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与免疫治疗相比,接受二线化疗的非小细胞肺癌患者的生活质量和症状负担。

Quality of Life and Symptom Burden in Non-Small-Cell Lung Cancer Patients Receiving Second-Line Chemotherapy Compared with Immunotherapy.

机构信息

Department of Nursing, University of West Attica, 12243 Athens, Greece.

Department of Nursing, Hellenic Mediterranean University, 71410 Heraklion, Greece.

出版信息

Medicina (Kaunas). 2024 Nov 9;60(11):1845. doi: 10.3390/medicina60111845.

Abstract

: The burdened symptomatology accompanying advanced non-small-cell lung cancer (NSCLC) is associated with poor prognosis and lower quality of life (QoL). Although both chemotherapy and immunotherapy increase survival, they are still associated with reduced functionality due to their toxicity. This study aimed to estimate the QoL and symptom burden of NSCLC patients receiving second-line chemotherapy compared to patients receiving second-line immunotherapy. : This comparative, prospective study, conducted from January 2020 to December 2021, included 111 NSCLC patients who were divided into two groups: 61 patients receiving second-line chemotherapy and 50 patients receiving second-line immunotherapy. Patients' QoL and symptom burden were estimated using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ C-30) (value range 0-100) from treatment cycle 1 to 6. : The QoL (mean score > 50) and functionality dimensions (mean score > 50) were moderate to good in both treatment groups, while the symptom burden did not appear to be a serious problem (mean score < 50). From cycle 3 to cycle 5, QoL was significantly better in the immunotherapy group. From cycle 3, the role and social functioning scores were higher in the immunotherapy group, while emotional and cognitive functioning were higher from cycle 2 ( <0.05). The chemotherapy group experienced higher levels of nausea/vomiting, constipation and financial difficulties in all the cycles ( < 0.05). Fatigue and appetite loss were significantly greater from cycle 2 and insomnia was significantly greater from cycle 3. On the contrary, the immunotherapy group experienced higher levels of diarrhea in cycles 5 and 6 ( < 0.05). : Although both therapy groups did not report significantly impaired QoL and severe symptoms, it seems that QoL improved in the immunotherapy group, which reported a lower symptom burden compared to the chemotherapy group.

摘要

:伴有晚期非小细胞肺癌(NSCLC)的负担症状与不良预后和较低的生活质量(QoL)相关。虽然化疗和免疫疗法都能提高生存率,但由于其毒性,它们仍与功能降低有关。本研究旨在评估接受二线化疗的 NSCLC 患者与接受二线免疫治疗的患者的 QoL 和症状负担。

:这是一项比较性、前瞻性研究,于 2020 年 1 月至 2021 年 12 月进行,共纳入 111 例 NSCLC 患者,分为两组:61 例接受二线化疗,50 例接受二线免疫治疗。从治疗周期 1 到 6,使用欧洲癌症研究与治疗组织生活质量问卷核心 30 项(EORTC QLQ C-30)(分值范围 0-100)评估患者的 QoL 和症状负担。

:两组治疗的 QoL(平均得分>50)和功能维度(平均得分>50)均为中等到良好,而症状负担似乎不是一个严重的问题(平均得分<50)。从第 3 周期到第 5 周期,免疫治疗组的 QoL 明显更好。从第 3 周期开始,免疫治疗组的角色和社会功能评分较高,而从第 2 周期开始,情绪和认知功能评分较高(<0.05)。在所有周期中,化疗组经历了更高水平的恶心/呕吐、便秘和经济困难(<0.05)。从第 2 周期开始,疲劳和食欲下降显著更大,从第 3 周期开始,失眠显著更大。相反,免疫治疗组在第 5 周期和第 6 周期经历了更高水平的腹泻(<0.05)。

:虽然两组治疗都没有报告 QoL 显著受损和严重症状,但似乎免疫治疗组的 QoL 有所改善,与化疗组相比,免疫治疗组报告的症状负担较低。

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