Department of Pulmonary Medicine, Amphia Hospital Breda, Breda, The Netherlands; Department of Pulmonary Medicine, Erasmus Medical Center Cancer Institute, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center University Medical Center, Rotterdam, The Netherlands.
Department of Pulmonary Medicine, Amphia Hospital Breda, Breda, The Netherlands; Department of Pulmonary Medicine, Erasmus Medical Center Cancer Institute, Rotterdam, The Netherlands.
Clin Lung Cancer. 2018 Jul;19(4):e503-e516. doi: 10.1016/j.cllc.2018.03.003. Epub 2018 Mar 17.
In patients with advanced non-small-cell lung cancer, the treatment benefits and risks need to be constantly weighed. We explored patient-reported satisfaction with therapy (SWT) and assessed its value in addition to quality of life (QoL) and adverse events (AEs).
In a prospective multicenter cohort study, patients with stage IIIB/IV non-small-cell lung cancer received platinum-pemetrexed chemotherapy. They completed the World Health Organization Quality of Life-BREF (WHOQoL-BREF) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) before and during chemotherapy. After the last cycle, patients reported on SWT, expectations of therapy, and feelings about side effects (FSE) using the Cancer Therapy Satisfaction Questionnaire. The explained variance (R) of QoL after treatment by SWT was calculated. Using multivariable linear regression, we examined the association of SWT with patient- and treatment-related variables, FSE, and AEs.
Eighty-nine patients finished 4 cycles of chemotherapy, 65 of whom completed the Cancer Therapy Satisfaction Questionnaire. Fifty-six patients (86.2%) would probably or definitely decide to undergo the same treatment again, regardless of deterioration or improvement in QoL or a high or low frequency of AEs during chemotherapy. The explained variance of QoL by SWT was greatest for the EORTC QLQ C-30 global health status/QoL scale (R = 0.170). Patient age (β = 0.43; 95% confidence interval [CI], 0.05-0.82), FSE (β = 0.17; 95% CI, 0.06-0.29), and tumor response (β = 7.93; 95% CI (1.64 to 14.22)) were independently associated with SWT.
SWT could provide important supplementary information in addition to QoL assessments and treatment toxicities. Tumor response, older age, and FSE score were associated with better SWT. These insights could affect decision-making during palliative chemotherapy.
在晚期非小细胞肺癌患者中，需要不断权衡治疗的获益和风险。我们探讨了患者报告的治疗满意度（SWT），并评估了其在生活质量（QoL）和不良事件（AEs）之外的价值。
在一项前瞻性多中心队列研究中，IIIb/IV 期非小细胞肺癌患者接受铂类培美曲塞化疗。他们在化疗前和化疗期间完成了世界卫生组织生活质量简表（WHOQoL-BREF）和欧洲癌症研究与治疗组织生活质量问卷核心 30 项（EORTC QLQ-C30）。最后一个周期后，患者使用癌症治疗满意度问卷报告 SWT、对治疗的期望和对副作用的感受（FSE）。用 SWT 计算治疗后 QoL 的解释方差（R）。采用多变量线性回归，我们研究了 SWT 与患者和治疗相关变量、FSE 和 AEs 的相关性。
89 例患者完成了 4 个周期的化疗，其中 65 例完成了癌症治疗满意度问卷。无论化疗期间 QoL 恶化或改善、AEs 发生频率高或低，56 例（86.2%）患者可能或肯定会再次选择相同的治疗。SWT 对 EORTC QLQ C-30 整体健康状况/生活质量量表的 QoL 解释方差最大（R=0.170）。患者年龄（β=0.43；95%置信区间[CI]，0.05-0.82）、FSE（β=0.17；95%CI，0.06-0.29）和肿瘤反应（β=7.93；95%CI（1.64 至 14.22））与 SWT 独立相关。
SWT 除了评估 QoL 和治疗毒性外，还能提供重要的补充信息。肿瘤反应、年龄较大和 FSE 评分与较好的 SWT 相关。这些发现可能会影响姑息化疗期间的决策。
