2022 ASCO:这些临床特征与晚期非小细胞肺癌患者的功能恢复能力有关

2022-05-31 MedSci原创 MedSci原创

随着晚期非小细胞肺癌(NSCLC)的治疗方案越来越多,临床医生仍然难以预测整个治疗过程中患者病情恢复与功能障碍的情况。功能恢复能力是指患者在面对干预性医疗事件时恢复基线功能状态的能力。为了确定晚期NS

随着晚期非小细胞肺癌NSCLC)的治疗方案越来越多,临床医生仍然难以预测整个治疗过程中患者病情恢复与功能障碍的情况。功能恢复能力是指患者在面对干预性医疗事件时恢复基线功能状态的能力。为了确定晚期NSCLC成年患者中与功能恢复能力相关的特征,来自美国俄亥俄州立大学的专家开展了相关研究,结果发表在近期ASCO大会上。

研究人员在一个新诊断的IV期NSCLC参与者的前瞻性队列中,根据mEQ-5D-5L中的三个功能障碍项目,通过12个月的随访,与基线得分相比进行功能复原力评估。其中,该研究包括接受化疗、免疫治疗、靶向药物和不治疗的所有患者。参与者被分为四组:功能下降、维持不变、有复原力或变化多样的。弹性是根据残疾评分的改善来确定的,功能状态评分增加1分代表mEQ-5D-5L的0.5个标准差变化。

患者特征包括人口统计学、合并症、ECOG表现状态、是否有脑或骨转移、情绪(GAD-7、PHQ9)和肺癌特定症状(QLQ-LC13)。治疗的毒性和毒性等级也被记录下来。组间差异通过Fisher精确检验或方差分析确定。

结果显示,在207名参与者中,87人(42.0%)保持了功能状态,78人(37.7%)经历了功能衰退,22人(10.6%)为复原力强的人,20人(9.7%)能力是多变的。其中,与较高复原力相关的特征包括就业(p = 0.02)和居住在城市环境中(p = 0.10)。与复原力无关的特征包括年龄、教育水平、吸烟状况、是否有脑转移、ECOG表现状况或心理症状。此外,大约一半接受治疗的参与者(n = 105,50.7%)出现了毒副作用。三分之一(33.8%)经历了≥3级的毒性反应。毒性等级和复原力之间没有明显的关联。

综上,与患者功能恢复力相关的特征主要是就业状况和生活环境。至少有一半的成人晚期NSCLC患者经历过治疗相关的毒性。

 

参考文献:

Characteristics associated with functional resilience versus functional decline among adult patients with advanced non–small cell lung cancer.

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    2022-06-01 mnda
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    2022-05-31 ms3000001364860097

    肿瘤前沿

    0

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