Department of Lung Cancer Surgery, Tianjin key laboratory of lung cancer metastasis and tumor microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China.
Department of Thoracic Surgery, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, China.
Thorac Cancer. 2021 Mar;12(6):783-795. doi: 10.1111/1759-7714.13830. Epub 2021 Jan 25.
Lung cancer, mainly non-small cell lung cancer (NSCLC), is one of the leading causes of death worldwide. Currently, chemotherapy is still the most significant treatment strategy for NSCLC. However, scant attention has been paid in previous studies to those patients who often experience various symptoms and discomfort during chemotherapy treatment cycles.
This study included 127 NSCLC patients who completed an EORTC QLQ-C30 questionnaire and specifically designed symptom diary. Chi-square test, factor analysis, Pearson correlation coefficient and hierarchical cluster analysis were used to perform multivariate analysis.
We identified the top five most-frequent symptoms within the chemotherapy cycle which included fatigue, insomnia, cough and sputum, appetite loss and hypodipsia. These symptoms were at a moderate level on chemotherapy treatment days 3-7, and were then reduced to a stable and lower level in the following two weeks. A statistically significant difference in adverse events (AEs) was found between 54 patients who received dexamethasone (treatment group) and the control group: fatigue (risk ratio [RR]: 1.48; 95% confidence interval [CI]: 1.120-1.961; p = 0.006), insomnia (RR: 1.34; 95% CI: 1.016-1.778; p = 0.038), cough and sputum (RR: 2.00; 95% CI: 1.484-2.695; p < 0.001), appetite loss (RR: 1.28; 95% CI: 0.959-1.696; p = 0.095). In total, 62 patients completed the EORTC QLQ-C30 scale. The functioning scales of the treatment group were higher than the control population within positive effect sizes (ES: 0.1-0.8). Apart from diarrhea scales, most symptom scales were lower than the control group within negative effect sizes (ES: 0.1-0.9).
In this study we identified the top five most frequent post-chemotherapy AEs in a chemotherapy treatment cycle and found that dexamethasone was well tolerated by NSCLC patients who received platinum-based chemotherapy and substantially alleviated the symptom burden and improved the health-related quality of life (HRQOL) of patients.
肺癌，主要是非小细胞肺癌（NSCLC），是全球范围内主要的死亡原因之一。目前，化疗仍然是 NSCLC 的最主要治疗策略。然而，以前的研究很少关注那些在化疗治疗周期中经常经历各种症状和不适的患者。
本研究纳入了 127 例完成 EORTC QLQ-C30 问卷和专门设计的症状日记的 NSCLC 患者。采用卡方检验、因子分析、皮尔逊相关系数和层次聚类分析进行多变量分析。
我们确定了化疗周期中最常见的前五种症状，包括疲劳、失眠、咳嗽和咳痰、食欲下降和口渴。这些症状在化疗治疗第 3-7 天处于中度水平，然后在接下来的两周内稳定下降到较低水平。在接受地塞米松（治疗组）和对照组的 54 名患者之间，发现不良事件（AE）有统计学显著差异：疲劳（风险比[RR]：1.48；95%置信区间[CI]：1.120-1.961；p=0.006）、失眠（RR：1.34；95%CI：1.016-1.778；p=0.038）、咳嗽和咳痰（RR：2.00；95%CI：1.484-2.695；p<0.001）、食欲下降（RR：1.28；95%CI：0.959-1.696；p=0.095）。共有 62 名患者完成了 EORTC QLQ-C30 量表。在正效应量范围内（ES：0.1-0.8），治疗组的功能量表高于对照组。除腹泻量表外，大多数症状量表在负效应量范围内（ES：0.1-0.9）均低于对照组。
本研究确定了化疗周期中最常见的五种化疗后不良事件，并发现地塞米松在接受铂类化疗的 NSCLC 患者中耐受性良好，显著减轻了症状负担，改善了患者的健康相关生活质量（HRQOL）。
