van der Weijst Lotte, Bultijnck Renée, Van Damme Axel, Huybrechts Vincent, van Eijkeren Marc, Lievens Yolande
Department of Human Structure and Repair, Ghent University, Ghent, Belgium.
Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium.
Front Oncol. 2023 Aug 25;13:1220248. doi: 10.3389/fonc.2023.1220248. eCollection 2023.
To better understand the impact of stereotactic body radiotherapy (SBRT) and its treatment-related toxicity on early-stage non-small cell lung cancer (ES-NSCLC) patients, we conducted the Lung PLUS study in a real-world setting.
This is a monocentric prospective longitudinal study up to 12 months post-treatment, evaluating clinician- and patient-reported toxicity (resp. CTCAE and PRO-CTCAE), health-related quality of life (HRQoL) (EORTC QLQ-C30 and LC-13), activities of daily living (HAQ-DI) and functional exercise capacity (6 Minute Walking Test (6MWT)). A mixed model approach was applied to analyze the data.
At baseline, clinicians and patients (n=51) reported mostly fatigue (63% vs 79%), cough (49% vs 75%) and dyspnea (65% vs 73%) of any grade. Dyspnea (p=.041) increased over time. Meaningful clinical improvements were particularly seen in pain, fatigue, and cough. Clinician reported clinically meaningful improvements and deteriorations over time in fatigue, cough, and dyspnea. Almost at every timepoint, more people reported deterioration to the clinician than improvement in aforementioned toxicities. Overall HRQoL (p=.014), physical (p=.011) and emotional (p<.001) functioning improved over time. At baseline, patients had a moderate daily functioning score and walked an average distance of 360 meters. No statistically significant differences were found in daily functioning and exercise capacity over time.
Our study showed an increase in patient-reported toxicity and dyspnea, without impacting functional status, following SBRT. Overall HRQoL, physical and emotional functioning improved over time. Understanding the impact of treatment on patient-reported outcomes is crucial to identify the needs/problems of patients to enhance their HRQoL.
为了更好地了解立体定向体部放疗（SBRT）及其治疗相关毒性对早期非小细胞肺癌（ES-NSCLC）患者的影响，我们在真实世界环境中开展了Lung PLUS研究。
这是一项单中心前瞻性纵向研究，随访至治疗后12个月，评估临床医生和患者报告的毒性（分别为CTCAE和PRO-CTCAE）、健康相关生活质量（HRQoL）（EORTC QLQ-C30和LC-13）、日常生活活动能力（HAQ-DI）和功能运动能力（6分钟步行试验（6MWT））。采用混合模型方法分析数据。
在基线时，临床医生和患者（n = 51）报告的任何级别的症状主要为疲劳（63%对79%）、咳嗽（49%对75%）和呼吸困难（65%对73%）。呼吸困难（p = 0.041）随时间增加。在疼痛、疲劳和咳嗽方面尤其观察到有意义的临床改善。临床医生报告疲劳、咳嗽和呼吸困难随时间有临床意义的改善和恶化。几乎在每个时间点，报告症状恶化的人数都多于上述毒性症状改善的人数。总体HRQoL（p = 0.014）、身体功能（p = 0.011）和情感功能（p < 0.001）随时间改善。在基线时，患者的日常功能评分中等，平均步行距离为360米。随时间推移，在日常功能和运动能力方面未发现统计学上的显著差异。
我们的研究表明，SBRT后患者报告的毒性和呼吸困难增加，但未影响功能状态。总体HRQoL、身体和情感功能随时间改善。了解治疗对患者报告结局的影响对于识别患者的需求/问题以提高其HRQoL至关重要。
