CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical Psychology, Tilburg University, Tilburg, The Netherlands.
Eur J Haematol. 2012 Oct;89(4):311-9. doi: 10.1111/j.1600-0609.2012.01831.x. Epub 2012 Aug 1.
This prospective population-based study describes health-related quality of life (HRQOL) and disease-specific complaints of patients with multiple myeloma (MM) up to 10 yr post-diagnosis.
The Eindhoven Cancer Registry was used to select all patients diagnosed with MM from 1999 to 2010. Patients with MM completed the EORTC QLQ-C30 and EORTC QLQ-MY20 questionnaires at baseline (n = 156; 74% response rate) and 1 yr later (n = 80). The EORTC QLQ-C30 was also completed by an age- and sex-matched normative population (n = 500).
Patients with MM reported statistically significant and clinically relevant worse scores on all EORTC QLQ-C30 scales (all P's at least < 0.01) compared to the norm. Also, patients with MM reported a mean decrease (e.g., worsening) between baseline and 1-yr follow-up scores for: quality of life (mean, 68 vs. 55, respectively, P < 0.001; 74% of patients had a deteriorated score), fatigue (33 vs. 39, P < 0.05; 50%), nausea and vomiting (6.3 vs. 13, P < 0.05; 71%), pain (33 vs. 43, P < 0.05; 59%), and dyspnea (17 vs. 33, P < 0.001; 66%). The most bothering symptoms during the past week were tingling hands/feet (32%), back pain (28%), bone aches/pain (26%), pain in arm/shoulder (19%), and feeling drowsy (18%). Also, 37% worried about their future health, 34% thought about their disease, and 21% worried about dying.
Patients with MM experience a very high symptom burden and low HRQOL. Future studies should focus on possible mechanisms that can predict low HRQOL and high symptom burden in patients with MM and should investigate optimal ways to alleviate these.
本前瞻性基于人群的研究描述了多发性骨髓瘤(MM)患者在诊断后 10 年内的健康相关生活质量(HRQOL)和特定疾病的抱怨。
使用埃因霍温癌症登记处选择了 1999 年至 2010 年期间诊断为 MM 的所有患者。MM 患者在基线时(n = 156;应答率为 74%)和 1 年后(n = 80)完成了 EORTC QLQ-C30 和 EORTC QLQ-MY20 问卷。EORTC QLQ-C30 也由年龄和性别匹配的正常人群(n = 500)完成。
与正常值相比,MM 患者在所有 EORTC QLQ-C30 量表上的评分均存在统计学意义上的显著且具有临床意义的下降(所有 P 值均至少<0.01)。此外,MM 患者在基线和 1 年随访之间的评分平均值呈下降趋势(例如,恶化):生活质量(分别为 68 分和 55 分,P < 0.001;74%的患者评分恶化)、疲劳(33 分和 39 分,P < 0.05;50%)、恶心和呕吐(6.3 分和 13 分,P < 0.05;71%)、疼痛(33 分和 43 分,P < 0.05;59%)和呼吸困难(17 分和 33 分,P < 0.001;66%)。过去一周最困扰的症状是手脚刺痛(32%)、背痛(28%)、骨痛/疼痛(26%)、手臂/肩膀疼痛(19%)和昏昏欲睡(18%)。此外,37%的患者担心自己的未来健康,34%的患者考虑过自己的疾病,21%的患者担心死亡。
MM 患者经历着极高的症状负担和较低的 HRQOL。未来的研究应重点关注可能预测 MM 患者低 HRQOL 和高症状负担的潜在机制,并探讨缓解这些问题的最佳方法。