Relationship between quality of life and clinical outcomes in advanced non-small cell lung cancer: best supportive care (BSC) versus BSC plus chemotherapy
Relationship between quality of life and clinical outcomes in advanced non-small cell lung cancer: best supportive care (BSC) versus BSC plus chemotherapy
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DOI：
10.1016/s0169-5002(99)00017-3
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发表时间：
1999-04-01
期刊：
影响因子：
5.3
通讯作者：
Clinch, J
中科院分区：
文献类型：
--
作者：
Thongprasert, S;Sanguanmitra, P;Clinch, J
在一项前瞻性随机研究中，287例ECOG体能状态（PS）为0 - 1或2的IIIb或IV期晚期非小细胞肺癌（NSCLC）患者被随机分配接受最佳支持治疗（BSC）或支持治疗加联合化疗（IEP方案：异环磷酰胺3 gm/m（2）IV联合美司钠尿保护，表阿霉素60 mg/m（2）第1天IV和顺铂60 mg/m（2）!第2天静脉注射;或MVP方案：丝裂霉素-C 8 mg/m（2），顺铂100 mg/m（2），第1天静脉注射，长春碱4 mg/m（2），第1天和第15天静脉注射）。采用Karnofsky体力状态（KPS）、改良癌症功能性生活指数（T-FLIC）和改良生活质量指数（T-QLI）评价患者的生活质量。在入组时、第3个月和完成治疗后2个月进行访谈。至少两个疗程的化疗被认为是足够的反应评估。患者共接受4至6个疗程的治疗或直至疾病进展。IEP和MVP组的部分缓解率分别为40%和41.7%。IEP和MVP化疗组的中位生存期分别为5.9和8.1个月，BSC组为4.1个月（对数秩检验：P = 0.0003）。BSC、IEP和MVP方案的1年生存率分别为13、29.8和39.3%。BSC、IEP和MVP方案的2年生存率分别为7.8%、6.4%和13.1%。在第一次，第二次和第三次采访的生活质量（QOL）评分的改善，化疗武器，而不是在BSC arm.We得出结论，联合化疗改善生活质量，以及延长晚期NSCLC患者的生存期。(C)1999爱思唯尔科学爱尔兰有限公司保留所有权利。
In a prospective randomized study, 287 patients with advanced non-small cell lung cancer (NSCLC) stage IIIb or IV with ECOG performance status (PS) 0-1 or 2 were randomly assigned to receive either best supportive care (BSC) or supportive care plus combination chemotherapy (IEP regimen: ifosfamide 3 gm/m(2) IV with mesna uroprotection, epirubicin 60 mg/m(2) IV on day 1 and cisplatin 60 mg/m(2)! IV on day 2; or MVP regimen: mitomycin-C 8 mg/m(2), cisplatin 100 mg/m(2) IV on day 1, vinblastine 4 mg/m(2) IV on days 1 and 15). Serial assessment of Karnofsky performance status (KPS), modified Functional Living Index-Cancer (T-FLIC) and modified Quality of Life-index (T-QLI) were used to estimate the quality of life. Interviews were done at entry, at the third month and at 2 months post complete treatment. At least two courses of chemotherapy were considered to be adequate for response evaluation. Patients were treated for a total of four to six courses or until progression of disease. Partial response rates were 40 and 41.7% in IEP and MVP arms. Median survival durations were 5.9 and 8.1 months for the IEP and MVP chemotherapy arms, and 4.1 months for BSC (log-rank test: P = 0.0003). One year survival was 13, 29.8 and 39.3% for the BSC, IEP and MVP regimens, respectively. Two years survival was 7.8, 6.4 and 13.1% for the BSC, IEP and MVP regimens, respectively. Improvement in quality of life (QOL) scores at the first, second and third interview were seen in chemotherapy arms only, not in the BSC arm. We conclude that combination chemotherapy improves the quality of life as well as prolonging the survival of patients with advanced NSCLC. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.