Iihara Naomi, Nishio Takayuki, Goda Tetsuko, Anzai Hideaki, Kagawa Masatoshi, Houchi Hitoshi, Kirino Yutaka
Kagawa School of Pharmaceutical Sciences, Tokushima Bunri University, 1314-1 Shido, Sanuki, Kagawa, 769-2193, Japan,
Support Care Cancer. 2015 Apr;23(4):1091-7. doi: 10.1007/s00520-014-2439-1. Epub 2014 Oct 8.
Cancer patients receiving chemotherapy will sometimes conceal their discomfort, but an excessive endurance for adverse drug reactions (ADRs) can lead to a poorer prognosis. The aim of this study was to clarify the association between ADR endurance and a preference of cancer patients for aggressive treatments.
A cross-sectional study was undertaken of inpatients under 75 years of age receiving injectable systemic chemotherapy or oral chronic medications at hospitals in Japan. Subjects were asked to respond to a validated questionnaire to assess the extent of their ADR endurance and whether they would choose a novel, more aggressive therapy if their life expectancy was estimated at 2 years.
Study participants were separated into the chemotherapy group (n = 36) and the non-chemotherapy group (n = 78). In the chemotherapy group, patients who had moderate ADR endurance scores were more likely to choose the new therapy (0-33, 34-67, and 68-100 points: 0.0, 54.5, and 27.3 %; χ (2) test, p = 0.15). Additionally, every patient on long-term chemotherapy (≥3 years) had high ADR endurance scores but did not choose the new, riskier treatment. In the non-chemotherapy group, the proportion of those choosing the new therapy was linearly associated with higher ADR endurance scores (25.9, 38.2, and 64.7 %; p = 0.04).
Cancer patients may prefer aggressive therapies, even when self-estimations of ADR endurance are not very high, especially if they have been receiving chemotherapy for a short period of time. These patients should be observed with great caution.
接受化疗的癌症患者有时会隐瞒自身不适，但对药物不良反应（ADR）过度耐受可能导致预后较差。本研究旨在阐明ADR耐受与癌症患者对积极治疗的偏好之间的关联。
对日本医院中接受注射用全身化疗或口服慢性药物治疗的75岁以下住院患者进行了一项横断面研究。受试者被要求回答一份经过验证的问卷，以评估其ADR耐受程度，以及如果预期寿命估计为2年，他们是否会选择一种新的、更积极的治疗方法。
研究参与者被分为化疗组（n = 36）和非化疗组（n = 78）。在化疗组中，ADR耐受得分中等的患者更有可能选择新疗法（0 - 33分、34 - 67分和68 - 100分：0.0%、54.5%和27.3%；χ²检验，p = 0.15）。此外，每位长期化疗（≥3年）的患者ADR耐受得分都很高，但并未选择新的、风险更高的治疗方法。在非化疗组中，选择新疗法的比例与较高的ADR耐受得分呈线性相关（25.9%、38.2%和64.7%；p = 0.04）。
癌症患者可能更喜欢积极的治疗方法，即使他们对ADR的自我耐受估计不是很高，尤其是如果他们接受化疗的时间较短。对这些患者应格外谨慎观察。
