在接受全身治疗的癌症患者中,基线疲劳和严重的毒性影响
Joseph M Unger1, Michael J Fisch2, Salene M W Jones1
1SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Center, Seattle, Washington.
JAMA oncology
|December 26, 2025
概括
在治疗开始时报告疲劳的癌症患者面临严重毒性影响的更高风险. 这一发现强调了疲劳作为个性化癌症护理和症状监测的潜在早期标志物.
科学领域:
- 在瘤学瘤学.
- 临床试验 临床试验
- 患者报告的结果
背景情况:
- 疲劳是癌症患者普遍出现的症状之一.
- 它对治疗相关毒性影响的预测价值仍未得到充分描述.
- 了解这种关联可以优化个性化癌症治疗.
研究的目的:
- 评估基线患者报告的疲劳和癌症治疗期间不良事件 (AE) 之间的联系.
- 研究疲劳作为治疗毒性的潜在预测因素.
主要方法:
- 一个对17个SWOG阶段2/3试验 (1990-2022) 的综合分析,涉及各种癌症类型.
- 基线疲劳使用5分利克尔特尺度进行评估.
- 不良事件 (AE) 通过常用术语标准对不良事件 (CTCAE) 进行分级,其结果包括严重 (等级≥3),危及生命 (等级≥4) 和致命 (等级5) 的AE.
主要成果:
- 在7086名患者中,39.1%的人在基线报告了一些或更多的疲劳.
- 基线疲劳患者的严重 (OR,2.09),危及生命 (OR,1.96) 和致命 (OR,2.35) 意外意外事件的风险显著增加.
- 观察到一种剂量与反应的关系,严重的疲劳与致命的副作用风险增加了约5倍 (OR,4.99).
结论:
- 患者报告的基线疲劳是癌症治疗相关毒性影响风险增加的重要预测因素.
- 在治疗开始时对疲劳的评估可以作为早期的临床标志物.
- 这些发现支持个性化治疗策略和在瘤学中加强症状监测.
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