Rapid deterioration in quality of life during interleukin-2- and α-interferon-based home therapy of renal cell carcinoma is associated with a good outcome
Rapid deterioration in quality of life during interleukin-2- and α-interferon-based home therapy of renal cell carcinoma is associated with a good outcome
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DOI：
10.1038/sj.bjc.6600996
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发表时间：
2003-07-07
影响因子：
8.8
通讯作者：
Reitz, M
中科院分区：
文献类型：
--
作者：
Atzpodien, J;Küchler, T;Reitz, M
我们对 22 名接受皮下注射干扰素 α2a 和皮下注射白细胞介素 2 治疗的进行性转移性肾细胞癌 (RCC) 患者进行了门诊免疫治疗期间的前瞻性生活质量分析。在免疫治疗前（第0周）和免疫治疗期间（第3周），通过欧洲癌症研究与治疗组织生活质量问卷QLQ-C30对患者的生活质量进行评估。晚期肾癌患者在治疗前（第0周）和治疗3周后总共完成了30份问卷。在治疗开始后的前 3 周内，他们的平均生活质量（整体健康质量状况）显着恶化，从 64 降至 41（P 小于或等于 0.001），原因是身体（从 82 至 65；P 小于或等于 0.001）、情感（从 77 至 61；P 小于或等于 0.01）、社交（从 78 至 55；P 小于或等于 0.01）、社交（从 78 至 55；P 小于或等于 0.01）平均下降。或等于0.01），以及角色功能（从82到58；P小于或等于0.01）。相比之下，治疗 3 周后，认知功能与治疗前评分没有显着差异。此外，在前3周内，食欲不振（从18到59；P小于或等于0.01）、疲劳（从33到56；P小于或等于0.01）、恶心/呕吐（从10到26；P小于或等于0.01）、睡眠障碍（从27到47；P小于或等于0.01）、腹泻（从5到27；P小于或等于0.01）。 P小于或等于0.01）和疼痛（从20到32；P小于或等于0.05）显着增加，而呼吸困难和便秘等生活质量症状并未受到治疗的显着影响。与进展或稳定疾病或部分肿瘤反应的患者相比，对肾细胞癌门诊免疫治疗的完全反应与功能生活质量的最显着下降相关。总之，门诊免疫治疗期间的生活质量分析显示，治疗开始后 3 周患者的健康状况发生了适度变化。由于功能生活质量的快速下降与治疗效果相关，因此建议生活质量分析可以作为转移性肾细胞癌免疫治疗反应的早期指标。
We conducted a prospective quality-of-life analysis during outpatient immunotherapy in 22 patients with progressive metastatic renal cell carcinoma (RCC) treated with subcutaneous interferon-alpha2a and subcutaneous interleukin-2. Patients' quality of life was assessed by the European Organization for Research and Treatment of Cancer quality-of-life questionnaire QLQ-C30 before (week 0) and once during immunotherapy (week 3). Advanced renal cancer patients completed a total of 30 questionnaires before therapy (week 0) and after 3 weeks of therapy. Their mean quality of life (global-quality-of-health status) deteriorated significantly, from 64 to 41 (Pless than or equal to0.001) during the first 3 weeks after treatment initiation, due to a mean reduction in physical (from 82 to 65; Pless than or equal to0.001), emotional (from 77 to 61; Pless than or equal to0.01), social (from 78 to 55; Pless than or equal to0.01), and role functioning (from 82 to 58; Pless than or equal to0.01). In contrast, cognitive functioning did not differ significantly from pretreatment scores after 3 weeks of therapy. In addition, during the first 3 weeks, appetite loss (from 18 to 59; Pless than or equal to0.01), fatigue (from 33 to 56; Pless than or equal to0.01), nausea/vomiting (from 10 to 26; Pless than or equal to0.01), sleep disturbance (from 27 to 47; Pless than or equal to0.01), diarrhoea (from five to 27; Pless than or equal to0.01), and pain (from 20 to 32; Pless than or equal to0.05) were significantly increased, while quality-of-life symptoms such as dyspnoea, and constipation were not significantly influenced by therapy. Complete response to RCC outpatient immunotherapy was associated with the most predominant reduction in functional quality of life when compared against patients in progressive or stable disease or partial tumour response. In conclusion, quality-of-life analysis during outpatient immunotherapy yielded modest changes in patients' health status 3 weeks after therapy initiation. Since the rapid decline in functional quality-of-life was associated with therapeutic efficacy, it is suggested that quality-of-life analysis might serve as an early indicator for immunotherapy response in metastatic RCC.