Lehtomäki Kaisa, Stedt Hanna P, Osterlund Emerik, Muhonen Timo, Soveri Leena-Maija, Halonen Päivi, Salminen Tapio K, Kononen Juha, Kallio Raija, Ålgars Annika, Heervä Eetu, Lamminmäki Annamarja, Uutela Aki, Nordin Arno, Lehto Juho, Saarto Tiina, Sintonen Harri, Kellokumpu-Lehtinen Pirkko-Liisa, Ristamäki Raija, Glimelius Bengt, Isoniemi Helena, Osterlund Pia
Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön Katu 34, 33520 Tampere, Finland.
Department of Oncology, Tays Cancer Centre, Tampere University Hospital, Teiskontie 35, 33520 Tampere, Finland.
Cancers (Basel). 2022 Mar 28;14(7):1713. doi: 10.3390/cancers14071713.
Metastasectomy and/or local ablative therapy in metastatic colorectal cancer (mCRC) patients often provide long-term survival. Health-related quality of life (HRQoL) data in curatively treated mCRC are limited. In the RAXO-study that evaluated repeated resectability, a multi-cross-sectional HRQoL substudy with 15D, EQ-5D-3L, QLQ-C30, and QLQ-CR29 questionnaires was conducted. Mean values of patients in different treatment groups were compared with age- and gender-standardized general Finnish populations. The questionnaire completion rate was 444/477 patients (93%, 1751 questionnaires). Mean HRQoL was 0.89−0.91 with the 15D, 0.85−0.87 with the EQ-5D, 68−80 with the EQ-5D-VAS, and 68−79 for global health status during curative treatment phases, with improvements in the remission phase (disease-free >18 months). In the remission phase, mean EQ-5D and 15D scores were similar to the general population. HRQoL remained stable during first- to later-line treatments, when the aim was no longer cure, and declined notably when tumour-controlling therapy was no longer meaningful. The symptom burden affecting mCRC survivors’ well-being included insomnia, impotence, urinary frequency, and fatigue. Symptom burden was lower after treatment and slightly higher, though stable, through all phases of systemic therapy. HRQoL was high in curative treatment phases, further emphasizing the strategy of metastasectomy in mCRC when clinically meaningful.
转移性结直肠癌（mCRC）患者接受转移灶切除术和/或局部消融治疗往往可实现长期生存。接受根治性治疗的mCRC患者的健康相关生活质量（HRQoL）数据有限。在评估重复可切除性的RAXO研究中，开展了一项多横断面HRQoL子研究，采用了15D、EQ-5D-3L、QLQ-C30和QLQ-CR29问卷。将不同治疗组患者的均值与年龄和性别标准化的芬兰普通人群进行比较。问卷完成率为444/477例患者（93%，共1751份问卷）。在根治性治疗阶段，使用15D问卷时平均HRQoL为0.89 - 0.91，使用EQ-5D问卷时为0.85 - 0.87，EQ-5D视觉模拟量表（VAS）评分为68 - 80，全球健康状况评分为68 - 79，在缓解期（无病生存期>18个月）有所改善。在缓解期，EQ-5D和15D的平均得分与普通人群相似。在一线至后续治疗期间，当目标不再是治愈时，HRQoL保持稳定，而当肿瘤控制治疗不再有意义时，HRQoL显著下降。影响mCRC幸存者幸福感的症状负担包括失眠、阳痿、尿频和疲劳。治疗后症状负担较低，在全身治疗的各个阶段虽略有升高但保持稳定。根治性治疗阶段的HRQoL较高，这进一步强调了在mCRC中进行转移灶切除术在临床可行时的策略。
