Gynaecology and Obstetrics Clinic, University of Duisburg-Essen, Essen, Germany.
Mapi Consultancy, Lyon, France.
Ann Oncol. 2012 Aug;23(8):1979-1985. doi: 10.1093/annonc/mds178. Epub 2012 Jun 24.
Malignant ascites (MA) is associated with poor prognosis and limited palliative therapeutic options. Therefore, quality of life (QoL) assessment is of particular importance to demonstrate new treatment value. Following the demonstration of the superiority of catumaxomab and paracentesis over paracentesis on puncture-free survival, this analysis aimed at comparing deterioration in QoL between both the treatment options.
In a randomised, multicentre, phase II/III study of patients with MA due to epithelial cell adhesion molecule (EpCAM) positive cancer, the QoL was evaluated using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 items (EORTC QLQ-C30) questionnaire at screening, 1, 3 and 7 months after treatment and in the case of re-puncture on the day of paracentesis. Time to first deterioration in QoL was defined as a decrease in the QoL score of at least five points and compared between the catumaxomab (n=160) and control (n=85) groups using the log-rank test and Cox proportional hazards models adjusted for baseline score, country and primary tumour type.
Deterioration in QoL scores appeared more rapidly in the control than in the catumaxomab group (median 19-26 days versus 47-49 days). The difference in time to deterioration in QoL between the groups was statistically significant for all scores (P<0.01). The hazard ratios ranged from 0.08 to 0.24 (P<0.01).
Treatment with catumaxomab delayed deterioration in QoL in patients with MA. Compared with paracentesis alone, catumaxomab enabled patients to benefit from better QoL for a prolonged survival period.
恶性腹水(MA)与预后不良和有限的姑息治疗选择相关。因此,生活质量(QoL)评估对于证明新的治疗价值尤为重要。在证明 catumaxomab 和经皮穿刺引流术优于单纯经皮穿刺引流术在无穿刺生存方面的优越性后,本分析旨在比较两种治疗方案之间 QoL 的恶化情况。
在一项针对上皮细胞黏附分子(EpCAM)阳性癌症所致 MA 患者的随机、多中心、II/III 期研究中,使用欧洲癌症研究与治疗组织生活质量问卷核心 30 项(EORTC QLQ-C30)问卷在筛选时、治疗后 1、3 和 7 个月以及在经皮穿刺引流当天进行 QoL 评估。QoL 首次恶化的时间定义为 QoL 评分至少下降 5 分,并使用对数秩检验和 Cox 比例风险模型比较 catumaxomab(n=160)和对照组(n=85)之间的差异,该模型调整了基线评分、国家和原发肿瘤类型。
对照组 QoL 评分恶化的速度快于 catumaxomab 组(中位数 19-26 天与 47-49 天)。两组间 QoL 恶化时间差异具有统计学意义(所有评分 P<0.01)。风险比范围为 0.08 至 0.24(P<0.01)。
catu- maxomab 治疗可延缓 MA 患者 QoL 的恶化。与单纯经皮穿刺引流术相比,catu- maxomab 使患者在延长的生存期间受益于更好的 QoL。