Kristensen Are, Solheim Tora S, Amundsen Tore, Hjelde Harald H, Kaasa Stein, Sørhaug Sveinung, Grønberg Bjørn H
a European Palliative Care Research Centre (PRC), Department of Cancer Research and Molecular Medicine, Faculty of Medicine , NTNU, Norwegian University of Science and Technology and St Olavs Hospital, Trondheim University Hospital , Trondheim , Norway.
b Cancer Clinic, St Olavs Hospital , Trondheim University Hospital , Trondheim , Norway.
Acta Oncol. 2017 May;56(5):737-745. doi: 10.1080/0284186X.2017.1279748. Epub 2017 Jan 24.
Side effects of chemotherapy may occur at different time-points in the treatment cycle, and the exact assessment time relative to chemotherapy may affect HRQoL scores. The current study examined the variation of HRQoL during chemotherapy cycles, and whether differences in HRQoL scores varied at selected time-points between patients allocated to two different chemotherapy regimens.
Patients with stage IIIB or IV non-small-cell lung cancer (NSCLC) were randomly assigned to receive three cycles of carboplatin plus vinorelbine (VC) or gemcitabine (GC) every 3 weeks. HRQoL was reported on the EORTC QLQ-C30 and LC13 on days 1, 4, 8, 11 and 15 of every cycle. Global health status, nausea/vomiting, fatigue and dyspnea (LC13) were defined as the HRQoL scales of primary interest.
Fifty-two patients were enrolled. Variation of mean scores of global health status, nausea/vomiting and fatigue showed a consistent pattern during chemotherapy. Day 4 appeared to be the time-point when chemotherapy influenced HRQoL the most. The differences in mean HRQoL scores between the two treatment arms varied at the different time-points, especially for nausea/vomiting.
There was a clinically relevant variation of HRQoL during chemotherapy cycles, with increased symptom burden the first week following treatment. Our results suggest that timing of HRQoL assessment can influence the chances of detecting differences between the treatment regimens.
化疗副作用可能在治疗周期的不同时间点出现，且相对于化疗的确切评估时间可能会影响健康相关生活质量（HRQoL）评分。本研究考察了化疗周期中HRQoL的变化情况，以及分配到两种不同化疗方案的患者在选定时间点的HRQoL评分差异是否有所不同。
ⅢB期或IV期非小细胞肺癌（NSCLC）患者被随机分配，每3周接受3个周期的卡铂联合长春瑞滨（VC）或吉西他滨（GC）治疗。在每个周期的第1、4、8、11和15天，使用欧洲癌症研究与治疗组织核心问卷（EORTC QLQ-C30）和肺癌模块（LC13）报告HRQoL。将总体健康状况、恶心/呕吐、疲劳和呼吸困难（LC13）定义为主要关注的HRQoL量表。
共纳入52例患者。化疗期间，总体健康状况、恶心/呕吐和疲劳的平均评分变化呈现出一致的模式。第4天似乎是化疗对HRQoL影响最大的时间点。两个治疗组之间的平均HRQoL评分差异在不同时间点有所不同，尤其是恶心/呕吐方面。
化疗周期中HRQoL存在临床相关的变化，治疗后第一周症状负担加重。我们的结果表明，HRQoL评估的时间会影响检测治疗方案之间差异的可能性。
