NCIC Clinical Trials Group; Department of Medical Oncology, Queen's University, Kingston, Canada.
Department of Medical Oncology, AGO, Düsseldorf, Germany.
Ann Oncol. 2012 Aug;23(8):2020-2027. doi: 10.1093/annonc/mdr583. Epub 2012 Jan 30.
In the CALYPSO trial, carboplatin-pegylated liposomal doxorubicin (CD) demonstrated superior therapeutic index versus carboplatin-paclitaxel (CP) in patients with recurrent ovarian cancer. This paper reports the health-related quality of life (HRQoL) findings.
HRQoL was measured with the EORTC QoL-QC30 questionnaire and OV28 ovarian cancer module. Mean change scores from baseline in HRQoL subscales (five functional scales and global health status) in each arm and the proportion of patients improved or worsened were calculated every 3 months until 12 months.
Compliance was 90% at baseline and 76%, 64%, 57% at 3, 6, and 9 months, respectively. Baseline HRQoL showed already impaired global scores (mean 62/100) and considerable symptom burden (90% of patients reporting nonzero scores). Global QoL and abdominal symptom scores improved over time in both arms; at 6 months, 36% of patients met criteria for improved symptoms. Treatment with CD resulted in less peripheral neuropathy (9.8 versus 24.2), fewer other chemotherapy side-effects (9.5 versus 16.2), and less impact on body image (3.8 versus 10.4) versus CP (all P<0.02) at 6 months.
These patient-reported outcomes confirm the overall lower toxicity of CD versus CP. The improved disease-related outcomes achieved with CD were not at the expense of QoL.
在 CALYPSO 试验中,与卡铂紫杉醇(CP)相比,卡铂聚乙二醇脂质体阿霉素(CD)在复发性卵巢癌患者中显示出更好的治疗指数。本文报告了健康相关生活质量(HRQoL)的研究结果。
使用 EORTC QoL-QC30 问卷和 OV28 卵巢癌模块测量 HRQoL。计算了每个手臂中从基线开始 HRQoL 子量表(五个功能量表和全球健康状况)的平均变化分数,以及在 3、6 和 9 个月时每个手臂中改善或恶化的患者比例。
基线时的依从性为 90%,3、6 和 9 个月时分别为 76%、64%和 57%。基线 HRQoL 显示全球评分已经受损(平均 62/100),且存在相当大的症状负担(90%的患者报告有非零评分)。在两个手臂中,全球 QoL 和腹部症状评分随时间推移而改善;在 6 个月时,36%的患者符合症状改善的标准。与 CP 相比,CD 治疗导致周围神经病变(9.8 对 24.2)、其他化疗副作用(9.5 对 16.2)和对身体形象的影响较小(3.8 对 10.4)(均 P<0.02)。
这些患者报告的结果证实了 CD 与 CP 相比总体毒性较低。CD 所取得的改善疾病相关结果并未以生活质量为代价。