Sunnybrook Odette Cancer Centre, University of Toronto, Canada.
Canadian Cancer Trials Group, Cancer Research Institute, Queen's University, Kingston, Canada.
Radiother Oncol. 2018 Mar;126(3):541-546. doi: 10.1016/j.radonc.2017.10.006. Epub 2017 Nov 5.
Patient's gender and age may influence physicians in prescribing palliative radiotherapy. The purpose of this secondary analysis of the National Cancer Institute of Canada Clinical Trials Group Symptom Control Trial SC.20 was to explore the gender and age differences in pain and patient reported outcomes in cancer patients with bone metastases undergoing re-irradiation.
Response to radiation was evaluated using the International Bone Metastases Consensus Endpoint Definitions. Patients completed the Brief Pain Inventory (BPI) and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (C30) before and 2 months after re-irradiation.
A total of 847 patients were analyzed. At baseline, men had more dyspnea, and mild pain. Older patients consumed less analgesic. More women reported clinically significant improvement in mood and enjoyment of life in the BPI after radiation. Similarly, younger patients reported better improvement in enjoyment of life. There were no significant gender or age differences in overall survival, response to radiation, or in C30 scores at 2 months.
Similar benefit in terms of pain relief was observed across all patient groups. Cancer patients with bone metastases should be offered palliative re-irradiation irrespective of gender or age.
NCT00080912; https://clinicaltrials.gov/ct2/show/NCT00080912.
患者的性别和年龄可能会影响医生开具姑息性放疗的决策。本研究对加拿大国家癌症研究所临床研究组症状控制试验（Symptom Control Trial，SC.20）的二次分析旨在探讨行再放疗的骨转移癌患者中，性别和年龄差异对疼痛和患者报告结局的影响。
使用国际骨转移共识终点定义评估放疗反应。患者在再放疗前和 2 个月时分别完成简短疼痛量表（Brief Pain Inventory，BPI）和欧洲癌症研究与治疗组织生活质量核心 30 问卷（European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30，C30）。
共分析了 847 例患者。基线时，男性呼吸困难和轻度疼痛更为常见，而老年患者的镇痛药用量较少。更多女性在 BPI 中报告放疗后情绪和生活乐趣有明显改善。同样，年轻患者的生活乐趣改善得更好。在总体生存、放疗反应或 2 个月时的 C30 评分方面，未观察到性别或年龄差异。
在所有患者群体中，疼痛缓解的获益相似。无论性别或年龄如何，均应向骨转移癌患者提供姑息性再放疗。
NCT00080912；https://clinicaltrials.gov/ct2/show/NCT00080912。
