Han J Y, Kim H K, Choi B G, Moon H, Hong Y S, Lee K S
Department of Internal Medicine, College of Medicine, Catholic University of Korea, Seoul, Korea.
Jpn J Clin Oncol. 1998 Dec;28(12):749-53. doi: 10.1093/jjco/28.12.749.
Quality of life (QOL) assessment has emerged to measure and quantify the balance between treatment benefit and toxicity, and has a value in predicting response and overall survival in cancer patients.
From July 1995 to February 1997, 38 symptomatic patients with advanced non-small cell lung cancer (NSCLC) were treated with MIP chemotherapy (mitomycin 6 mg/m2, ifosfamide 3000 mg/m2 and cisplatin 50 mg/m2 on day 1 every 3 weeks). Patients were assessed for QOL including physical well-being, general symptoms and lung cancer-specific symptoms, as well as objective response.
The overall response rate was 38.9% (14/36, all were partial response) and the median duration of response was 3.5 months [95% confidence interval (CI) 2.0-4.0]. The median duration of overall survival was 7 months (95% CI 5.9-8.5). The overall improvement of QOL was 58.3% with 21 patients feeling better on treatment. The toxicity of chemotherapy was mild, mainly nausea/vomiting and minimal alopecia. Using multiple clinical predictors of survival (age, histology, stage, performance status), only change of QOL emerged significantly (P = 0.0007).
MIP had an endurable response and low toxicity profile, and provided good QOL. Integral QOL data in our study provided the strong prediction of survival in advanced NSCLC. Further experienced QOL study will provide greatly enhanced outcome data in clinical trials.
生活质量(QOL)评估已逐渐用于衡量和量化治疗益处与毒性之间的平衡,并且在预测癌症患者的反应和总生存期方面具有价值。
从1995年7月至1997年2月,38例有症状的晚期非小细胞肺癌(NSCLC)患者接受了MIP化疗(丝裂霉素6 mg/m²、异环磷酰胺3000 mg/m²和顺铂50 mg/m²,每3周的第1天给药)。对患者进行了生活质量评估,包括身体健康、一般症状和肺癌特异性症状,以及客观反应。
总缓解率为38.9%(14/36,均为部分缓解),中位缓解持续时间为3.5个月[95%置信区间(CI)2.0 - 4.0]。总生存期的中位持续时间为7个月(95% CI 5.9 - 8.5)。生活质量的总体改善率为58.3%,21例患者在治疗后感觉好转。化疗的毒性较轻,主要是恶心/呕吐和轻微脱发。使用多个生存的临床预测因素(年龄、组织学、分期、体能状态),只有生活质量的变化具有显著意义(P = 0.0007)。
MIP具有持久的反应和低毒性特征,并提供了良好的生活质量。我们研究中的综合生活质量数据为晚期NSCLC的生存提供了有力预测。进一步有经验的生活质量研究将在临床试验中提供大大增强的结果数据。