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接受免疫治疗的癌症患者生活质量评估及健康相关生活质量问卷数据记录困难分析

Assessment of Quality of Life and Difficulties in Recording Data from Health-Related Quality of Life Questionnaires in Patients with Cancer Undergoing Immunotherapy Treatment.

作者信息

Bibiano Guillén Laura, Recio Carrasco Cristina, Cárdenas Rebollo José Miguel, van Niekerk Dihan, Rodríguez Pascual Jesús, Rubio-Rodríguez María Carmen, Reina Miguel A

机构信息

Department of Oncology, HM Puerta del Sur Hospital, 28938 Madrid, Spain.

Department of Mathematics and Data Science, CEU-San-Pablo University, 28925 Madrid, Spain.

出版信息

Healthcare (Basel). 2025 Apr 26;13(9):1002. doi: 10.3390/healthcare13091002.

Abstract

Prospective studies evaluating the challenges of systematically assessing health-related quality of life in patients with cancer outside clinical trials are lacking. This study aimed to evaluate the quality of life of patients with cancer treated with immunotherapy such as checkpoint inhibitors and to determine the difficulties and limitations in achieving data collection from health-related quality of life questionnaires. We carried out a prospective observational study over 15 months in 30 patients with solid tumors undergoing checkpoint inhibitor therapy in an outpatient setting. We assessed health-related quality of life using the European Organization for Research and Treatment of Cancer QLQ-C30 quality of life questionnaire at treatment initiation, three months, and six months. We analyzed compliance rates, reported difficulties, and treatment-related toxicities. Of the 30 patients, 26 completed the health-related quality of life standardized questionnaire at one month (86.6%), 24 at three months (80%), and 18 at six months (56.6%). Patients receiving checkpoint inhibitor monotherapy showed an improvement in global health status scores from 60 at baseline to 65 at three months and 70.8 at six months. These findings suggest that checkpoint inhibitor therapy delays symptom onset and positively impacts quality of life. Fatigue was the most frequently reported adverse effect, followed by pain, dyspnea, and gastrointestinal symptoms. Checkpoint inhibitor treatments may delay the onset of cancer-related symptoms, positively influencing patient-reported health-related quality of life (HRQoL) outcomes. However, this study highlights significant methodological challenges in collecting standardized HRQoL questionnaire data outside of clinical trials, including declining patient compliance over time. These findings underscore the need for adapted HRQoL assessment strategies tailored to the unique treatment trajectories of immunotherapy patients.

摘要

缺乏对癌症患者在临床试验之外系统评估健康相关生活质量挑战的前瞻性研究。本研究旨在评估接受免疫疗法(如检查点抑制剂)治疗的癌症患者的生活质量,并确定在通过健康相关生活质量问卷收集数据时所面临的困难和局限性。我们在门诊环境中对30例接受检查点抑制剂治疗的实体瘤患者进行了为期15个月的前瞻性观察研究。我们在治疗开始时、三个月和六个月时使用欧洲癌症研究与治疗组织的QLQ-C30生活质量问卷评估健康相关生活质量。我们分析了依从率、报告的困难以及与治疗相关的毒性。在30例患者中,26例在一个月时完成了健康相关生活质量标准化问卷(86.6%),24例在三个月时完成(80%),18例在六个月时完成(56.6%)。接受检查点抑制剂单药治疗的患者的总体健康状况评分从基线时的60分提高到三个月时的65分和六个月时的70.8分。这些发现表明,检查点抑制剂疗法可延迟症状出现,并对生活质量产生积极影响。疲劳是最常报告的不良反应,其次是疼痛、呼吸困难和胃肠道症状。检查点抑制剂治疗可能会延迟癌症相关症状的出现,对患者报告的健康相关生活质量(HRQoL)结果产生积极影响。然而,本研究突出了在临床试验之外收集标准化HRQoL问卷数据时存在的重大方法学挑战,包括患者依从性随时间下降。这些发现强调了需要针对免疫治疗患者独特的治疗轨迹制定适应性的HRQoL评估策略。

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