吉非替尼改善晚期非小细胞肺癌患者生活质量的临床研究

目的评价吉非替尼对非小细胞肺癌患者生活质量的影响。方法对68例应用吉非替尼的非小细胞肺癌患者治疗前后生活质量进行统计学分析,生活质量分析采用欧洲癌症研究和治疗组织（European Organization for Research and Treatment of Cancer,EORTC）简体中文版EORTCQLQ-C30和QLQ-LC13问卷对治疗前、后症状和生活质量的改变进行评价。结果68例患者完成了问卷调查。治疗后患者5种功能状态（躯体、角色、情感、认知、社会）及整体生活质量评分均值显著增加,与治疗前相比差异有显著性（P〈0.05）。治疗后乏力症状评分的均值显著降低,与治疗前相比差异有显著性（P〈0.05）,治疗后肺癌相关症状（咳嗽、胸痛、呼吸困难）评分的均值显著降低,与治疗前相比差异有显著性（P〈0.05）。症状和生活质量的改善与疾病控制相一致。生活质量改善者生存延长。结论吉非替尼可改善晚期非小细胞肺癌患者的症状和生活质量。     

表皮生长因子受体抑制剂gefitinib对改善晚期非小细胞肺癌患者生活质量的作用

背景与目的生活质量是评价非小细胞肺癌治疗方法的重要指标。本研究的目的是观察表皮生长因子受体抑制剂gefitinib对晚期非小细胞肺癌患者生活质量的影响。方法对gefitinib慈善用药计划中31例晚期非小细胞肺癌患者进行研究。患者每日口服gefitinib250mg,直至病情进展或出现严重的副反应。采用中文版EORTCQLQ-C30和QLQ-LC13问卷对治疗前后症状和生活质量的改变进行评价。结果25例接受gefitinib治疗的患者完成问卷。和治疗前相比,治疗8周后,患者4种功能状态(体格、角色、情感、社会)和整体生活质量评分的均值显著增加,全身症状(乏力和食欲不振)以及疾病相关症状(呼吸困难、咳嗽、胸痛、手臂和肩膀疼痛、身体其他部位疼痛)评分的均值显著降低。治疗后5种功能状态和整体生活质量的有效率均超过50%。主要的全身症状和疾病相关症状的有效率也达到44%~84%。症状和生活质量的改善与临床客观疗效相一致。结论gefitinib对于常规治疗失败的晚期非小细胞肺癌仍能够改善患者的症状和生活质量。     

吉非替尼对晚期非小细胞肺癌患者生活质量的影响

背景与目的：提高晚期非小细胞肺癌患者的生活质量是肿瘤学者关注的问题之一。吉非替尼己广泛用于治疗晚期非小细胞肺癌。本研究探讨吉非替尼对晚期非小细胞肺癌患者生活质量的影响。方法：70例晚期非小细胞肺癌患者，每日口服吉非替尼250mg，直至病情进展或出现严重不良反应。采用欧洲癌症研究和治疗组织（European Organization for Research and Treatment of Cancer，EORTC）简体中文版EORTCQLQ—C30和QLQ—LC13问卷对治疗前、后症状和生活质量的改变进行评价。结果：58例患者（85．3％）完成了问卷调查。治疗前和治疗8周后患者5种功能状态（躯体、角色、情感、认知、社会）的均值分别为52和63，49和56，64和68，60和65，52和61，整体生活质量评分的均值分别为53和60，差异有显著性（P〈0．05）；治疗前、后全身症状（乏力、食欲不振）的均值分别为61和58，52和48，肺癌相关症状（呼吸困难、咳嗽、咯血、胸痛）的均值分别为55和49，54和47，28和27，29和25，其中乏力、呼吸困难、咳嗽、胸痛的差异有显著性（P〈0．05）。治疗后5种功能状态和整体生活质量的有效率均超过50％，全身症状和肺癌相关症状的有效率均超过40％。症状和生活质量的改善与疾病控制相一致。生活质量改善者生存延长。结论：吉非替尼明显改善晚期非小细胞肺癌患者的症状和生活质量。     

支气管动脉碘油化疗栓塞术对非小细胞肺癌患者生活质量的影响

[目的]探讨支气管动脉碘油化疗栓塞术对非小细胞肺癌患者近期生活质量的影响.[方法]采用肺癌治疗功能评价量表FACT-L中文版对33例使用超选择支气管动脉碘油化疗栓塞术治疗的非小细胞肺癌患者的近期生活质量进行测定,分析介入术前、术后1个月及3个月患者生活质量的变化,并与同期采用全身化疗的30例非小细胞肺癌患者进行比较.[结果]化疗栓塞组术后1、3个月的生活质量评分均较术前明显提高(P＜0.01).与全身化疗比较,化疗栓塞组在临床疗效和提高患者术后生活质量程度方面优于全身化疗组(P＜0.05).与疾病症状和治疗副作用有关的项目评分(分别为生理状况和附加关注)显示,化疗栓塞组在分项评分中同样优于全身化疗组(P＜0.05).[结论]超选择支气管动脉碘油化疗栓塞术比全身化疗更能提高中晚期非小细胞肺癌患者的生活质量.     

重组人红细胞生成素对非小细胞肺癌化疗疗效及生活质量影响

[目的]探讨重组人红细胞生成素(rHuEPO)对非小细胞肺癌患者化疗疗效及生活质量的影响.[方法]97例非小细胞肺癌患者随机分为治疗组与对照组.治疗组49例采用化疗联合rHuEPO;对照组48例行单纯化疗;化疗方案均为NP,化疗4周期后进行疗效及生活质量评价.[结果]治疗组与对照组的近期疗效无显著性差异(P＞0.05);治疗组的血红蛋白水平、体力状况评分(KPS)、生活质量(QOL)评分较对照组显著改善(P＜0.05).[结论]rHuEPO联合化疗可以改善非小细胞肺癌患者的生活质量,但对肿瘤的近期疗效无明显影响.     

异长春花碱单药化疗75岁以上高龄晚期非小细胞肺癌

目的 评价异长春花碱单药化疗对高龄晚期非小细胞肺癌患者生活质量的影响及其耐受性。方法 治疗75岁以上高龄晚期非小细胞肺癌38例。治疗组20例予以异长春花碱(NVB)25mg／m^2第l，8天，28天为一疗程；对照组18例辅以最佳的支持治疗(BSC)。结果 治疗组有效率20％，对照组有效率0。结论 对高龄晚期非小细胞肺癌患者，异长春花碱单药化疗较支持治疗有更好的疗效和生活质量，更长的生存期，且毒副作用轻微，可以耐受。     

安罗替尼三线治疗非小细胞肺癌的疗效观察

目的 探讨安罗替尼三线治疗非小细胞肺癌对患者近远期生活质量及不良反应的影响.方法 选取2018年5月至2020年5月间广东省潮州市人民医院收治的90例非小细胞肺癌患者为研究对象.将其按就诊顺序生成随机号,再将随机号随机分为对照组和观察组,每组45例.对照组患者采用吉西他滨加顺铂方案治疗,观察组患者采用安罗替尼治疗.比较...     

消癌平注射液联合化疗治疗晚期非小细胞肺癌的临床观察

目的观察消癌平注射液联合化疗治疗晚期非小细胞肺癌的临床疗效与安全性。方法 68例非小细胞肺癌患者随机分为治疗组、对照组,治疗组35例采用消癌平注射液联合GP或NP化疗方案;对照组33例单纯采用GP或NP化疗方案,2周期后评价近期疗效、毒副反应及生活质量。结果治疗组、对照组总有效率分别为54.28%、39.40%,比较差异无统计学意义(P>0.05)。治疗组生活质量改善率高于对照组,比较差异有统计学意义(P<0.05)。治疗组毒副反应发生率及程度低于对照组,但比较差异无统计学意义(P>0.05)。结论消癌平注射液联合化疗治疗晚期非小细胞肺癌疗效优于单纯化疗,生活质量显著高于单纯化疗,临床应用安全。     

注射用核糖核酸联合胸腺五肽在晚期非小细胞肺癌化疗中的作用

目的探讨注射用核糖核酸联合胸腺五肽在晚期非小细胞肺癌化疗中的作用。方法选取2012年12月至2013年12月间收治的晚期非小细胞肺癌患者60例,随机分为观察组和对照组,各30例。对照组患者给予TC方案(紫杉醇+卡铂)化疗,观察组患者在TC方案化疗基础上加用核糖核酸联合胸腺五肽治疗,比较两组患者的临床疗效、生活质量及不良反应。结果观察组总有效率(56.7%),对照组(46.9%),差异无统计学意义(P>0.05);观察组生活质量显著优于对照组,差异有统计学意义(P<0.05);观察组患者不良反应发生率显著低于对照组,差异有统计学意义(P<0.05)。结论注射用核糖核酸联合胸腺五肽配合化疗治疗晚期非小细胞肺癌,可降低化疗对患者免疫功能的影响和不良反应,改善患者的生活质量,值得在临床上应用和推广。     

拉司太特单药治疗老年晚期非小细胞肺癌疗效观察

目的评价拉司太特单药治疗晚期老年非小细胞肺癌(NSCLC)的疗效和安全性。方法30例晚期非小细胞肺癌患者采用拉司太特口服25mg,每日2次,服药21d,间隔1周后重复,共3周期,并进行评价。治疗前、治疗后2个月及3个月分别用肺癌患者生存质量测定量表FACT-L中文版进行生活质量(QOL)测评。结果30例患者均完成3个周期化疗,部分缓解7例,总有效率23.3%。Ⅲ/Ⅳ度白细胞减少发生率16.7%,其他副反应轻微。结论拉司太特治疗晚期非小细胞肺癌有一定疗效,但要注意白细胞下降。     

Prospective assessment of quality of life in long‐term ovarian cancer survivors

The objective of our study was to compare prospectively the QoL in long‐term ovarian cancer survivors with short‐term survivors and to explore discriminating variables between short‐term and long‐term survival. Thirty‐three patients were included, 22 died within 5 years post diagnosis and 11 survived beyond 10 years. QoL data were collected pre‐treatment (baseline), 1‐year post diagnoses and for long‐term survivors 10 years post‐treatment using the EORTC QLQ‐C30. At baseline, there was no difference in terms of FIGO stage, residual tumor and adjuvant chemotherapy. Significantly, more short‐term survivors (96%) had intra operative ascites as compared to long‐term survivors (55%) (p=0.01). Before treatment, short‐term survivors had clinically significantly lower QoL scores on the physical functioning (mean 75.45) and role functioning scale (mean 68.94) compared to long‐term survivors (mean 68.94 and 84.85, respectively). They also reported higher levels of symptoms. One year post‐diagnosis, QoL scores were comparable in most domains. Long‐term survivors had a significantly better global QoL but more insomnia. Emotional functioning and global QoL/health status improved significantly from baseline to 1‐year post‐diagnosis and remained relatively stable at the 10‐year follow‐up. The presence of intra operative ascites and a supporting social network were identified as significant variables that discriminated between short‐term and long‐term survival. Compared to a reference sample, long‐term survivors showed similar QoL scores but more dyspnoea. Although ovarian cancer patients do not belong to the most prevalent survivor populations, we found that long‐term survivors have QoL scores similar to females without a history of cancer.     

Quality of life of adolescent and adult survivors of childhood cancer in Europe—A systematic review

Advances in diagnostics and treatment of childhood cancer during the past few decades have substantially increased survival, resulting in a growing population of survivors of childhood cancer. Somatic and mental late effects of the cancer and the treatment may impact the quality of life (QoL). Previous reviews of QoL in survivors of childhood cancer have shown contradictory findings across studies and the majority of studies included have been based on data from North America and may not be directly comparable to a European setting. The aim of our study was to critically evaluate and summarise the latest evidence on the QoL of childhood cancer survivors in Europe and to identify survivors at particular risk. The eligible studies were published between 2008 and 2022, conducted in Europe and included participants who had survived at least 5 years after diagnosis of a childhood cancer. The main outcome of interest was QoL of survivors which was measured with validated qualitative and quantitative QoL questionnaires. A systematic literature search conducted in PubMed, EMBASE, PsycINFO and CINALH resulted in inclusion of 36 articles with a total of 14 342 survivors of childhood cancer. The majority of included studies found that childhood cancer survivors reported poorer QoL than comparisons. Female gender, treatment with haematopoietic stem cell transplantation and a brain tumour diagnosis were associated with lower QoL. With a growing population of childhood cancer survivors with many years ahead of them, targeted interventions and optimal follow-up care are important to improve the QoL of survivors.     

Quality of Life in NSCLC Survivors — A Multicenter Cross-Sectional Study

Introduction

The objective was to assess quality of life (QoL) in lung cancer survivors, compare it to the general population, and identify factors associated with global QoL, physical functioning, emotional functioning, fatigue, pain, and dyspnea.

The impact of brain metastasis on quality of life,resource utilization and survival in patients with non-small-cell lung cancer

This systematic review aims to improve understanding of the burden of disease associated with brain metastases from non-small-cell lung cancer (NSCLC) in terms of survival, quality of life (QoL) and economic impact. PubMed/MEDLINE, Cochrane collaboration and EMBASE databases were searched for articles published in English from 2000 to 2014. Of 3288 abstracts retrieved, 3156 were eliminated without a full-text review. Of the 132 articles that received a full-text review, a final set of 93 articles was included in an initial literature analysis. In order to homogenize the patient populations evaluated, we included entries that were either entirely composed of NSCLC patients or that had >50% of NSCLC patients in the total study population. From the studies identified in this systematic review, median OS and PFS varied based on the type of treatment received, although whole-brain radiotherapy (WBRT) was associated with the shortest OS and PFS durations. Regimens incorporating targeted therapy in molecularly selected patients were associated with the longest OS and PFS durations. QoL findings varied among studies, generally WBRT resulted in stable or worsening QoL scores rather than improvements. Healthcare costs were increased following diagnosis of brain metastases regardless of treatment. The findings from this review highlight the need for more effective treatments of brain metastases from NSCLC that improve survival function, QoL and potentially decrease costs.     

Quality of life in survivors of oropharyngeal cancer: A systematic review and meta-analysis of 1366 patients

Human papillomavirus (HPV)-associated oropharyngeal cancer (OPC) is rapidly increasing in incidence and has a favourable prognosis compared with HPV-negative disease. Current combined therapies include significant risks of morbidity for the growing group of survivors. This systematic review and meta-analysis investigates how treatment affects quality of life (QoL) in survivors of oropharyngeal cancer. PubMed, EMBASE and the Cochrane Library were systematically searched for all studies reporting patient-assessed QoL at least 1 year after treatment for OPC. In a meta-analysis, weighted average QoL scores from the four most commonly utilised QoL instruments were compared with baseline and reference group scores using the concept of minimal clinically important difference. The meta-analysis included data from 1366 patients from 25 studies and 12 countries. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30) was answered by 704 patients, 644 patients answered the EORTC QLQ Head and Neck-35 (H&N-35), 474 patients answered the University of Washington Quality of Life Questionnaire, and 381 patients answered the M. D. Anderson Dysphagia Inventory. Moderate to large clinically important deteriorations in QoL were found in the domains dry mouth and sticky saliva for the EORTC QLQ-H&N35, saliva, chewing, swallowing, speech, taste, appearance and shoulder for the University of Washington Quality of Life Questionnaire, and the global, physical and emotional subscales for the M. D. Anderson Dysphagia Inventory. In conclusion, survivors of OPC face clinically important deteriorations in QoL that most markedly centre on xerostomia, dysphagia and chewing. These ailments indicate a potential for improvement in patient management.     

Patient-reported Outcomes After the Treatment of Early Stage Non–small-cell Lung Cancer With Stereotactic Body Radiotherapy Compared With Surgery

IntroductionAs there is increasing evidence for comparable survival after either stereotactic body radiotherapy (SBRT) or surgery for patients with stage I non–small-cell lung cancer (NSCLC), treatment impact on the quality of life (QoL) is essential for well-informed decision-making. Our previous work evaluated health utility between surgery and SBRT in stage I NSCLC. The aim of this secondary analysis is to directly compare QoL in the first year after SBRT and surgery.Materials and MethodsQoL was assessed at baseline and 3, 6, and 12 months after treatment. Two prospectively collected databases of patients with clinically proven stage I NSCLC, from 2 large hospitals in the Netherlands, were pooled (n = 306; 265 patients were treated with SBRT and 41 patients with surgery). To correct for confounding, propensity scores were calculated, to be selected for surgical treatment. A mixed model analysis was used to study differences in QoL between the 2 treatments.ResultsThe 41 surgical patients were matched to 41 SBRT patients on propensity score with a 1:1 ratio. At baseline, patients in the surgery group report a lower QoL compared with patients in the SBRT group. However, during the first year after treatment, no clinical meaningful differences were observed, except for role functioning, between patients treated using either modality.ConclusionThis study comparing a matched cohort revealed no clinically significant differences in QoL following either SBRT or surgery for early stage NSCLC. These results support the hypothesis that surgery and SBRT are comparable treatments.     

Quality of life and sexual functioning after cervical cancer treatment: a long-term follow-up study

Objective: The purpose of the study was to investigate the long‐term treatment side effects on the quality of life (QoL) and sexual functioning of cervical cancer survivors undergoing different treatment regimens. Methods: QoL and sexual functioning were measured using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire, the Cervix Cancer Module, and the Sexual Activity Questionnaire. Results: One hundred twenty‐one cervical cancer survivors (63 Surgery, 38 Surgery/CT, and 20 Surgery/RT) participated. Patients in the Surgery/RT Group reported significantly worse QoL outcomes (lower scores on physical, role, cognitive, and social functioning) compared with patients in the Surgery Group or patients in the Surgery/CT Group. The level of symptoms such as nausea/vomiting, pain, appetite loss, frequent urination (p=0.019), leaking of urine (p=0.015), and the feeling of a tight vagina (p=0.018) was significantly higher in irradiated patients. Concerning sexual functioning, patients in the Surgery/RT Group reported a significantly lower sexual activity rate compared with women in the Surgery Group or women in the Surgery/CT group (p<0.05). However, there were no statistically significant differences concerning sexual pleasure and sexual discomfort among the three treatment groups (p>0.05). Conclusions: Cervical cancer survivors treated with adjuvant radiotherapy are more likely at risk for impaired QoL. Survivors treated with surgery or adjuvant chemotherapy return to a similar level of QoL as women without a history of cancer. Although the sexual activity rate is lower in irradiated patients their sexual pleasure is similar to patients after surgery and chemotherapy. Copyright © 2008 John Wiley & Sons, Ltd.     

A randomised clinical trial of two docetaxel regimens (weekly vs 3 week) in the second-line treatment of non-small-cell lung cancer. The DISTAL 01 study

Docetaxel (75 mg m(-2) 3-weekly) is standard second-line treatment in advanced non-small-cell lung cancer (NSCLC) with significant toxicity. To verify whether a weekly schedule (33.3 mg m(-2) for 6 weeks) improved quality of life (QoL), a phase III study was performed with 220 advanced NSCLC patients, < or =75 years, ECOG PS < or =2. QoL was assessed by EORTC questionnaires and the Daily Diary Card (DDC). No difference was found in global QoL scores at 3 weeks. Pain, cough and hair loss significantly favoured the weekly schedule, while diarrhoea was worse. DDC analysis showed that loss of appetite and overall condition were significantly worse in the 3-week arm in the first week, while nausea and loss of appetite were more severe in the weekly arm in the third week. Response rate and survival were similar, hazard ratio of death in the weekly arm being 1.04 (95% CI 0.77-1.39). A 3-weekly docetaxel was more toxic for leukopenia, neutropenia, febrile neutropenia and hair loss; any grade 3-4 haematologic toxicity was significantly more frequent in the standard arm (25 vs 6%). The weekly schedule could be preferred for patients candidate to receive docetaxel as second-line treatment for advanced NSCLC, because of some QoL advantages, lower toxicity and no evidence of strikingly different effect on survival.     

Quality of life and fatigue among colorectal cancer survivors according to stoma status - the national VICAN survey

Abstract

Objective: To assess colorectal cancer survivors' quality of life (QoL) and fatigue according to stoma status.

Methods: In this large-scale national survey, we examined and compared QoL (SF-12) and fatigue (QLQ-C30) of colorectal cancer survivors according to stoma status and against population norms. Of the 487 colorectal cancer survivors who participated in the VICAN survey, 43 had a reversed stoma. We randomly selected 43 survivors without stoma as a comparison group.

Findings: Colorectal cancer survivors had lower QoL scores compared to population norms. Fatigue affected survivors even two years after diagnosis. Participants with a reversed stoma scored lower on the physical QoL scale than participants without stoma.

Conclusion: QoL and fatigue are impaired during a considerable period after cancer diagnosis and differ according to stoma status.

Implications for psychosocial providers: Interventions aimed at improving QoL and fatigue for colorectal cancer survivors should be offered on a long-term basis, even two years after diagnosis.