Effect of dexamethasone on quality of life in children with acute lymphoblastic leukaemia: a prospective observational study
Effect of dexamethasone on quality of life in children with acute lymphoblastic leukaemia: a prospective observational study
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DOI：
10.1186/1477-7525-6-103
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发表时间：
2008-11-26
影响因子：
3.6
通讯作者：
Gemke, Reinoud J. B. J.
中科院分区：
文献类型：
--
作者：
de Vries, Machteld A. G.;van Litsenburg, Raphaele R. L.;Gemke, Reinoud J. B. J.
背景：糖皮质激素在儿童急性淋巴细胞白血病（ALL）的治疗中非常重要。然而，高剂量糖皮质激素的周期性给药可能会导致生活质量（QoL）的快速和实质性变化。荷兰ALL-9方案的维持期包括交替使用地塞米松（6 mg/m2/天）2周和停用5周。本研究进行评估地塞米松对生活质量的影响，在治疗ALL根据本protocol.Methods：在多中心前瞻性队列研究，生活质量进行了评估中途（T1），并在两年的治疗结束时（T2）。一个通用的（儿童健康问卷）和疾病特异性（PedsQL（TM）癌症版本）的QoL问卷被用来评估QoL在两个时期：在和关闭地塞米松，分别Results：41名儿童（56%男性）进行了评估，平均年龄在诊断为5.6岁。CHQ的身体和心理社会总得分显着低于人口标准。在T1和T2时，总体QoL无显著变化。然而，关于特定领域（疼痛、认知功能、情绪/行为和身体功能），生活质量随时间推移而下降。生活质量显着受损期间dexamethason.Conclusion：地塞米松与生活质量下降。在治疗结束时，地塞米松治疗期间报告的QoL在某些量表（疼痛、认知功能、情绪/行为和身体功能）上甚至恶化得更多。生活质量的具体方面的知识是必不可少的，以改善咨询和应对儿科肿瘤。在设计治疗方案时，应考虑特定药物对生活质量的不良影响。
Background: Glucocorticoids are important in the treatment of childhood acute lymphoblastic leukaemia (ALL). However, cyclic administration of high dose glucocorticoids may cause rapid and substantial changes in quality of life (QoL). The maintenance phase of the Dutch ALL-9 protocol consisted of alternating two weeks on and five weeks off dexamethasone (6 mg/m(2)/day). The present study was performed to assess the effect of dexamethasone on QoL during treatment for ALL according to this protocol.Methods: In a multicentre prospective cohort study, QoL was assessed halfway (T1) and at the end of the two-year treatment (T2). A generic (Child Health Questionnaire) and disease specific (PedsQL (TM) cancer version) QoL questionnaire were used to assess QoL in two periods: on and off dexamethasone, respectively.Results: 41 children (56% males) were evaluated, mean age at diagnosis was 5.6 years. The CHQ physical and psychosocial summary scores were significantly lower than population norms. At T1 and T2, overall QoL showed no significant change. However, regarding specific domains (pain, cognitive functioning, emotion/behaviour and physical functioning) QoL decreased over time. QoL was significantly more impaired during periods on dexamethasone.Conclusion: Dexamethasone was associated with decreased QoL. At the end of treatment, reported QoL during dexamethasone deteriorated even more on certain scales (pain, cognitive functioning, emotion/behaviour and physical functioning). Knowledge of the specific aspects of QoL is essential to improve counselling and coping in paediatric oncology. Adverse effects of specific drugs on QoL should be taken into account when designing treatment protocols.