Department of Pulmonary Medicine, Suleyman Demirel University Faculty of Medicine, Isparta, Turkey.
Department of Biostatistics and Medical Informatics, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey.
Support Care Cancer. 2020 Apr;28(4):2005-2014. doi: 10.1007/s00520-019-05003-9. Epub 2019 Aug 6.
Lung cancer is associated with high level of symptoms and patient-reported symptoms have been rarely used as a prognostic score to predict patients survival.
Frequency and burden of symptoms in lung cancer patients were evaluated before the diagnosis with the Memorial Symptom Assessment-Short Form (MSAS-SF) and Condensed Memorial Symptom Assessment Scale (CMSAS) questionnaires. Performance status, stage of disease, serum albumin, and C-reactive protein (CRP) levels were recorded. Patients were staged according to 8th TNM classification. A survival analysis was applied.
The mean age of 116 patients (adenocarcinoma 51, squamous cell 43, non-small cell 5, small cell 17) was 65.2 ± 10.1 (28-87) years. The most common seen physical and psychological symptoms were cough (86.3%), lack of energy (74.3%), dyspnea (70.1%), and feeling sad (61.5%), feeling nervous (61.5%), and worrying (53.8%). Total and subscores of MSAS and CMSAS are significantly higher in M1 disease than M0 disease. All MSAS-SF and CMSAS scores, but not MSAS-PSYCH and CMSAS-PSYCH, positively correlated with age, high serum CRP, white blood cells/neutrophils counts, and TNM stage, and negatively correlated with albumin levels, performance status, and overall survival (OS). Median survival was 77, 195, 370, and 579 days for the four prognostic interquartile groups according to CMSAS-SUM score (p < 0.0001).
MSAS-SF and CMSAS questionnaires can be useful tool for discriminating metastatic from non-metastatic disease in treatment-naïve patients with lung cancer. Since both questionnaires well correlated with OS and important prognostic factors, they can use to plan palliative care and to help for predicting survival of lung cancer patients.
肺癌与高水平的症状相关,且患者报告的症状很少被用作预测患者生存的预后评分。
使用简短版纪念症状评估量表(MSAS-SF)和简化版纪念症状评估量表(CMSAS)在肺癌患者被诊断之前评估症状的频率和负担。记录体能状态、疾病分期、血清白蛋白和 C 反应蛋白(CRP)水平。根据第 8 版 TNM 分类对患者进行分期。进行生存分析。
116 例患者(腺癌 51 例、鳞癌 43 例、非小细胞癌 5 例、小细胞癌 17 例)的平均年龄为 65.2±10.1(28-87)岁。最常见的躯体和心理症状为咳嗽(86.3%)、乏力(74.3%)、呼吸困难(70.1%)、悲伤(61.5%)、紧张(61.5%)和担忧(53.8%)。M1 期患者的 MSAS 和 CMSAS 总分及各亚量表评分均显著高于 M0 期患者。MSAS-SF 和 CMSAS 评分的所有项目均与年龄、高血清 CRP、白细胞/中性粒细胞计数和 TNM 分期呈正相关,与白蛋白水平、体能状态和总生存期(OS)呈负相关,但 MSAS-PSYCH 和 CMSAS-PSYCH 评分除外。根据 CMSAS-SUM 评分,四个预后四分位组的中位生存时间分别为 77、195、370 和 579 天(p<0.0001)。
MSAS-SF 和 CMSAS 问卷可作为区分初治肺癌转移与非转移患者的有用工具。由于这两个问卷与 OS 和重要预后因素均有良好的相关性,因此可用于计划姑息治疗并帮助预测肺癌患者的生存情况。