Yu Jianhong, Wang Zaozao, Li Zhexuan, Liu Ying, Fan Yingcong, Di Jiabo, Cui Ming, Xing Jiadi, Zhang Chenghai, Yang Hong, Yao Zhendan, Zhang Nan, Chen Lei, Liu Maoxing, Xu Kai, Tan Fei, Gao Pin, Su Xiangqian
Department of Gastrointestinal Surgery IV, Key Laboratory of Carcinogenesis and Translational Research, Peking University Cancer Hospital and Institute, Beijing, China.
Key Laboratory of Carcinogenesis and Translational Research, Department of Cancer Epidemiology, Peking University Cancer Hospital and Institute, Beijing, China.
Front Oncol. 2022 Apr 4;12:853337. doi: 10.3389/fonc.2022.853337. eCollection 2022.
Some high-quality clinical trials have proven the efficacy and safety of perioperative and postoperative S-1 with oxaliplatin (peri-SOX and post-SOX) for patients with locally advanced gastric cancer (LAGC) undergoing D2 gastrectomy. However, little is known about how health-related quality of life (HRQOL) changes over time in patients receiving peri-SOX or post-SOX chemotherapy.
A prospective observational cohort (NCT04408859) identified 151 eligible patients with LAGC who underwent D2 gastrectomy with at least six cycles of peri-SOX or post-SOX chemotherapy from 2018 to 2020. HRQOL was assessed using the EROTC QLQ-C30 and its gastric module, QLQ-STO22, at indicated measurements, including the baseline, 1st, 3rd, 6th and 12th month after initiation of therapy. Baseline characteristics, therapeutic effects, and longitudinal HRQOL were compared between the peri-SOX and post-SOX groups after propensity score matching. HRQOL changes over time and the risk factors for scales with severe deterioration were further analyzed.
No statistically significant differences in longitudinal HRQOL were observed between patients in the peri-SOX and post-SOX groups, with comparable surgical outcomes and adverse chemotherapy events. Scales of social functioning, abnormal taste, and anxiety improved earlier in the peri-SOX group than in the post-SOX group. Score changes in both groups indicated that general deterioration and slower recovery usually occurred in the scales of physical, social, and role functioning, as well as symptoms of fatigue, reflux, diarrhea, and anxiety.
Peri-SOX showed a longitudinal HRQOL comparable to post-SOX in patients with LAGC who underwent D2 gastrectomy. The peri-SOX group had better performance in social functioning, abnormal taste, and anxiety at some measurements.
一些高质量的临床试验已证明，围手术期及术后使用S-1联合奥沙利铂（围手术期SOX和术后SOX）对接受D2胃切除术的局部晚期胃癌（LAGC）患者具有疗效和安全性。然而，对于接受围手术期SOX或术后SOX化疗的患者，其健康相关生活质量（HRQOL）如何随时间变化，人们知之甚少。
一项前瞻性观察队列研究（NCT04408859）纳入了151例符合条件的LAGC患者，这些患者在2018年至2020年间接受了D2胃切除术，并接受了至少六个周期的围手术期SOX或术后SOX化疗。在指定的测量时间点，包括治疗开始时的基线、第1、3、6和12个月，使用欧洲癌症研究与治疗组织生活质量核心问卷（QLQ-C30）及其胃癌模块QLQ-STO22评估HRQOL。在倾向得分匹配后，比较围手术期SOX组和术后SOX组的基线特征、治疗效果和纵向HRQOL。进一步分析HRQOL随时间的变化以及严重恶化量表的危险因素。
围手术期SOX组和术后SOX组患者的纵向HRQOL无统计学显著差异，手术结果和化疗不良事件相当。围手术期SOX组的社会功能、味觉异常和焦虑量表改善早于术后SOX组。两组的得分变化表明，身体、社会和角色功能量表以及疲劳、反流、腹泻和焦虑症状通常会出现总体恶化和恢复较慢的情况。
对于接受D2胃切除术的LAGC患者，围手术期SOX的纵向HRQOL与术后SOX相当。围手术期SOX组在某些测量中的社会功能、味觉异常和焦虑方面表现更好。
