CAJ | 학술논문

目的探讨厄洛替尼单药二线或三线治疗对晚期非小细胞肺癌(NSCLC)患者生活质量的影响.方法经化疗失败的Ⅲb期和Ⅳ期NSCLC患者50例,口服厄洛替尼150 mg/d,直至疾病进展.采用欧洲癌症研究和治疗组织(EORTC)的生活质量调查核心问卷QLQ-C30和肺癌专用问卷QLQ-LC13,对治疗前后患者的生活质量和症状评价.结果 47例患者可以评价疗效,其中部分缓解18例,稳定(SD)21例,进展(PD)8例.厄洛替尼治疗2个周期后,48例患者完成了问卷.与治疗前比较,除认知功能外,体格、角色、情感、社会4种功能状态和整体生活质量评分均显著提高(均P<0.05);乏力和食欲不振两个全身症状以及除咯血外的疾病相关症状评分显著降低(P<0.05).5种功能状态和整体生活质量的有效率均≥44%,乏力和食欲不振两个全身症状以及除咯血外的疾病相关症状有效率均≥46%.生活质量和症状与临床疗效有关(P<0.05),不同临床疗效患者间的主要症状恶化时间差异有统计学意义(P<0.001).结论厄洛替尼用于二、三线治疗,不仅能够延长晚期NSCLC患者的生存时间,还能够显著改善肺癌相关症状,提高患者的生活质量.生活质量和症状的改善与临床疗效相关.
목적 탐토액락체니단약이선혹삼선치료대만기비소세포폐암(NSCLC)환자생활질량적영향.방법 경화료실패적Ⅲb기화Ⅳ기NSCLC환자50례,구복액락체니150 mg/d,직지질병진전.채용구주암증연구화치료조직(EORTC)적생활질량조사핵심문권QLQ-C30화폐암전용문권QLQ-LC13,대치료전후환자적생활질량화증상평개.결과 47례환자가이평개료효,기중부분완해18례,은정(SD)21례,진전(PD)8례.액락체니치료2개주기후,48례환자완성료문권.여치료전비교,제인지공능외,체격、각색、정감、사회4충공능상태화정체생활질량평분균현저제고(균P<0.05);핍력화식욕불진량개전신증상이급제각혈외적질병상관증상평분현저강저(P<0.05).5충공능상태화정체생활질량적유효솔균≥44%,핍력화식욕불진량개전신증상이급제각혈외적질병상관증상유효솔균≥46%.생활질량화증상여림상료효유관(P<0.05),불동림상료효환자간적주요증상악화시간차이유통계학의의(P<0.001).결론 액락체니용우이、삼선치료,불부능구연장만기NSCLC환자적생존시간,환능구현저개선폐암상관증상,제고환자적생활질량.생활질량화증상적개선여림상료효상관.
Objective To investigate the impact of erlotinib as a second or third line treatment on the symptoms and quality of life (QOL) in patients with advanced non-small cell lung cancer (NSCLC). Methods Fifty patients with stage Ⅲ b and Ⅳ NSCLC, treated previously with at least one regimen of platinum-based chemotherapy, received 150mg of erlotinib orally, once a day till disease progression. QOL was assessed by European Organization for Research and Treatment of Cancer QLQ-C30 and the lung cancer module (QLQ-LC13). The primary end points for QOL analysis were time to deterioration of three common lung cancer symptoms: cough, dyspnea and pain. Results Among 47 evaluable eases, there were partial remission (PR) in 18 cases, stable disease (SD) in 21 cases, and progressive disease (PD) in 8 eases. After two cycles of treatment, the mean scores of global QOL and all 5 functioning scales except the cognitive function increased significantly (P<0.05). Mean scores of major general symptoms, hypodynamia and anorexia, and disease-related symptoms alleviated significantly. Both response rates of five functioning and global QOL were more than 44% after erlotinib treatment. Response rates of major general symptoms and disease-related symptoms varied from 14% to 76%. Patients with complete or partial response likely had improvement in the QOL response (P<0.05), and the time to major symptom deterioration in those were significantly longer (P<0.001) than that in patients with stable or even progressive disease. Conclusion Erlotinib is effective to improve not only survival, but also tumor-related symptoms and quality of life in patients with advanced NSCLC previously treated with cisplatin-contained regimens. The improvement in the quality of life is positively correlated with objective tumor response.