Lewis Cari, Xun Pengcheng, He Ka
Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, 1025 E. Seventh Street, SPH C032, Bloomington, Indiana, 47405, USA.
Support Care Cancer. 2016 Apr;24(4):1463-71. doi: 10.1007/s00520-015-2931-2. Epub 2015 Sep 9.
The purpose of this cohort study was to investigate the association of adjuvant chemotherapy with quality of life (QoL), survival, and recurrence over the 24 months following diagnosis in stage II colon cancer patients.
Overall, 453 patients were recruited from North Carolina from 2009 to 2011 and interviewed with a closed-ended survey detailing quality of life, health behaviors, treatment, and cancer recurrence at three times points: diagnosis, 12-, and 24-months post-diagnosis; mortality was obtained via the National Death Index.
In sum, 265 patients received chemotherapy. Receipt of chemotherapy exhibited an inverse association with total Functional Assessment of Cancer Treatment (FACT)-General (P < 0.01), FACT-Colorectal (P < 0.01), physical (P < 0.01), emotional (P = 0.02), and functional (P < 0.01) well-being; the inverse association between receiving chemotherapy and emotional well-being persisted for Caucasians but not African Americans (P interaction = 0.049). Those who received chemotherapy demonstrated significantly higher odds of cancer recurrence (odds ratio (OR) 2.74; 95 % confidence interval (CI) 1.18, 6.35) and all-cause mortality (OR: 1.95; 95 % CI: 1.05, 3.62).
In this study, stage II colon cancer patients who received chemotherapy treatment were more likely to have poor QoL, recurrence, and all-cause mortality after 24 months compared to those who did not receive chemotherapy. Future research focusing on subtypes of chemotherapy treatment, as well as a longer follow-up period, is needed.
本队列研究旨在调查Ⅱ期结肠癌患者诊断后24个月内辅助化疗与生活质量(QoL)、生存率和复发率之间的关联。
2009年至2011年期间,共从北卡罗来纳州招募了453名患者,并通过封闭式调查进行访谈,详细了解其在三个时间点的生活质量、健康行为、治疗情况和癌症复发情况:诊断时、诊断后12个月和24个月;通过国家死亡指数获取死亡率。
总计265名患者接受了化疗。接受化疗与癌症治疗功能评估量表(FACT)-通用版总分(P<0.01)、FACT-结直肠癌量表(P<0.01)、身体状况(P<0.01)、情绪状况(P=0.02)和功能状况(P<0.01)呈负相关;接受化疗与情绪状况之间的负相关在白人中持续存在,但在非裔美国人中不存在(P交互作用=0.049)。接受化疗的患者癌症复发几率(优势比[OR]2.74;95%置信区间[CI]1.18,6.35)和全因死亡率(OR:1.95;95%CI:1.05,3.62)显著更高。
在本研究中,与未接受化疗的Ⅱ期结肠癌患者相比,接受化疗的患者在24个月后更有可能出现生活质量差、复发和全因死亡。未来需要针对化疗治疗亚型以及更长随访期开展研究。