Picozzi Vincent, Narayanan Siva, Henry Hu X, Vacirca Jeffrey
Virginia Mason Medical Center, 1100 Ninth Ave, Seattle, Washington, 38101, USA.
Market Access Solutions, Raritan, NJ, USA.
J Gastrointest Cancer. 2017 Mar;48(1):103-109. doi: 10.1007/s12029-016-9902-9.
Due to its clinical course and often-late detection, many patients with metastatic pancreatic cancer (mPC) experience poor quality of life (QoL). This pilot project assessed real-world QoL in patients with mPC at different stages of treatment.
A cross-sectional survey was conducted in the following groups of patients with mPC: before initiation of first-line (1L) chemotherapy (no treatment); with partial response (PR) or stable disease (SD) upon receipt of ≥3 cycles of 1L nab-paclitaxel plus gemcitabine (nab-paclitaxel plus gemcitabine PR or SD); and with disease progression during ≥1L chemotherapy and not currently receiving nab-paclitaxel (≥1L PD). Eligible participants completed three QoL instruments, EORTC QLQ-C30, the pancreatic cancer module of EORTC QLQ-PAN26, and the EQ-5D, during their clinical visits at 14 clinics across the USA.
Demographic characteristics were similar among groups (no treatment, n = 29; nab-paclitaxel plus gemcitabine PR or SD, n = 26; ≥1L PD, n = 17). Patients in the nab-paclitaxel plus gemcitabine PR or SD group had lower mean pain scores by EORTC-QLQ-C30 (27.6 vs 47.1; P = 0.02) and lower mean pancreatic pain scores by EORTC-QLQ-PAN26 (27.9 vs 45.4; P = 0.02) compared with the no treatment group. The groups did not differ significantly in QoL as measured by the EQ-5D.
Patients who experienced PR or SD with 1L nab-paclitaxel plus gemcitabine had improved general and pancreatic pain scores and no clinically meaningful deterioration in QoL compared with patients who had not yet initiated chemotherapy.
由于转移性胰腺癌（mPC）的临床病程以及常常较晚才被发现，许多mPC患者的生活质量（QoL）较差。本试点项目评估了处于不同治疗阶段的mPC患者的真实世界QoL。
对以下几组mPC患者进行了横断面调查：一线（1L）化疗开始前（未治疗）；接受≥3个周期的1L纳米白蛋白结合型紫杉醇加吉西他滨治疗后出现部分缓解（PR）或疾病稳定（SD）（纳米白蛋白结合型紫杉醇加吉西他滨PR或SD）；以及在≥1L化疗期间疾病进展且目前未接受纳米白蛋白结合型紫杉醇治疗（≥1L PD）。符合条件的参与者在美国14家诊所进行临床就诊期间完成了三项QoL评估工具，即欧洲癌症研究与治疗组织生活质量核心问卷（EORTC QLQ-C30）、欧洲癌症研究与治疗组织胰腺癌模块问卷（EORTC QLQ-PAN26）和欧洲五维度健康量表（EQ-5D）。
各组之间的人口统计学特征相似（未治疗组，n = 29；纳米白蛋白结合型紫杉醇加吉西他滨PR或SD组，n = 26；≥1L PD组，n = 17）。与未治疗组相比，纳米白蛋白结合型紫杉醇加吉西他滨PR或SD组患者的EORTC-QLQ-C30平均疼痛评分较低（27.6对47.1；P = 0.02），EORTC-QLQ-PAN26平均胰腺疼痛评分较低（27.9对45.4；P = 0.02）。通过EQ-5D测量的QoL在各组之间没有显著差异。
与尚未开始化疗的患者相比，接受1L纳米白蛋白结合型紫杉醇加吉西他滨治疗后出现PR或SD的患者总体疼痛评分和胰腺疼痛评分有所改善，且QoL没有临床上有意义的恶化。
