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评估 1 期临床试验中的支持性护理需求、性健康和生活质量:一项前瞻性单中心研究。

Evaluation of supportive care needs, sexuality and quality of life in phase 1 trials: a prospective monocentric study.

机构信息

Département d'Innovation Thérapeutique et d'Essais Précoces (DITEP), Gustave Roussy, Université Paris-Saclay, 94140, Villejuif, France.

Biostatistics and Epidemiology Department, Gustave Roussy, Université Paris-Saclay, Villejuif, France.

出版信息

Support Care Cancer. 2022 Dec;30(12):9841-9849. doi: 10.1007/s00520-022-07407-6. Epub 2022 Oct 22.

Abstract

PURPOSE

Patients enrolled in oncology phase 1 trials (ph1) usually have advanced heavily pre-treated cancers with few therapeutic options. Quality of life (QoL) is one of the key cancer-treatment outcome measures, especially in ph1, and sexuality is an important part of Qol but rarely explored. This prospective study aims to assess supportive care needs, QoL and sexuality in ph1.

METHODS

Between September 2020 and June 2021, we prospectively recruited patients enrolled in ph1 at Gustave Roussy in France. Supportive care needs, QoL (EORTC QLQ-C30) and sexuality (female sexual function index for women, male sexual health questionnaire [MSHQ] for men) were assessed at baseline, one, three and 5 months. We performed multivariate analyses to identify associations between clinical characteristics, QoL and quality of sexual life over time.

RESULTS

At baseline, we analyzed 187 patients (45% women (n = 84) and 55% men (n = 103)). Patients expressed the need for consultations in pain management, nutrition, psychology and sexology in 28%, 26%, 19% and 9%, respectively. Lower global QoL was independently associated with Royal Marsden Hospital score (p = 0.012), urogenital location tumor (p = 0.021), elevated CRP levels (p = 0.014) and pain intensity (p = 0.005). Ninety-two percent of women had sexual dysfunction. In men, a lower MSHQ score was independently associated with urogenital location tumor (p = 0.021), ECOG Performance Status (p = 0.006), comorbidity at risk (p = 0.024) and pain intensity (p = 0.004).

CONCLUSIONS

There are significant needs for supportive care in ph1, especially in some subgroups of patients. New models of care should be developed to improve early phase pathways.

摘要

目的

入组肿瘤学 1 期临床试验(ph1)的患者通常患有晚期、经大量预处理且治疗选择有限的癌症。生活质量(QoL)是癌症治疗结果的关键衡量标准之一,特别是在 ph1 中,而性是 QoL 的重要组成部分,但很少被探索。本前瞻性研究旨在评估 ph1 患者的支持性护理需求、生活质量和性生活。

方法

2020 年 9 月至 2021 年 6 月,我们前瞻性招募了法国古斯塔夫·鲁西研究所(Gustave Roussy)入组 ph1 的患者。在基线、1、3 和 5 个月时评估支持性护理需求、生活质量(EORTC QLQ-C30)和性生活(女性性功能指数用于女性,男性性健康问卷[MSHQ]用于男性)。我们进行了多变量分析,以确定临床特征与随时间变化的生活质量和性生活质量之间的关联。

结果

在基线时,我们分析了 187 名患者(45%为女性(n=84),55%为男性(n=103))。患者分别表示需要在疼痛管理、营养、心理和性学方面进行咨询,比例分别为 28%、26%、19%和 9%。全球 QoL 较低与皇家马斯登医院评分(p=0.012)、泌尿生殖部位肿瘤(p=0.021)、CRP 水平升高(p=0.014)和疼痛强度(p=0.005)独立相关。92%的女性存在性功能障碍。在男性中,较低的 MSHQ 评分与泌尿生殖部位肿瘤(p=0.021)、ECOG 表现状态(p=0.006)、高危合并症(p=0.024)和疼痛强度(p=0.004)独立相关。

结论

ph1 中存在显著的支持性护理需求,特别是在某些亚组患者中。应开发新的护理模式,以改善早期阶段的途径。

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