Juravinski Cancer Centre, McMaster University, Department of Oncology, Hamilton, Ontario, Canada.
Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Department of Radiation Oncology, Toronto, Ontario, Canada.
Clin Oncol (R Coll Radiol). 2021 Jul;33(7):468-475. doi: 10.1016/j.clon.2021.03.002. Epub 2021 Mar 26.
We report on the first prospective series of patient-reported quality of life (QoL) following stereotactic body radiation therapy (SBRT) for primary kidney cancer.
Patients were treated on a multi-institutional prospective cohort study with 30-42 Gy SBRT in three or five fractions. QoL assessments were carried out using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-15 Palliative (EORTC-QLQ-C15-PAL), the Functional Assessment of Cancer Therapy-Kidney Symptom Index-19 (FACT FKSI-19) and the EuroQol-5D-3L tools at baseline, 1 week, and 1, 3 and 6 months post-treatment. QoL over time was analysed using linear mixed modelling, pairwise and anchor-based analyses.
Twenty-eight patients were included. No significant reduction in any QoL metric was observed on repeated measures. However, a trend to reduced EORTC global QoL and fatigue was observed at 1 week, with improvement over time in other symptom scores such as pain, appetite and nausea. On pairwise analysis, there were statistically significant reductions in global QoL at 1 week (with subsequent recovery) and dyspnoea at 6 months post-SBRT. Trends to improved pain, appetite and nausea were observed following SBRT. Less than half of patients reported stable or better EORTC global QoL at 1 week. For all other QoL and symptom scales, most patients had reported stable or better scores at all times, with a slight proportional improvement in emotional functioning, nausea, fatigue, pain and appetite, and a slight worsening of physical functioning and dyspnoea over time.
SBRT results in well-preserved QoL in the weeks to months following treatment for primary kidney cancer.
我们报告了立体定向体部放射治疗(SBRT)治疗原发性肾癌后患者报告的生活质量(QoL)的首个前瞻性系列研究结果。
患者参加了一项多机构前瞻性队列研究,接受 30-42Gy 的 SBRT 治疗,分为 3 或 5 个分次。使用欧洲癌症研究与治疗组织生活质量问卷核心 15 项(EORTC-QLQ-C15-PAL)、癌症治疗功能评估-肾脏症状指数-19 (FACT-KFSI-19)和欧洲五维健康量表(EQ-5D-3L)在基线、治疗后 1 周、1、3 和 6 个月时进行 QoL 评估。使用线性混合模型、配对和锚定分析对随时间的 QoL 进行分析。
共纳入 28 例患者。在重复测量中,没有观察到任何 QoL 指标的显著降低。然而,在 1 周时观察到 EORTC 总体 QoL 和疲劳呈下降趋势,随着时间的推移,其他症状评分(如疼痛、食欲和恶心)有所改善。在配对分析中,在 SBRT 后 1 周时,全球 QoL 显著降低(随后恢复),6 个月时呼吸困难。在 SBRT 后观察到疼痛、食欲和恶心有改善趋势。在 1 周时,不到一半的患者报告 EORTC 全球 QoL 稳定或更好。对于所有其他 QoL 和症状量表,大多数患者在所有时间都报告稳定或更好的评分,情绪功能、恶心、疲劳、疼痛和食欲略有改善,身体功能和呼吸困难略有恶化。
SBRT 治疗原发性肾癌后数周至数月内,生活质量得到很好的维持。