上皮性卵巢癌幸存者的长期疲劳与生活质量：GINECO 病例对照 VIVROVAIRE I 研究。

Long-term fatigue and quality of life among epithelial ovarian cancer survivors: a GINECO case/control VIVROVAIRE I study.

机构信息

Department of Oncology, Centre François Baclesse, Caen; INSERM, U1086, Caen; UMR-S1077, University of Caen Basse-Normandie, Caen; Department of Oncology, CHU de Caen, Caen.

Department of Oncology, Centre François Baclesse, Caen; INSERM, U1086, Caen.

出版信息

Ann Oncol. 2019 May 1;30(5):845-852. doi: 10.1093/annonc/mdz074.

DOI:10.1093/annonc/mdz074

PMID:30851097

Abstract

BACKGROUND

Few data are available on long-term fatigue (LTF) and quality of life (QoL) among epithelial ovarian cancer survivors (EOCS). In this case-control study, we compared LTF, symptoms and several QoL domains in EOCS relapse-free ≥3 years after first-line treatment and age-matched healthy women.

PATIENTS AND METHODS

EOCS were recruited from 25 cooperative GINECO centers in France. Controls were randomly selected from the electoral rolls. All participants completed validated self-reported questionnaires: fatigue (FACIT-F), QoL (FACT-G/O), neurotoxicity (FACT-Ntx), anxiety/depression (HADS), sleep disturbance (ISI), and physical activity (IPAQ). Severe LTF (SLTF) was defined as a FACIT-F score <37/52. Univariate and multivariate logistic regressions were conducted to analyze SLTF and its influencing factors in EOCS.

RESULTS

A total of 318 EOCS and 318 controls were included. EOCS were 63-year-old on average, with FIGO stage I/II (50%), III/IV (48%); 99% had received platinum and taxane chemotherapy, with an average 6-year follow-up. There were no differences between the two groups in socio-demographic characteristics and global QoL. EOCS had poorer FACIT-F scores (40 versus 45, P < 0.0001), lower functional well-being scores (18 versus 20, P = 0.0002), poorer FACT-O scores (31 versus 34 P < 0.0001), and poorer FACT-Ntx scores (35 versus 39, P < 0.0001). They also reported more SLTF (26% versus 13%, P = 0.0004), poorer sleep quality (63% versus 47%, P = 0.0003), and more depression (22% versus 13%, P = 0.01). Fewer than 20% of EOCS and controls exercised regularly. In multivariate analyses, EOCS with high levels of depression, neurotoxicity, and sleep disturbance had an increased risk of developing SLTF (P < 0.01).

CONCLUSION

Compared with controls, EOCS presented similar QoL but persistent LTF, EOC-related symptoms, neurotoxicity, depression, and sleep disturbance. Depression, neuropathy, and sleep disturbance are the main conditions associated with severe LTF.

摘要

背景

上皮性卵巢癌幸存者（EOCS）在一线治疗后无复发生存期≥3 年后，有关其长期疲劳（LTF）和生活质量（QoL）的资料很少。在这项病例对照研究中，我们比较了 LTF、症状和 EOCS 复发后无复发生存期≥3 年的 EOCS 和年龄匹配的健康女性的多个 QoL 领域。

患者和方法

EOCS 是从法国 25 个合作 GINECO 中心招募的。对照组是从选民名单中随机选择的。所有参与者都完成了经过验证的自我报告问卷：疲劳（FACIT-F）、QoL（FACT-G/O）、神经毒性（FACT-Ntx）、焦虑/抑郁（HADS）、睡眠障碍（ISI）和身体活动（IPAQ）。严重疲劳（SLTF）定义为 FACIT-F 评分<37/52。采用单变量和多变量逻辑回归分析 EOCS 中 SLTF 及其影响因素。

结果

共纳入 318 名 EOCS 和 318 名对照组。EOCS 的平均年龄为 63 岁，FIGO 分期 I/II（50%）、III/IV（48%）；99%接受了铂类和紫杉烷类化疗，平均随访 6 年。两组在社会人口统计学特征和总体 QoL 方面无差异。EOCS 的 FACIT-F 评分较低（40 分与 45 分，P<0.0001），功能健康状况评分较低（18 分与 20 分，P=0.0002），FACT-O 评分较低（31 分与 34 分，P<0.0001），FACT-Ntx 评分较低（35 分与 39 分，P<0.0001）。EOCS 报告的 SLTF 更多（26%与 13%，P=0.0004），睡眠质量较差（63%与 47%，P=0.0003），抑郁较多（22%与 13%，P=0.01）。EOCS 和对照组中定期锻炼的人数均不足 20%。多变量分析显示，抑郁、神经毒性和睡眠障碍程度高的 EOCS 发生 SLTF 的风险增加（P<0.01）。