Health-related quality of life in men with metastatic prostate cancer treated with prednisone alone or mitoxantrone and prednisone
Health-related quality of life in men with metastatic prostate cancer treated with prednisone alone or mitoxantrone and prednisone
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DOI：
10.1200/jco.1999.17.6.1654
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发表时间：
1999-06-01
影响因子：
45.3
通讯作者：
Neville, AJ
中科院分区：
文献类型：
--
作者：
Osoba, D;Tannock, IF;Neville, AJ
目的：米托蒽醌加泼尼松联合治疗转移性、耐药前列腺癌患者的疼痛减轻效果优于单用泼尼松。本研究的目的是评估这些治疗对健康相关的生活质量（HQL）的影响。患者和方法：男性转移性前列腺癌（n = 161）随机接受每日泼尼松单独或米托蒽醌（每3周）加泼尼松。那些单独接受泼尼松的患者，如果疼痛没有改善，6周后可以加入米托蒽醌。在治疗开始前，使用欧洲癌症研究与治疗组织生活质量问卷C30（EORTC QLQ-C30）和生活质量模块-前列腺14（QOLM-P14）（为本研究开发的试验特定模块）每3周一次评估HQL。使用意向治疗分析来确定HQL改善的平均持续时间和患者组之间改善持续时间的差异。结果：在6周时，两组均显示出几个HQL领域的改善，并且只有米托蒽醌加泼尼松组的身体功能和疼痛优于单用泼尼松组。6周后，服用泼尼松的患者HQL评分没有改善，而服用米托蒽醌加泼尼松的患者在总体生活质量（P = 0.009）、4个功能领域和9个症状方面有显著改善（0.001 < P <0.01），并且改善（0 - 100量表> 10个单位）持续时间长于单用泼尼松组（0.004 < P <0.05）。在单用泼尼松治疗失败后加用米托蒽醌与疼痛、疼痛影响、疼痛缓解、失眠和总体生活质量的改善相关（.001 < P < .003）。结论：与单用泼尼松治疗相比，米托蒽醌加用泼尼松治疗在几个HQL领域和症状方面的改善更大、更长。(C)1999年，美国临床肿瘤学会。
Purpose: A combination of mitoxantrone plus prednisone is preferable to prednisone alone for reduction of pain in men with metastatic, hormone-resistant, prostate cancer. The purpose of this study was to assess the effects of these treatments on health-related qualify of life (HQL).Patients and Methods: Men with metastatic prostate cancer (n = 161) were randomized to receive either daily prednisone alone or mitoxantrone (every 3 weeks) plus prednisone. Those who received prednisone alone could have mitoxantrone added after 6 weeks if there was no improvement in pain. HQL was assessed before treatment initiation and then every 3 weeks using the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire C30 (EORTC QLQ-C30) and the Quality of Life Module-Prostate 14 (QOLM-P14), a trial-specific module developed for this study. an intent-to-treat analysis was used to determine the mean duration of HQL improvement and differences in improvement duration between groups of patients.Results: at 6 weeks, both groups showed improvement several HQL domains, and only physical functioning and pain were better in the mitoxantrone-plus-prednisone group than in the prednisone-alone group. After 6 weeks,:patients taking prednisone showed no improvement in HQL scores, whereas those taking mitoxantrone plus prednisone showed significant improvements in global quality of life (P = .009), four functioning domains, and nine symptoms (.001 < P < .01), and the improvement (> 10 units on a scale of 0 to 100) lasted longer than in the prednisone-alone group (.004 < P < .05). The addition of mitoxantrone to prednisone after failure of prednisone alone was associated with improvements in pain, pain impact, pain relief, insomnia, and global quality of life (.001 < P < .003).Conclusion: Treatment with mitoxantrone plus prednisone was associated with greater and longer-casting improvement in several HQL domains and symptoms than treatment with prednisone alone. (C) 1999 by American Society of Clinical Oncology.