Lee Dawn, Nielsen Sandy Kildegaard, van Keep Marjolijn, Andersson Fredrik, Greene Damien
BresMed, Sheffield, United Kingdom.
BresMed, Sheffield, United Kingdom.
J Urol. 2015 Mar;193(3):839-46. doi: 10.1016/j.juro.2014.09.098. Epub 2014 Sep 28.
We used responses to questionnaires included in the CS21 degarelix trial and published mapping algorithms to address the paucity of evidence for health related quality of life in patients with advanced hormone dependent prostate cancer treated with degarelix.
We measured health related quality of life in 610 patients enrolled in the CS21 trial using SF-12® and EORTC QLQ-C30. Based on responses to these questionnaires we estimated patient utility using 4 published mapping algorithms. Utility was tested for relationships with aspects of the symptom and side effect burden that may be affected by degarelix treatment, that is prostate specific antigen progression and adverse events.
Average utility in patients without prostate specific antigen progression or an adverse event was 0.742, similar to previously published utilities for nonprogressed prostate cancer states. Prostate specific antigen progression was associated with a utility decrement of between 0.062 and 0.134 depending on the mapping algorithm used. Of adverse events considered in our analysis musculoskeletal events were associated with the greatest effects on patient utility with a decrement of between 0.029 and 0.086. The 4 mapping algorithms generated similar utility estimates, although values derived from SF-12 were consistently lower than those derived from EORTC QLQ-C30.
Prostate specific antigen progression status and the incidence of treatment and disease related adverse events result in significant decrements to patient health related quality of life. By slowing prostate specific antigen progression degarelix may improve patient utility and the health related quality of life burden.
我们利用醋酸亮丙瑞林微球(degarelix)CS21试验中所包含问卷的答复以及已发表的映射算法,来解决在接受degarelix治疗的晚期激素依赖性前列腺癌患者中,与健康相关生活质量的证据不足问题。
我们使用SF-12®和欧洲癌症研究与治疗组织核心生活质量问卷C30(EORTC QLQ-C30),对CS21试验中纳入的610例患者的健康相关生活质量进行了测量。基于这些问卷的答复,我们使用4种已发表的映射算法来估计患者效用。对效用与可能受degarelix治疗影响的症状和副作用负担方面(即前列腺特异性抗原进展和不良事件)的关系进行了检验。
无前列腺特异性抗原进展或不良事件的患者的平均效用为0.742,与先前发表的非进展性前列腺癌状态的效用相似。根据所使用的映射算法,前列腺特异性抗原进展与0.062至0.134之间的效用降低相关。在我们分析中考虑的不良事件中,肌肉骨骼事件对患者效用的影响最大,效用降低在0.029至0.086之间。尽管来自SF-12的值始终低于来自EORTC QLQ-C30的值,但这4种映射算法产生了相似的效用估计值。
前列腺特异性抗原进展状态以及治疗和疾病相关不良事件的发生率会导致患者健康相关生活质量显著下降。通过减缓前列腺特异性抗原进展,degarelix可能会提高患者效用以及减轻与健康相关的生活质量负担。