Department of Medical Oncology, Sydney Cancer Centre, Sydney, Australia.
Support Care Cancer. 2013 Mar;21(3):697-705. doi: 10.1007/s00520-012-1569-6. Epub 2012 Aug 31.
Malignant pleural mesothelioma (MPM) is a highly aggressive and symptomatic disease. We examined the relationship between health-related quality of life (HRQoL) and inflammatory markers, and the prognostic role of HRQoL in MPM patients.
MPM patients from two parallel phase II studies (thalidomide alone or thalidomide with chemotherapy) were included. HRQoL was assessed at baseline using the modified Lung Cancer Symptom Scale (LCSS). Baseline inflammatory markers and cytokines were measured. Spearman correlation was used to examine the relationship between inflammatory markers and HRQoL measures. The prognostic value of the HRQoL domains was examined using Cox proportional hazard model.
Sixty-three patients were included: median age 61 years (range 44-79); 82% male; 77% Eastern Cooperative Oncology Group (ECOG) performance status 0-1; 44% epithelial histology subtype. Baseline systemic symptoms of anorexia and fatigue, the summation symptoms of overall symptomatic distress, interference with normal activity and global QoL and the aggregate score of total LCSS score were all associated with elevated neutrophil-to-lymphocyte ratio, C-reactive protein and vascular endothelial growth factor levels at baseline (rho ≥ 0.25; p < 0.05). Baseline anorexia, fatigue, cough, dyspnoea, pain, overall symptomatic distress, interference with normal activity, global QoL and total LCSS score were all significantly related to survival (p < 0.05) after adjusting for established prognostic factors (age, gender, histological subtype and performance status) and treatment effect.
In conclusion, HRQoL seems to relate to a patient's systemic inflammatory status and is associated with survival in MPM patients.
恶性胸膜间皮瘤（MPM）是一种侵袭性强且有症状的疾病。我们研究了健康相关生活质量（HRQoL）与炎症标志物之间的关系，以及 HRQoL 在 MPM 患者中的预后作用。
纳入了两项平行的 II 期研究（单独使用沙利度胺或沙利度胺联合化疗）中的 MPM 患者。使用改良肺癌症状量表（LCSS）在基线时评估 HRQoL。测量基线炎症标志物和细胞因子。采用 Spearman 相关分析检验炎症标志物与 HRQoL 指标之间的关系。采用 Cox 比例风险模型检验 HRQoL 各领域的预后价值。
共纳入 63 例患者：中位年龄 61 岁（范围 44-79）；82%为男性；77%的东部肿瘤协作组（ECOG）表现状态为 0-1；44%为上皮组织学亚型。基线时全身性症状（厌食和疲劳）、总体症状困扰的总和症状、正常活动的干扰、全球 QoL 和总 LCSS 评分的总和与基线时升高的中性粒细胞与淋巴细胞比值、C 反应蛋白和血管内皮生长因子水平相关（rho≥0.25；p＜0.05）。在调整了既定预后因素（年龄、性别、组织学亚型和表现状态）和治疗效果后，基线时的厌食、疲劳、咳嗽、呼吸困难、疼痛、总体症状困扰、正常活动的干扰、全球 QoL 和总 LCSS 评分均与生存显著相关（p＜0.05）。
总之，HRQoL 似乎与患者的全身炎症状态有关，并与 MPM 患者的生存相关。
