患者报告的结局,瘤标记物,以及晚期胃肠道癌的生存结果
Joy X Jarnagin1, Anurag Saraf2, Islam Baiev1
1Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston.
JAMA network open
|November 17, 2023
概括
患者报告结果 (PRO) 的早期变化与晚期胃肠道癌的治疗反应和存活率相关. 瘤标志物 (TM) 显示的关联不太一致,强调了对临床结果的PRO监测.
科学领域:
- 在瘤学瘤学.
- 临床结果研究研究
- 患者报告的结果
背景情况:
- 患者报告的结果 (PROs),如生活质量 (QOL) 和症状,在癌症治疗中至关重要.
- 瘤学家传统上使用瘤标记物 (TM) 和成像来监测胃肠道 (GI) 癌症的治疗疗效.
研究的目的:
- 调查PRO和TM的早期 (1个月) 变化与晚期肠胃癌患者的治疗反应和存活率之间的关联.
- 为了确定PRO变化是否比TM变化更能预测结果.
主要方法:
- 马萨诸塞州总医院癌症中心的一项队列研究包括159名转移性肠道癌患者接受一线全身治疗.
- 在基线和1个月后评估了PROs (QOL,身体,心理症状) 和TMs (CEA,CA19-9).
- 回归模型分析了1个月变化与治疗反应,无进展生存 (PFS) 和整体生存 (OS) 的关联.
主要成果:
- 一个月的PRO变化与治疗反应显著相关 (例如,FACT-G,ESAS-总,ESAS-物理,PHQ4-抑郁症).
- PRO变化 (FACT-G,ESAS-总,ESAS-物理,PHQ4-抑郁) 和CEA变化与PFS相关.
- ESAS总和ESAS物理变化与OS相关,但TMs与生存结果没有一致的关联.
结论:
- 早期PRO变化与晚期胃肠道癌的治疗反应和存活率有关.
- 与PROs相比,TMs与临床结果的相关性不太一致.
- 监测早期的PRO变化可能为患者的预后提供有价值的见解,并强调解决患者QOL和症状的重要性.
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