Greene D, Nail L M, Fieler V K, Dudgeon D, Jones L S
Cancer Pract. 1994 Jan-Feb;2(1):57-62.
Patient's perceptions of side effects and the influence of treatment on daily activities are important considerations in choosing a chemotherapy regimen. However, there are no studies comparing patients' experiences with three commonly used chemotherapy regimens for breast cancer. The authors compared the patient-reported side effects and disruption in usual activities for cyclophosphamide and fluorouracil combined with methotrexate (CMF), doxorubicin (CAF), or mitoxantrone (CNF) in 86 women receiving treatment for breast cancer. The incidence and severity of side effects and disruption in usual activities were recorded by patients in a self-care diary (SCD) 2 and 5 days after the first and second drug cycles. Patients reported a mean of 3.2 to 4.9 side effects at each point in time. Fatigue, nausea, anorexia, taste changes, and headache were the most frequently reported side effects and did not differ in incidence among the three drug regimens. When repeated measures analysis of covariance was conducted using mean substitution for missing data and controlling for stage of disease, women receiving CAF reported more severe nausea than women receiving CMF or CNF (P < 0.05). Fatigue was significant for time; however, a distinct clinical pattern of fatigue was not apparent. Patients reported moderate levels of disruption in activities of daily living, with those receiving CAF having greater disruption. There was no difference among treatment groups in reports of overall disruption in activities. These data on patient reported experiences with side effects of chemotherapy can be used to prepare patients for specific side effects of treatment and facilitate symptom management.
患者对副作用的感知以及治疗对日常活动的影响是选择化疗方案时的重要考量因素。然而，尚无研究比较患者使用三种常用乳腺癌化疗方案的体验。作者比较了86名接受乳腺癌治疗的女性使用环磷酰胺、氟尿嘧啶联合甲氨蝶呤（CMF）、多柔比星（CAF）或米托蒽醌（CNF）时患者报告的副作用以及日常活动的干扰情况。在第一个和第二个化疗周期后的第2天和第5天，患者通过自我护理日记（SCD）记录副作用的发生率和严重程度以及日常活动的干扰情况。患者在每个时间点报告的平均副作用为3.2至4.9种。疲劳、恶心、厌食、味觉改变和头痛是最常报告的副作用，三种化疗方案的发生率没有差异。当使用均值替代缺失数据并控制疾病分期进行重复测量协方差分析时，接受CAF治疗的女性比接受CMF或CNF治疗的女性报告的恶心更严重（P<0.05）。疲劳在时间上有显著差异；然而，疲劳的明显临床模式并不明显。患者报告日常生活活动有中度干扰，接受CAF治疗的患者干扰更大。各治疗组在活动总体干扰报告方面没有差异。这些关于患者报告的化疗副作用体验的数据可用于让患者为治疗的特定副作用做好准备并促进症状管理。
