单独肾癌骨转移患者手术前后联合靶向治疗和不联合靶向治疗的生活质量评价

S. V. Kostritskiy, V. Shirokorad, B. Alekseev, D. Semenov, A. Kalpinskiy, Y. Korneva
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摘要

背景。目前,低转移性肾癌的治疗策略是一个有争议的话题,因为其相对局限的过程和高风险的骨骼相关事件(SRE)。因此,治疗对这些患者生活质量的影响是一个重要的课题。目的评价单纯性肾癌骨转移患者手术前后联合靶向治疗和不联合靶向治疗的生活质量。材料和方法。该研究包括64例伴有SRE症状的孤立性骨转移患者。单发肾癌骨转移行手术治疗并联合靶向治疗的患者(第一组;N = 25),未进行靶向治疗(第二组;N = 39)。采用EORTC-QLQ-C30问卷评估手术治疗对患者病情的影响。在第一组中,EORTC-QLQ-C30问卷的30项指标中有8项:日常活动受限、呼吸困难、食欲不振、恶心、呕吐、疲劳、紧张、经济困难,差异无统计学意义。其他指标在统计上显示出显著的改善趋势。在第二组中,30项指标中有7项没有统计学上的显著差异:日常活动受限、呼吸困难、睡眠障碍、食欲不振、腹泻、紧张、经济困难。问卷的其他点也显示出改善(特别是在减轻疼痛综合征方面)。第二组患者术前、术后需要休息、疲劳、食欲减退、工作受限的情况较第一组明显。此外,手术后该组患者需要更多的时间坐在椅子上,腹泻更频繁,而手术前他们抱怨更多的恶心和疲劳。第一组患者术前和术后的后2项总体生活质量评价指标较高,说明该组患者的基线状况较好,不受治疗的影响。因此,根据EORTC-QLQ-C30问卷对研究组患者生活质量评价结果显示,联合靶向治疗和不联合靶向治疗的肾癌骨转移手术治疗均显著改善了患者的生活质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of quality of life of patients with solitary renal cancer metastases in bones before and after surgical treatment in combination with targeted therapy and without it
Background. Currently, treatment tactics for oligometastatic renal cancer are a debatable topic due to relatively localized process and high risk of skeletal-related events (SRE). Therefore, the effect of treatment on quality of life of these patients is an important subject.Aim. To evaluate quality of life of patients with solitary renal cancer metastases in the bones before and after surgical treatment in combination with targeted therapy and without it.Materials and methods. The study included 64 patients with solitary bone metastases and symptoms of SRE. The patients underwent surgical treatment due to solitary bone metastases of renal cancer in combination with targeted therapy (1st group; n = 25) and without targeted therapy (2nd group; n = 39). The effects of surgical treatment on patients’ condition were evaluated using the EORTC-QLQ-C30 questionnaire.Results. In the 1st group, no statistically significant differences were shown for 8 of 30 indicators of the EORTC-QLQ-C30 questionnaire: restrictions in daily activities, dyspnea, appetite loss, nausea, vomiting, fatigue, tension, financial difficulties. The rest of the indicators showed statistically significant shift toward improvement. In the 2nd group, 7 of 30 indicators did not show statistically significant differences: restrictions in daily activities, dyspnea, sleep disorders, appetite loss, diarrhea, tension, financial difficulties. The rest of the questionnaire points also showed improvement (especially in decreased pain syndrome). In patients of the 2nd group before and after surgery, need for rest, fatigue, appetite loss and restrictions in performing work were more pronounced than in the 1st group. Additionally, after surgery patients of this group required more time in the chair and had more frequent diarrhea, while prior to surgery they complained more of nausea and fatigue. The last 2 parameters evaluating overall quality of life were higher in the 1st group before and after surgery which shows better baseline condition of these patients which was not affected by the treatment.Conclusion. Therefore, surgical treatment of renal cancer bone metastases both in combination with targeted therapy and without it significantly improves quality of life according to the results of quality of life evaluation using the EORTC-QLQ-C30 questionnaire in patients of the studied groups.
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