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晚期肾细胞癌治疗中疲劳、黏膜炎、手足综合征和味觉障碍的横断面调查:FAMOUS研究的最终结果

A Cross-Sectional Investigation of Fatigue, Mucositis, Hand-Foot Syndrome and Dysgeusia in Advanced Renal Cell Carcinoma Treatment: Final Results From the FAMOUS Study.

作者信息

Goebell Peter J, Müller Lothar, Hurtz Hans-Jürgen, Koska Michaela, Busies Sabine, Marschner Norbert

机构信息

Department of Urology, Friedrich-Alexander University, Erlangen, Germany.

Oncology Outpatient-Centre, Leer, Germany.

出版信息

Clin Genitourin Cancer. 2016 Feb;14(1):63-8. doi: 10.1016/j.clgc.2015.09.004. Epub 2015 Sep 25.

Abstract

UNLABELLED

Treatment of metastatic renal cell carcinoma can be associated with adverse symptoms. The perception of fatigue, mucositis, hand-foot syndrome, and dysgeusia, and quality of life (QOL) was assessed in 63 oncologists and their patients receiving first-line treatment. Physicians underestimated the severity of the symptoms and the severity correlated with a lower QOL. A consistent assessment of symptoms in routine practice might improve QOL, adherence to treatment, and outcome.

BACKGROUND

The management of symptoms associated with treatment of metastatic renal cell carcinoma (mRCC) is crucial to ensure treatment adherence and outcome. The perception of symptoms can vary between the treating physician and patient, leading to assumptions and subsequent changes in treatment, potentially affecting treatment effectiveness. The aim of the present cross-sectional study was to evaluate the perception of the common symptoms of fatigue, mucositis, hand-foot syndrome, and dysgeusia in patients with mRCC receiving systemic therapies in routine practice.

PATIENTS AND METHODS

German patients receiving first-line systemic treatment for mRCC and their physicians were independently queried about the incidence and severity of fatigue, mucositis, hand-foot syndrome, and dysgeusia. Patients also completed the Functional Assessment of Cancer Therapy-General questionnaire to assess their quality of life (QOL). The effect of the 4 symptoms on QOL was analyzed using linear regression modeling.

RESULTS

A total of 63 matching questionnaires were completed by both physicians and patients with first-line treatment. The incidence and severity of symptoms differed between the patients and physicians. Patients rated the severity of symptoms significantly higher than did the physicians. A greater severity of symptoms correlated with a lower QOL. In multivariate regression analysis, fatigue adversely affected overall QOL.

CONCLUSION

Physicians underestimated the severity of common symptoms in patients with mRCC. The incorporation of patient-reported outcome measures into routine practice might increase awareness of patients' overall QOL and thereby potentially improve treatment adherence. A thorough evaluation of fatigue, its potential underlying causes, and active measures to manage fatigue could potentially improve patients' QOL.

摘要

未标注

转移性肾细胞癌的治疗可能会伴有不良症状。对63名肿瘤学家及其接受一线治疗的患者的疲劳、粘膜炎、手足综合征、味觉障碍以及生活质量(QOL)感知情况进行了评估。医生低估了症状的严重程度,且症状严重程度与较低的生活质量相关。在常规实践中对症状进行一致的评估可能会改善生活质量、提高治疗依从性并改善治疗结果。

背景

转移性肾细胞癌(mRCC)治疗相关症状的管理对于确保治疗依从性和治疗结果至关重要。治疗医生和患者对症状的感知可能存在差异,从而导致假设并随后改变治疗方案,这可能会影响治疗效果。本横断面研究的目的是评估在常规实践中接受全身治疗的mRCC患者对疲劳、粘膜炎、手足综合征和味觉障碍等常见症状的感知情况。

患者与方法

对接受mRCC一线全身治疗的德国患者及其医生分别询问疲劳、粘膜炎、手足综合征和味觉障碍的发生率及严重程度。患者还完成了癌症治疗功能评估通用问卷以评估其生活质量(QOL)。使用线性回归模型分析这4种症状对生活质量的影响。

结果

医生和接受一线治疗的患者共完成了63份匹配问卷。患者和医生对症状的发生率和严重程度的评估存在差异。患者对症状严重程度的评分显著高于医生。症状越严重,生活质量越低。在多变量回归分析中,疲劳对总体生活质量有不利影响。

结论

医生低估了mRCC患者常见症状的严重程度。将患者报告的结局指标纳入常规实践可能会提高对患者总体生活质量的认识,从而有可能改善治疗依从性。对疲劳、其潜在根本原因进行全面评估以及采取积极措施管理疲劳可能会改善患者的生活质量。

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