项研究中,我们调查了接受大剂量化疗(HDCT)后接受外周血干细胞移植(PBSCT)的霍奇金淋巴瘤长期幸存者的生活质量(QoL)。将该组的 QoL 与接受常规化疗的患者的 QoL 以及德国健康人群的 QoL 进行了比较。应用了两个标准化问卷,EORTC QLQ-C30 和 EQ-5D,包括视觉模拟量表(VAS)。共有 98 名患者入组,均在我们机构接受治疗。37 名患者于 1986 年至 2007 年接受 HDCT 和 PBSCT 治疗,与 61 名患者于 1998 年至 2009 年接受常规化疗和补充放疗进行比较。HDCT 组的中位随访时间为 11 年。通过单样本 t 检验的统计分析显示,两组患者的 QoL 均低于健康人群。与接受常规化疗的患者相比,接受 HDCT 的患者在 EORTC-QLQ-C30 的三个主要类别中均存在 QoL 降低的趋势。然而,除了接受 BCNU 含大剂量方案治疗的患者呼吸困难亚类外,这些差异均无统计学意义。我们得出结论,HDCT 和常规治疗对霍奇金淋巴瘤长期幸存者的 QoL 产生的负面影响不应被低估,这应该促使我们开发出毒性更小的治疗策略。