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骨髓瘤患者纵向研究中与健康相关生活质量的系统评价。

A systematic review of health-related quality of life in longitudinal studies of myeloma patients.

作者信息

Nielsen Lene Kongsgaard, Jarden Mary, Andersen Christen Lykkegaard, Frederiksen Henrik, Abildgaard Niels

机构信息

Quality of Life Research Centre, Department of Haematology, Odense University Hospital, Odense, Denmark.

The Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Odense, Denmark.

出版信息

Eur J Haematol. 2017 Jul;99(1):3-17. doi: 10.1111/ejh.12882. Epub 2017 Apr 25.

Abstract

OBJECTIVES

Multiple myeloma (MM) patients report high symptom burden and reduced health-related quality of life (HRQoL) compared to patients with other haematological malignancies. The aim of this review was to analyse published longitudinal studies including MM patients according to a change in HRQoL scores, which is perceived as beneficial to the patient according to two published guidelines.

METHODS

A literature search was performed May 2016. Publications with longitudinal follow-up using the EORTC QLQ-C30 instrument for HRQoL measurement of physical functioning, global quality of life, fatigue and/or pain were included. An analysis of mean change from baseline was carried out according to minimal important difference (MID).

RESULTS

Large and medium HRQoL improvements were reported during first-line treatments. No clinically beneficial change or deteriorations in scores of global QoL or fatigue were reported during relapse treatment. HRQoL data during maintenance therapy are sparse and inconclusive.

CONCLUSIONS

Guidelines for interpreting changes in HRQoL including definitions of MID have been developed; however, consensus is missing. Improvements in HRQoL are far more likely to occur during first-line compared to relapsed treatment regimens. The background of these findings should be in focus in future studies, and HRQoL measurements should be integrated in maintenance studies.

摘要

目的

与其他血液系统恶性肿瘤患者相比,多发性骨髓瘤(MM)患者报告的症状负担较重,健康相关生活质量(HRQoL)较低。本综述的目的是根据HRQoL评分变化分析已发表的纳入MM患者的纵向研究,根据两项已发表的指南,这种变化被认为对患者有益。

方法

于2016年5月进行文献检索。纳入使用欧洲癌症研究与治疗组织QLQ-C30工具对身体功能、总体生活质量、疲劳和/或疼痛进行HRQoL测量的纵向随访出版物。根据最小重要差异(MID)对基线平均变化进行分析。

结果

一线治疗期间报告了较大和中等程度的HRQoL改善。复发治疗期间未报告总体生活质量或疲劳评分有临床有益变化或恶化。维持治疗期间的HRQoL数据稀少且无定论。

结论

已制定了解释HRQoL变化的指南,包括MID的定义;然而,尚未达成共识。与复发治疗方案相比,一线治疗期间HRQoL改善的可能性要大得多。这些发现的背景应在未来研究中重点关注,并且HRQoL测量应纳入维持研究中。

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