Centro de Câncer de Brasília, Instituto Unity de Ensino e Pesquisa, Brasília, DF, Brazil.
Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
Oncologist. 2023 Jun 2;28(6):494-500. doi: 10.1093/oncolo/oyad028.
There is a lack of consensus regarding the optimal method of assessing health-related quality of life (HR-QOL) among patients with metastatic renal cell carcinoma (mRCC). This study explored the perceived relevance of items that make up the Functional Assessment of Cancer Therapy Kidney Symptom Index-19 (FKSI-19), as judged by patients with mRCC.
This was a multinational cross-sectional survey. Eligible patients responded to a questionnaire composed of 18 items that assessed the perceived relevance of each item in the FKSI-19 questionnaire. Open-ended questions assessed additional issues deemed relevant by patients. Responses were grouped as relevant (scores 2-5) or nonrelevant (score 1). Descriptive statistics were collated, and open-ended questions were analyzed and categorized into descriptive categories. Spearman correlation statistics were used to test the association between relevance and clinical characteristics.
A total of 151 patients were included (gender: 78.1 M, 21.9F; median age: 64; treatment: 38.4 immunotherapy, 29.8 targeted therapy, 13.9 immuno-TKI combination therapy) in the study. The most relevant questions evaluated fatigue (77.5), lack of energy (72.2), and worry that their condition will get worse (71.5). Most patients rated blood in urine (15.2), fevers (16.6), and lack of appetite (23.2) as least relevant. Qualitative analysis of open-ended questions revealed several themes, including emotional and physical symptoms, ability to live independently, effectiveness of treatment, family, spirituality, and financial toxicity.
There is a need to refine widely used HR-QOL measures that are employed among patients diagnosed with mRCC treated with contemporary therapies. Guidance was provided for the inclusion of more relevant items to patients' cancer journey.
在转移性肾细胞癌(mRCC)患者中,评估健康相关生活质量(HR-QOL)的最佳方法尚未达成共识。本研究探讨了 mRCC 患者对构成功能性评估癌症治疗-肾脏症状指数-19(FKSI-19)的各项指标的感知相关性。
这是一项多国家的横断面调查。符合条件的患者对由 18 项组成的问卷做出回应,评估了 FKSI-19 问卷中每个项目的感知相关性。开放性问题评估了患者认为相关的其他问题。根据相关性(评分 2-5)或不相关性(评分 1)对回答进行分组。对描述性统计数据进行整理,并对开放性问题进行分析和分类为描述性类别。使用 Spearman 相关统计来检验相关性与临床特征之间的关联。
共有 151 名患者(性别:78.1%为男性,21.9%为女性;中位年龄:64 岁;治疗方法:38.4%免疫治疗,29.8%靶向治疗,13.9%免疫-TKI 联合治疗)参与了这项研究。最相关的问题评估了疲劳(77.5%)、缺乏精力(72.2%)和担心病情恶化(71.5%)。大多数患者认为血尿(15.2%)、发热(16.6%)和食欲不振(23.2%)最不相关。对开放性问题的定性分析揭示了几个主题,包括情绪和身体症状、独立生活能力、治疗效果、家庭、精神信仰和财务毒性。
对于接受当代治疗方法治疗的 mRCC 患者,有必要对广泛使用的 HR-QOL 测量方法进行细化。为纳入更多与患者癌症旅程相关的项目提供了指导。