U1086 INSERM-UCBN "Cancers & Préventions", Normandie Université, Caen, France.
U1086 INSERM-UCBN "Cancers & Préventions", Normandie Université, Caen, France; Departments of Clinical Research Unit, Centre François Baclesse, Caen, France.
Clin Genitourin Cancer. 2018 Oct;16(5):369-375.e1. doi: 10.1016/j.clgc.2018.05.013. Epub 2018 May 21.
Targeted therapies, in particular antiangiogenic therapies (AATs), have become the standard of treatment for metastatic renal cell carcinoma (mRCC). Although common adverse effects like fatigue have been well-established, sexual disorders induced by these treatments, although often reported, have been poorly evaluated. The aim of this study was to evaluate the impact of AATs on the sexual life of patients with mRCC and the relationships with quality of life (QoL), fatigue, and biologic parameters.
This longitudinal study included patients with mRCC on first- or second-line AATs. Sexuality was evaluated by the French version of Changes in Sexual Functioning Questionnaire short-Form (CSFQ); QoL and fatigue were measured by the Functional Assessment of Cancer Therapy General (FACT-G) and the Multidimensional Fatigue Inventory (MFI-20), respectively. Biologic parameters were also assessed.
Among 75 patients included in the study, 39 agreed to respond to the sexual functioning questionnaire (CSFQ). At baseline, all patients had at least 1 sexual dysfunction. No relationship with QoL, fatigue, and biologic parameters was shown. After 3 months of treatment, a decrease in at least 1 sexual dimension was observed in 69% of patients. The most affected sexual dimensions were pleasure (34%) and desire/interest (38%). No significant relationship between sexual dysfunctions and biologic parameters was found. The percentage of non-participants (50%) and the absence of a control arm are the main limitations.
Patients with mRCC exhibit sexual dysfunction that could be increased by AATs independently of the impact on fatigue and QoL. Further studies aiming to define the role of biologic parameters like inflammatory markers and thyroid parameters are warranted.
Sexual disorders induced or degraded by AAT are an independent side effect that should be taken into account in oncology supportive care departments.
靶向治疗,特别是抗血管生成治疗(AAT),已成为转移性肾细胞癌(mRCC)的标准治疗方法。尽管常见的不良反应,如疲劳,已经得到很好的证实,但这些治疗引起的性功能障碍,尽管经常被报道,但评估不佳。本研究旨在评估 AAT 对 mRCC 患者性生活的影响,以及与生活质量(QoL)、疲劳和生物学参数的关系。
这项纵向研究纳入了接受一线或二线 AAT 治疗的 mRCC 患者。通过法语版性功能变化问卷短表(CSFQ)评估患者的性功能;通过癌症治疗功能评估一般量表(FACT-G)和多维疲劳量表(MFI-20)分别评估 QoL 和疲劳;同时还评估了生物学参数。
在纳入研究的 75 名患者中,有 39 名同意回答性功能问卷(CSFQ)。基线时,所有患者至少存在 1 种性功能障碍。与 QoL、疲劳和生物学参数均无相关性。治疗 3 个月后,69%的患者至少有 1 项性功能维度下降。受影响最严重的性功能维度是快感(34%)和欲望/兴趣(38%)。未发现性功能障碍与生物学参数之间存在显著相关性。不参与的比例(50%)和缺乏对照组是主要的局限性。
mRCC 患者存在性功能障碍,AAT 可能会独立于对疲劳和 QoL 的影响而加重这些障碍。进一步研究确定炎症标志物和甲状腺参数等生物学参数的作用是必要的。
AAT 引起或降低的性功能障碍是一种独立的副作用,在肿瘤支持治疗部门应予以考虑。