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加拿大晚期黑色素瘤患者报告的与治疗相关的症状负担。

Patient-reported treatment-related symptom burden for patients with advanced melanoma in Canada.

机构信息

BC Cancer Agency and University of British Columbia, Vancouver, BC, Canada.

Optum, Johnston, RI, USA.

出版信息

Support Care Cancer. 2019 Jan;27(1):219-227. doi: 10.1007/s00520-018-4316-9. Epub 2018 Jun 23.

Abstract

BACKGROUND

Little is known on the impact of emerging treatments for advanced melanoma (stages III and IV) on patients' functioning and well-being. The objective of this study was to describe the patient-reported treatment-related symptom (TRS) burden in advanced melanoma.

METHOD

Twenty-nine in-depth, qualitative interviews were conducted among adult patients with advanced melanoma in Canada using a semi-structured interview method. Interviews were transcribed verbatim, and key concepts were identified using a grounded theory analytic approach.

RESULTS

The 29 patients reported 13 unique treatment journeys involving the following drug therapy categories: cytotoxic chemotherapies, CTLA-4 inhibitors, BRAF or MEK inhibitors, and PD-1 inhibitors. Patients typically underwent multiple treatment episodes over time. Common TRSs included nausea, fatigue, diarrhea or constipation, and skin rashes. Patients described these as impacting their physical functioning, ability to perform activities of daily living, social functioning, and overall quality of life.

CONCLUSION

Our findings provide a description of the patient's experience with treatment for advanced melanoma. Our sample included patients typically diagnosed in mid-life, facing an urgent sequence of medical procedures and a pharmacological treatment journey that was burdensome. There is a need for less toxic and more efficacious treatments earlier in the patient journey to alleviate the impact of advanced melanoma treatment on patients' health-related quality of life.

摘要

背景

对于新兴的晚期黑色素瘤(III 期和 IV 期)治疗方法对患者功能和幸福感的影响,我们知之甚少。本研究的目的是描述晚期黑色素瘤患者报告的与治疗相关的症状(TRS)负担。

方法

采用半结构式访谈方法,在加拿大对 29 名晚期黑色素瘤成年患者进行了 29 次深入的定性访谈。访谈内容逐字转录,并使用扎根理论分析方法确定关键概念。

结果

这 29 名患者报告了 13 种独特的治疗经历,涉及以下药物治疗类别:细胞毒性化疗、CTLA-4 抑制剂、BRAF 或 MEK 抑制剂和 PD-1 抑制剂。患者通常随着时间的推移经历多次治疗。常见的 TRS 包括恶心、疲劳、腹泻或便秘以及皮疹。患者将这些描述为影响他们的身体功能、日常生活活动能力、社交功能和整体生活质量。

结论

我们的研究结果提供了对晚期黑色素瘤患者治疗体验的描述。我们的样本包括通常在中年确诊的患者,他们面临着一系列紧急的医疗程序和药物治疗旅程,这是一种负担。需要在患者的旅程早期使用毒性更小、疗效更高的治疗方法,以减轻晚期黑色素瘤治疗对患者健康相关生活质量的影响。

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Humanistic burden of disease for patients with advanced melanoma in Canada.加拿大晚期黑色素瘤患者的人文疾病负担。
Support Care Cancer. 2018 Jun;26(6):1985-1991. doi: 10.1007/s00520-017-4025-9. Epub 2018 Jan 10.

本文引用的文献

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Humanistic burden of disease for patients with advanced melanoma in Canada.加拿大晚期黑色素瘤患者的人文疾病负担。
Support Care Cancer. 2018 Jun;26(6):1985-1991. doi: 10.1007/s00520-017-4025-9. Epub 2018 Jan 10.
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Pembrolizumab versus Ipilimumab in Advanced Melanoma.帕博利珠单抗对比伊匹单抗用于晚期黑色素瘤。
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