目的:通常在个体基础上讨论软组织肉瘤患者的放疗和切除顺序。因此,更好地了解接受辅助(ART)与新辅助放疗(NART)的患者与健康相关的生活质量(QoL)的潜在差异有助于临床决策。
方法:来自39家医院的成人肉瘤患者完成了欧洲癌症研究和治疗组织的生活质量核心问卷(EORTCQLQ-C30)。全球QoL的差异,身体机能,角色功能,疲劳,疼痛,用多元回归分析了ART与NART之间的失眠,调整年龄,性别,化疗,分级,舞台,肿瘤位置,复发/远处转移,肉瘤类型,自上次治疗以来的时间,和使用验证阈值的治疗状态。
结果:共有1110名患者参加。其中,340人接受了放疗(NART:n=95,28%;ART:n=245,72%)。NART后全球QoL平均为59.3,ART后为60.5(Badj=1.0,p=0.74)。身体功能为65.9,而为70.5(Badj=4.2;p=0.16),角色功能48.8vs.56.7(Badj=7.0,p=0.08),疲劳47.5vs.45.4(Badj=-1.2;p=0.71),疼痛40.2vs.34.1(Badj=-6.8;p=0.08),和失眠33.7vs.41.6(Badj=5.5,p=0.16)。在NART患者中,与治疗后<2年相比,治疗后2年的临床相关QoL损伤发生率较低(n=6vs.平均n=4)。
结论:几乎没有证据表明两个照射组之间大多数领域的QoL和总体QoL存在差异。然而,与ART后患者相比,NART后患者的角色功能和疼痛可能更差,但失眠问题更少.
The sequence of radiotherapy and resection in patients with soft tissue sarcomas is usually discussed on an individual basis. Better understanding of potential differences of health-related quality of life (QoL) between patients undergoing adjuvant (ART) versus neoadjuvant radiotherapy (NART) is therefore helpful for clinical decision making.
Adult sarcoma patients from 39 hospitals completed the European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30). Differences in global QoL, physical functioning, role functioning, fatigue, pain, and insomnia between ART versus NART were investigated with multivariate regression, adjusting for age, gender, chemotherapy, grading, stage, tumor location, recurrence/distant metastasis, sarcoma type, time since last treatment, and treatment status using validated thresholds.
A total of 1110 patients participated. Of them, 340 had received radiotherapy (NART: n = 95, 28%; ART: n = 245, 72%). Global QoL was 59.3 on average after NART and 60.5 after ART (Badj = 1.0, p = 0.74). Physical functioning was 65.9 compared to 70.5 (Badj = 4.2; p = 0.16), role function 48.8 vs. 56.7 (Badj = 7.0, p = 0.08), fatigue 47.5 vs. 45.4 (Badj = -1.2; p = 0.71), pain 40.2 vs. 34.1 (Badj = -6.8; p = 0.08), and insomnia 33.7 vs. 41.6 (Badj = 5.5, p = 0.16). Among patients with NART, clinically relevant QoL impairments were less frequent 2 years after treatment compared to < 2 years thereafter (n = 6 vs. n = 4 on average).
There is little evidence for QoL differences in most domains and overall QoL between the two irradiation groups. However, patients after NART might experience worse role functioning and pain but fewer problems with insomnia compared to patients after ART.