Wei Hao, Sun Yu, He Jun, Liu Jie-Wei, Xie Ke, Zheng Yu-Zhu, Zhu Jiang
Department of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu 610041, China.
Radiotherapy Physics & Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2023 Jan;54(1):148-154. doi: 10.12182/20230160109.
To primarily explore the efficacy of Zi Huangjing preparation in patients with cancer-related fatigue (CRF) during chemotherapy.
This study was designed as a prospective, single-arm, multicenter clinical trial. According to the plan of the study, patients with malignant tumors who had received at least one cycle of chemotherapy and had moderate-to-severe CRF (Piper Fatigue Scale score≥4) were enrolled. All the enrolled patients took Zi Huangjing preparation (2.1 g, twice a day) every day during the two subsequent cycles of chemotherapy and were followed up. During the period, the enrolled patients independently completed the Piper Fatigue Scale and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) scale, and part of their biochemical and immunological indicators were measured at the baseline, before the second cycle of chemotherapy (day 21), and before the third cycle of chemotherapy (day 42). The primary endpoint was the change in Piper Fatigue Scale scores between the baseline and day 42.
Eventually, 47 patients completed the entire study. After treatment, the mean score of the Piper Fatigue Scale assessed before the third cycle of chemotherapy (day 42) was 3.21±1.67, which was significantly lower than that at baseline (5.89±1.36) ( =0.000), and the patients' CRF was significantly improved. In terms of quality of life, the patient's global quality of life, physical functions, role function, emotional function, cognitive function, and social function were significantly improved. In terms of symptom management, the patient's symptoms, such as fatigue, nausea and vomiting, insomnia, and appetite loss also significantly improved. No severe adverse reactions (grades 3 and 4) occurred during the observation period of this study. After evaluation, the adverse reactions that the patients actually had were considered to be related to chemotherapy, but unrelated to Zi Huangjing preparation.
According to our preliminary investigation, Zi Huangjing preparation is safe and has the potential therapeutic effect of improving CRF in cancer patients during chemotherapy. However, further larger-scale randomized controlled clinical studies are needed to confirm the efficacy of Zi Huangjing in improving CRF.
初步探究紫黄精制剂对化疗期间癌症相关疲劳(CRF)患者的疗效。
本研究设计为一项前瞻性、单臂、多中心临床试验。根据研究方案,纳入接受过至少一个周期化疗且患有中度至重度CRF(派珀疲劳量表评分≥4)的恶性肿瘤患者。所有纳入患者在随后两个化疗周期中每天服用紫黄精制剂(2.1克,每日两次)并进行随访。在此期间,纳入患者独立完成派珀疲劳量表和欧洲癌症研究与治疗组织生活质量问卷核心30项(EORTC QLQ-C30)量表,部分生化和免疫指标在基线、化疗第二周期前(第21天)以及化疗第三周期前(第42天)进行测量。主要终点为基线至第42天派珀疲劳量表评分的变化。
最终,47例患者完成了整个研究。治疗后,化疗第三周期前(第42天)评估的派珀疲劳量表平均评分为3.21±1.67,显著低于基线时的评分(5.89±1.36)(P =0.000),患者的CRF得到显著改善。在生活质量方面,患者的总体生活质量、身体功能、角色功能、情感功能、认知功能和社会功能均显著改善。在症状管理方面,患者的疲劳、恶心呕吐、失眠和食欲减退等症状也显著改善。本研究观察期间未发生严重不良反应(3级和4级)。经评估,患者实际出现的不良反应被认为与化疗有关,但与紫黄精制剂无关。
根据我们的初步调查,紫黄精制剂安全,对化疗期间癌症患者的CRF具有潜在治疗作用。然而,需要进一步开展更大规模的随机对照临床研究来证实紫黄精改善CRF的疗效。