Fosså S D, Aaronson N K, Newling D, van Cangh P J, Denis L, Kurth K H, de Pauw M
Norwegian Radium Hospital, Montebello, Oslo.
Eur J Cancer. 1990;26(11-12):1133-6. doi: 10.1016/0277-5379(90)90269-y.
72 patients with hormone resistant, progressing prostatic cancer completed a self-administered questionnaire to assess subjective morbidity and quality of life before they were entered into a phase III trial of estramustine (34) vs. mitomycin (38). At least one post-treatment assessment was available in 43 patients. This considerable degree of non-compliance is explained by practical problems related to completion and collection of the questionnaires in these rapidly deteriorating patients. Doctors underestimated subjective morbidity (pain, decreased performance status, nausea) in 30-50% of the cases. Decreased functional status, fatigue and pain were identified as the most frequent major morbidities before study entry. In most patients, treatment did not reduce this morbidity. The routine application of self-administered quality of life questionnaires has considerable practical problems but yields clinically worthwhile information about subjective morbidity. Simple but relevant monitoring of subjective morbidity by the patient should be mandatory in cancer trials where palliation is a major endpoint.
72例激素抵抗性进展期前列腺癌患者在进入雌莫司汀（34例）与丝裂霉素（38例）的III期试验之前，完成了一份自我管理的问卷，以评估主观发病率和生活质量。43例患者至少有一次治疗后评估结果。这些快速恶化的患者在问卷填写和收集方面存在实际问题，这解释了相当程度的不依从性。在30%-50%的病例中，医生低估了主观发病率（疼痛、体能状态下降、恶心）。功能状态下降、疲劳和疼痛被确定为研究入组前最常见的主要发病情况。在大多数患者中，治疗并未降低这种发病率。自我管理的生活质量问卷的常规应用存在相当大的实际问题，但能产生有关主观发病率的具有临床价值的信息。在以姑息治疗为主要终点的癌症试验中，应由患者对主观发病率进行简单但相关的监测。
