Department of Medical Oncology, Radboud University Medical Center, 452, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
Department of Health Evidence, Radboud University Medical Center, 133, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
Support Care Cancer. 2018 Apr;26(4):1233-1242. doi: 10.1007/s00520-017-3946-7. Epub 2017 Dec 11.
The CONDOR study showed that docetaxel/cisplatin/5-fluorouracil (TPF) followed by conventional radiotherapy with cisplatin 100 mg/m on days 1, 22, and 43 (cis100 + RT; n = 27)) versus accelerated radiotherapy with cisplatin weekly 40 mg/m (cis40 + ART; n = 29) in locally advanced head and neck cancer (LAHNC) patients was not feasible. Here, we report the analysis of health-related quality of life (HRQOL) of the patients entered in this study.
HRQOL was assessed at baseline, after two TPF, before start of chemoradiotherapy, and 1, 4, 8, 12, and 24 months after completion of chemoradiotherapy using the EORTC-QLQ-C30 and QLQ-H&N35 in 62 patients.
Compliance with the QOL questionnaires was 94% (59/62) at baseline and 61% (30/49) at 12 months, respectively. HRQOL decreased after TPF and further decreased during chemoradiohteray in both arms equally. Pain and swallowing dysfunction improved significantly during TPF but deteriorated below baseline levels during chemoradiotherapy, cis40 + ART > cis100 + RT (p < 0.05). HRQOL and symptoms restored to baseline within 12 months in both arms and remained at that level until 24 months.
After TPF, cis40 + ART had a larger negative impact on symptoms than cis100 + RT, probably due to the ART. HRQOL and symptoms restored to baseline levels within 12 months after end of treatment in both arms, which is an important perspective for patients during the phase of most serious acute side effects of treatment.
NCT00774319.
CONDOR 研究表明,多西他赛/顺铂/5-氟尿嘧啶(TPF)联合常规顺铂 100mg/m2 第 1、22 和 43 天(cis100+RT;n=27)与每周顺铂 40mg/m2 加速放疗(cis40+ART;n=29)治疗局部晚期头颈部癌症(LAHNC)患者不可行。在这里,我们报告了这项研究中入组患者的健康相关生活质量(HRQOL)分析结果。
62 例患者在基线、两次 TPF 后、放化疗前、放化疗结束后 1、4、8、12 和 24 个月时使用 EORTC-QLQ-C30 和 QLQ-H&N35 评估 HRQOL。
基线时 QOL 问卷的依从率为 94%(59/62),12 个月时为 61%(30/49)。TPF 后 HRQOL 下降,在两个治疗组中,放化疗期间 HRQOL 进一步下降。PF 后疼痛和吞咽功能障碍显著改善,但放化疗期间恶化至低于基线水平,cis40+ART>cis100+RT(p<0.05)。在两个治疗组中,HRQOL 和症状在 12 个月内恢复至基线水平,并在 24 个月内保持在该水平。
TPF 后,cis40+ART 对症状的负面影响大于 cis100+RT,可能是由于 ART。在两个治疗组中,治疗结束后 12 个月内 HRQOL 和症状恢复至基线水平,这是患者在治疗最严重急性副作用阶段的一个重要方面。
NCT00774319。