Yanwei L, Dongying L, Zhuchen Y, Ling L, Yu Z, Zhanyu P
Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China.
Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.
Eur J Cancer Care (Engl). 2017 Nov;26(6). doi: 10.1111/ecc.12665. Epub 2017 Mar 7.
This study aimed to examine whether awareness of cancer diagnosis and prognosis among patients with stage IV lung cancer treated with first-line erlotinib vary with psychological distress and quality of life (QoL). This study was carried out at the Comprehensive treatment Department of Tianjin Cancer Hospital between August 2013 and September 2015 among patients ≥18 years-old and suffering from EGFR mutation-positive stage IV non-small cell lung cancer (NSCLC) treated with first-line erlotinib (150 mg/day; N = 137). The Hospital Anxiety and Depression Scale (HADS) was administered before (baseline) and after 12 weeks of treatment. QoL was assessed using the Functional Assessment of Cancer Therapy-Lung (FACT-L) questionnaire. Diagnosis and prognosis awareness was assessed by interview. Among patients, 21% reported to be fully aware of their disease; 41% were only aware of the diagnosis, not the stage; and 51% were not aware at all. Among patients, 63.5% reported elevated anxiety, 71.5% were depressed, and 75.2% had HADS score ≥15 (emotional distress). Patients who were totally and partly aware experienced improvements in HADS and FACT-L compared with baseline (all p < .05). Patients who were not aware scored better than the other patients for all FACT-L subscales from baseline to 12 weeks (all p < .05). Aware patients experienced improvements from baseline in HADS and FACT-L (all p < .05). Awareness of cancer diagnosis and stage was associated with initially high global distress and poorer QoL. Unaware patients exhibited better emotional distress and QoL during first-line therapy with erlotinib for EGFR mutation-positive advanced NSCLC.
本研究旨在探讨一线使用厄洛替尼治疗的IV期肺癌患者对癌症诊断和预后的知晓情况是否随心理困扰和生活质量（QoL）而变化。本研究于2013年8月至2015年9月在天津医科大学肿瘤医院综合治疗科开展，研究对象为年龄≥18岁、接受一线厄洛替尼（150mg/天）治疗的表皮生长因子受体（EGFR）突变阳性IV期非小细胞肺癌（NSCLC）患者（N = 137）。在治疗前（基线）和治疗12周后使用医院焦虑抑郁量表（HADS）进行评估。使用癌症治疗功能评价量表-肺癌（FACT-L）问卷评估生活质量。通过访谈评估诊断和预后知晓情况。患者中，21%报告完全知晓自己的病情；41%仅知晓诊断，不知晓分期；51%完全不知晓。患者中，63.5%报告焦虑情绪升高，71.5%存在抑郁情绪，75.2%的HADS评分≥15（情绪困扰）。与基线相比，完全知晓和部分知晓的患者在HADS和FACT-L方面有改善（所有p < 0.05）。从基线到12周，不知晓的患者在所有FACT-L子量表上的得分均高于其他患者（所有p < 0.05）。知晓的患者在HADS和FACT-L方面较基线有改善（所有p < 0.05）。癌症诊断和分期的知晓与最初较高的整体困扰和较差的生活质量相关。在EGFR突变阳性的晚期NSCLC患者一线使用厄洛替尼治疗期间，不知晓的患者表现出更好的情绪困扰和生活质量。
