Fernandez C, Rosell R, Abad-Esteve A, Monras P, Moreno I, Serichol M, Roviralta M
Department of Medicine, Hospital De Badalona Germans Trias i Pujol, Barcelona, Spain.
Acta Oncol. 1989;28(1):29-33. doi: 10.3109/02841868909111177.
To evaluate the usefulness of chemotherapy in non-small cell lung cancer, objective response, length of remission and survival have been considered the main yardsticks. Subjective improvement and gain in Karnofsky performance status have attracted very little attention. Thirty-one patients with stages III and IV underwent combination chemotherapy with high-dose cisplatin, and were assessed with categorical scales and 100 mm visual analogue scales used by patients themselves to report on several symptoms of their illness. After chemotherapy 17 of 19 patients (89%) gained weight; 20 presented anorexia, 10 of those (50%) improved; 15 had pain, 7 of those (47%) were alleviated; cough was reported in 22, in 10 (45%) it was ameliorated; hemoptysis disappeared in 10 of 11 patients (91%); of the 9 patients who had dyspnea, 7 improved (78%); and astenia was attenuated in 8 of 16 patients (50%). Quality of life was reported improved in 75% of those patients who had considered themselves seriously affected prior to the treatment. When compared with Karnofsky performance status, no relationship was found (r = 0.31). It is concluded that, apart from the objective response achieved, a significant proportion of patients did benefit from treatment as demonstrated by a marked relief of symptoms.
为评估化疗在非小细胞肺癌中的效用,客观缓解率、缓解期长度和生存期一直被视为主要衡量标准。主观改善情况以及卡诺夫斯基功能状态评分的提高很少受到关注。31例Ⅲ期和Ⅳ期患者接受了高剂量顺铂联合化疗,并使用分类量表和患者自行填写的100毫米视觉模拟量表对其多种疾病症状进行评估。化疗后,19例患者中有17例(89%)体重增加;20例存在厌食症状,其中10例(50%)有所改善;15例有疼痛症状,其中7例(47%)得到缓解;22例有咳嗽症状,其中10例(45%)有所减轻;11例咯血患者中有10例(91%)咯血消失;9例呼吸困难患者中有7例(78%)症状改善;16例乏力患者中有8例(50%)症状减轻。75%在治疗前认为自身受到严重影响的患者报告生活质量有所改善。与卡诺夫斯基功能状态评分相比,未发现相关性(r = 0.31)。得出的结论是,除了实现的客观缓解外,相当一部分患者确实从治疗中获益,表现为症状明显缓解。