目的:本研究的目的是确定通过癌症疾病治疗-疲劳功能评估(FACIT-F)评估的癌症相关性疲劳(CRF)的频率和严重程度相关因素。之前,以及12周的免疫检查点抑制剂(ICIs)。我们还探讨了ICI对疲劳维度和日常活动干扰的影响(多维功能症状量表,MFSI-SF,与患者相关的结果症状测量信息系统简式疲劳7a,PROMISF-SF),QOL(癌症治疗的功能评估-一般,FACT-G),和癌症症状(埃德蒙顿症状评估量表,ESA)。
方法:在此前瞻性中,纵向观测研究,对诊断为晚期癌症接受ICIs的患者进行了评估.患者人口统计学,事实G,FACIT-F,MFSI-SF,PROMISF-SF,和ESAS收集之前,在12周的ICI中。
结果:对212名入选患者中的160名进行了分析。中位年龄为61岁,60%是女性,最常见的癌症是黑色素瘤(73%),最常见的ICI为nivolumab,占46%.基线时,临床显着疲劳的频率(定义为FACIT-F评分≤34/52)为25.6%,第8周为25.7%,第12周为19.5%。FACIT-F有显著改善(P=0.016),FACT-G身体健康(P=0.041),FACT-G情绪幸福感(P=0.011),ESAS焦虑(P=0.045),从基线到ICI第12周的ESAS心理困扰(P=0.03)评分。多变量分析发现,临床显著CRF与PROMISF-SF(P<0.001)和MFSI-SF全局评分(P<0.001)之间存在显著关联。
结论:CRF在开始ICI治疗之前是常见的。超过12周的ICI治疗,CRF显著提高。FACT-G身体健康,FACT-G情感幸福,ESAS焦虑,和ESAS心理困扰得分改善加时赛。需要进一步的研究来验证这些发现。
OBJECTIVE: The aim of this study was to determine the frequency and factors associated with severity of cancer related fatigue (CRF) as assessed by Functional Assessment of Cancer Illness Therapy-Fatigue (FACIT-F), prior to, and during 12 weeks of immune-checkpoint inhibitors (ICIs). We also explored the effects of ICIs on fatigue dimensions and interference with daily activities (Multidimensional Functional Symptom Inventory, MFSI-SF, Patient-Related Outcome Symptom Measurement Information System Short form Fatigue 7a, PROMIS F-SF), QOL (Functional Assessment of Cancer Therapy-General, FACT-G), and cancer symptoms (Edmonton Symptom Assessment Scale, ESAS).
METHODS: In this prospective, longitudinal observational study, patients with a diagnosis of advanced cancer receiving ICIs were evaluated. Patient demographics, FACT-G, FACIT-F, MFSI-SF, PROMIS F-SF, and ESAS were collected prior to, and during 12 weeks of ICIs.
RESULTS: A total of 160 of the 212 enrolled patients were analyzed. The median age was 61 years, 60% were female, most common cancer was melanoma (73%), and most common ICI was nivolumab 46%. The frequency of clinically significant fatigue (defined as ≤ 34/52 on FACIT-F score) was 25.6% at baseline, 25.7% at week 8, and 19.5% at week 12. There was significant improvement in FACIT-F (P = 0.016), FACT-G physical well-being (P = 0.041), FACT-G emotional well-being (P = 0.011), ESAS anxiety (P = 0.045), and ESAS psychological distress (P = 0.03) scores from baseline to week 12 of ICIs. Multivariate analysis found significant association between clinically significant CRF and PROMIS F-SF (P < 0.001) and MFSI-SF global scores (P < 0.001).
CONCLUSIONS: CRF is frequent prior to the initiation of ICI treatment. Over 12 weeks of ICI treatment, CRF significantly improved. FACT-G physical well-being, FACT-G emotional well-being, ESAS anxiety, and ESAS psychological distress scores improved overtime. Further studies are needed to validate these findings.