背景:检查点抑制剂改变了晚期黑素瘤患者的总生存期。然而,缺乏关于长期晚期黑色素瘤幸存者的健康相关生活质量(HRQoL)的数据,经过多年的治疗。因此,我们评估了长期晚期黑色素瘤幸存者的HRQoL,并将研究结果与无癌症的配对对照进行了比较.
方法:接受伊匹单抗治疗的晚期黑色素瘤幸存者在最后一次服用伊匹单抗后至少两年没有疾病证据,也没有随后的全身治疗。欧洲癌症研究和治疗组织的生活质量问卷核心30(EORTCQLQ-C30),多维疲劳清单(MFI),医院焦虑和抑郁量表(HADS),并进行癌症治疗功能评估-黑色素瘤问卷(FACT-M)。对照组分别进行年龄匹配,性别,和教育地位。幸存者和对照组的结果使用广义估计方程进行比较,根据已发表的指南,差异被解释为临床相关.
结果:本研究共分析了89名幸存者和265名对照。在中位随访39(范围,17-121)个月,幸存者在身体上得分明显较低(83.7vs.89.8,差异(差异)=-5.80,p=0.005),角色(83.5vs.90,差异=-5.97,p=.02),认知(83.7vs.91.9,差异=-8.05,p=.001),和社会功能(86.5vs.95.1,差异=-8.49,p=<.001),并且具有较高的疲劳症状负担(23.0vs.15.5,差异=7.48,p=.004),呼吸困难(13.3vs.6.7,差异=6.47p=.02),腹泻(7.9vs.4.0,差异=3.78,p=.04),和财务影响(10.5与2.5,diff=8.07,p=.001)比匹配的对照。组差异显示为临床相关。
结论:与匹配的对照组相比,长期晚期黑色素瘤幸存者的总体功能评分较差,更多的身体症状,和财政困难。这些数据可能有助于发展适当的生存护理。
BACKGROUND: Checkpoint inhibitors have changed overall survival for patients with advanced melanoma. However, there is a lack of data on health-related quality of life (HRQoL) of long-term advanced melanoma survivors, years after treatment. Therefore, we evaluated HRQoL in long-term advanced melanoma survivors and compared the study outcomes with matched controls without cancer.
METHODS: Ipilimumab-treated advanced melanoma survivors without evidence of disease and without subsequent systemic therapy for a minimum of two years following last administration of ipilimumab were eligible for this study. The European Organization for Research and Treatment of Cancer quality of life questionnaire Core 30 (EORTC QLQ-C30), the Multidimensional Fatigue Inventory (MFI), the Hospital Anxiety and Depression Scale (HADS), and the Functional Assessment of Cancer Therapy-Melanoma questionnaire (FACT-M) were administered. Controls were individually matched for age, gender, and educational status. Outcomes of survivors and controls were compared using generalized estimating equations, and differences were interpreted as clinically relevant according to published guidelines.
RESULTS: A total of 89 survivors and 265 controls were analyzed in this study. After a median follow-up of 39 (range, 17-121) months, survivors scored significantly lower on physical (83.7 vs. 89.8, difference (diff) = -5.80, p=.005), role (83.5 vs. 90, diff = -5.97, p=.02), cognitive (83.7 vs. 91.9, diff = -8.05, p=.001), and social functioning (86.5 vs. 95.1, diff = -8.49, p= <.001) and had a higher symptom burden of fatigue (23.0 vs. 15.5, diff = 7.48, p=.004), dyspnea (13.3 vs. 6.7, diff = 6.47 p=.02), diarrhea (7.9 vs. 4.0, diff = 3.78, p=.04), and financial impact (10.5 vs. 2.5, diff = 8.07, p=.001) than matched controls. Group differences were indicated as clinically relevant.
CONCLUSIONS: Compared to matched controls, long-term advanced melanoma survivors had overall worse functioning scores, more physical symptoms, and financial difficulties. These data may contribute to the development of appropriate survivorship care.