Quality of life is impaired in association with the need for prolonged postoperative therapy by somatostatin analogs in patients with acromegaly
Quality of life is impaired in association with the need for prolonged postoperative therapy by somatostatin analogs in patients with acromegaly
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DOI：
10.1530/eje-11-0853
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发表时间：
2012-04-01
影响因子：
5.8
通讯作者：
van Beek, Andre P.
中科院分区：
文献类型：
--
作者：
Postma, Mark R.;Netea-Maier, Romana T.;van Beek, Andre P.
目的：探讨早期垂体手术后应用长效生长抑素类似物对肢端肥大症患者长期健康相关生活质量(HR-QOL)的影响。设计：这是一项在荷兰两个三级转诊中心进行的横断面研究。患者与方法：108例肢端肥大症患者，其中经蝶手术101例(94%)，经颅手术7例(6%)。随后，46人(43%)接受了额外的放射治疗，41人(38%)因研究时的持续性或复发性疾病正在接受SSTA的术后治疗。所有受试者都填写了测量HR-QOL的标准化问卷。结果：接受SSTA治疗的患者IGF1SD略高于未使用SSTA的患者(0.85+/-1.52vs0.25+/-1.21，P=0.026)，但控制不足的患者(IGF1SDS和GT；2)的比例无差异(17vs9%，P=0.208)。使用SSTA的患者报告在RAND-36的大多数分量表和肢端肥大症QOL以及多维疲劳量表-20的所有分量表上得分较低。对IGF1水平相近的患者(SSTA+，n=26，IGF1 SDS0.44+/-0.72 vs SSTA-，n=44，IGF1 SDS0.41+/-0.65)的亚组分析显示，接受SSTA治疗的患者在所有HR-QOL问卷中的身体功能、身体疲劳、活动减少、活力和总体健康感觉方面得分较差。结论：尽管IGF1水平相似，但肢端肥大症患者的生活质量受到损害，这与SSTA需要延长术后治疗时间有关。
Objective: To assess the influence of long-acting somatostatin analogs (SSTA) after initial pituitary surgery on long-term health-related quality of life (HR-QoL) in relation to disease control in patients with acromegaly.Design: This is a cross-sectional study in two tertiary referral centers in The Netherlands.Patients and methods: One hundred and eight patients with acromegaly, in whom transsphenoidal (n = 101, 94%) or transcranial (n = 7, 6%) surgery was performed. Subsequently, 46 (43%) received additional radiotherapy and 41 (38%) were on postoperative treatment with SSTA because of persistent or recurrent disease at the time of study. All subjects filled in standardized questionnaires measuring HR-QoL. Disease control at the time of study was assessed by local IGF1 SDS.Results: IGF1 SDS were slightly higher in patients treated with SSTA in comparison with patients without use of SSTA (0.85 +/- 1.52 vs 0.25 +/- 1.21, P = 0.026), but the percentage of patients with insufficient control (IGF1 SDS >2) was not different (17 vs 9%, P = 0.208). Patients using SSTA reported poorer scores on most subscales of the RAND-36 and the acromegaly QoL and on all subscales of the multidimensional fatigue inventory-20. A subgroup analysis in patients with similar IGF1 levels (SSTA+, n = 26, IGF1 SDS 0.44 +/- 0.72 vs SSTA-, n = 44, IGF1 SDS 0.41 +/- 0.65) revealed worse scores on physical functioning, physical fatigue, reduced activity, vitality, and general health perception across all HR-QoL questionnaires in patients treated with SSTA.Conclusion: QoL is impaired in association with the need for prolonged postoperative therapy by SSTA in patients with acromegaly despite similar IGF1 levels.