Department of Radiation Oncology, Sant' Andrea Hospital, University Sapienza, Rome, Italy.
Int J Radiat Oncol Biol Phys. 2013 Jun 1;86(2):285-91. doi: 10.1016/j.ijrobp.2013.02.013.
To describe the quality of life (QOL) in elderly patients with glioblastoma (GBM) treated with an abbreviated course of radiation therapy (RT; 40 Gy in 15 fractions) plus concomitant and adjuvant temozolomide (TMZ).
Health-related QOL (HRQOL) was assessed by European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core-30 (QLQ-C30, version 3) and EORTC Quality of Life Questionnaire Brain Cancer Module (QLQ-BN20). Changes from baseline in the score of 9 preselected domains (global QLQ, social functioning, cognitive functioning, emotional functioning, physical functioning, motor dysfunction, communication deficit, fatigue, insomnia) were determined 4 weeks after RT and thereafter every 8 weeks during the treatment until disease progression. The proportion of patients with improved HRQOL scores, defined as a change of 10 points or more, and duration of changes were recorded.
Sixty-five patients completed the questionnaires at baseline. The treatment was consistently associated with improvement or stability in most of the preselected HRQOL domains. Global health improved over time; mean score differed by 9.6 points between baseline and 6-month follow-up (P=.03). For social functioning and cognitive functioning, mean scores improved over time, with a maximum difference of 10.4 points and 9.5 points between baseline and 6-month follow-up (P=.01 and P=.02), respectively. By contrast, fatigue worsened over time, with a difference in mean score of 5.6 points between baseline and 4-month follow-up (P=.02).
A short course of RT in combination with TMZ in elderly patients with GBM was associated with survival benefit without a negative effect on HRQOL until the time of disease progression.
描述接受短程放射治疗(RT;40Gy/15 次)联合替莫唑胺(TMZ)同期及辅助治疗的老年胶质母细胞瘤(GBM)患者的生活质量(QOL)。
采用欧洲癌症研究与治疗组织(EORTC)生活质量核心问卷 30 项(QLQ-C30,第 3 版)和 EORTC 脑肿瘤模块问卷(QLQ-BN20)评估健康相关 QOL(HRQOL)。在 RT 后 4 周以及治疗期间每 8 周(直至疾病进展),根据 9 个预先选定的领域(总体 QLQ、社会功能、认知功能、情绪功能、身体功能、运动功能障碍、沟通障碍、疲劳、失眠)的基线评分变化,确定患者 HRQOL 评分的变化。记录 HRQOL 评分改善(定义为变化 10 分或更多)的患者比例和变化持续时间。
65 例患者在基线时完成了问卷。大多数预先选定的 HRQOL 领域的治疗结果均为改善或稳定。总体健康状况随时间推移而改善;与基线相比,6 个月随访时的平均评分差异为 9.6 分(P=.03)。社会功能和认知功能的平均评分随时间推移而改善,与基线相比,6 个月随访时的评分差异最大分别为 10.4 分和 9.5 分(P=.01 和 P=.02)。相反,疲劳状况随时间推移而恶化,与基线相比,4 个月随访时的平均评分差异为 5.6 分(P=.02)。
对于老年 GBM 患者,短程 RT 联合 TMZ 治疗可带来生存获益,且在疾病进展前不会对 HRQOL 产生负面影响。