接受细胞毒和细胞毒加靶向治疗的转移性结直肠癌患者的生活质量。

IF 3.4 2区 医学 Q2 ONCOLOGY
Hong Tham Pham, Tuan Anh Nguyen, Thao Le Ba, Vo Ngoc Minh Tran, Ronald L Castelino, Kim-Huong Truong-Nguyen, Bao Khanh Nguyen, Megan K Fischer, Viet Dung Tran, Minh-Hoang Tran
{"title":"接受细胞毒和细胞毒加靶向治疗的转移性结直肠癌患者的生活质量。","authors":"Hong Tham Pham, Tuan Anh Nguyen, Thao Le Ba, Vo Ngoc Minh Tran, Ronald L Castelino, Kim-Huong Truong-Nguyen, Bao Khanh Nguyen, Megan K Fischer, Viet Dung Tran, Minh-Hoang Tran","doi":"10.1186/s12885-025-14388-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Targeted therapies in the treatment of metastatic colorectal cancer (mCRC) have reportedly been associated with better quality of life (QoL). Previous studies have revealed uncontrolled sources of biases or confounders that could distort this association. Given the lack of robust evidence and causal inference, we aimed to investigate the effects of targeted therapy-added regimens versus cytotoxic therapy (CyT) on QoL and components of QoL in patients with mCRC eligible for curative-intent treatment.</p><p><strong>Methods: </strong>We conducted a prospective cohort study on adults undergoing curative-intent mCRC treatment with survival prognosis of ≥ 1 year. The exposure was either CyT alone (including CAPEOX, mFOLFOX-6, mFOLFOX-7, FOLFIRI, and FOLFOXIRI) or CyT combined with targeted therapy (Cy-TaT, including CAPEOX-TaT, mFOLFOX-6-TaT, mFOLFOX-7-TaT, FOLFIRI-TaT, and FOLFOXIRI-TaT). Available targeted therapies included bevacizumab and regorafenib. The primary outcome was overall health and QoL (H/QoL), measured at month 12 using the EORTC QLQ-C30 global health status/QoL scale (in percentage point) and the EQ-5D-3L utility score. The secondary outcomes included each component of the EORTC QLQ-C30 functional scales and symptom scales/items (in percentage point), measured at month 12. Mean difference (MD) and 95% confidence interval (95% CI) were estimated using g-estimation.</p><p><strong>Results: </strong>During 12 months of follow-up, among 1143 participants (mean age 58.1, 39.4% being female, 623 in CyT group and 520 in Cy-TaT group), overall H/QoL was higher in those receiving Cy-TaT (EORTC QLQ-C30 global health status/QoL scale: MD 16.6, 95% CI 14.8 to 18.4, p < 0.001 [largest effect in CAPEOX-TaT versus CAPEOX: MD 18.7, 95% CI 15.2 to 22.2]; EQ-5D-3L utility score: MD 0.076, 95% CI 0.060 to 0.091 [largest effect in mFOLFOX-7-TaT versus mFOLFOX-7: MD 0.123, 95% CI 0.085 to 0.161]). For the EORTC QLQ-C30 functional scales and most areas of the symptom scales/items, treatment with Cy-TaT was also associated with better outcomes than with CyT, except for a contradictory association in financial difficulties. Symptoms with consistently large improvements from Cy-TaT were fatigue (MD 13.8, 95% CI 11.7 to 15.9), dyspnoea (MD 10.9, 95% CI 8.8 to 12.9), and insomnia (MD 13.0, 95% CI 10.2 to 15.7).</p><p><strong>Conclusion: </strong>Compared with those on CyT alone, patients with mCRC receiving Cy-TaT showed improved overall H/QoL, functional scales, and symptom scales/items. These benefits were consistent across most subgroups of chemotherapy, with the greatest improvements in H/QoL observed in the CAPEOX-TaT and mFOLFOX-7-TaT groups.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"25 1","pages":"957"},"PeriodicalIF":3.4000,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117682/pdf/","citationCount":"0","resultStr":"{\"title\":\"Quality of life in patients with metastatic colorectal cancer receiving cytotoxic and cytotoxic plus targeted therapy.\",\"authors\":\"Hong Tham Pham, Tuan Anh Nguyen, Thao Le Ba, Vo Ngoc Minh Tran, Ronald L Castelino, Kim-Huong Truong-Nguyen, Bao Khanh Nguyen, Megan K Fischer, Viet Dung Tran, Minh-Hoang Tran\",\"doi\":\"10.1186/s12885-025-14388-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Targeted therapies in the treatment of metastatic colorectal cancer (mCRC) have reportedly been associated with better quality of life (QoL). Previous studies have revealed uncontrolled sources of biases or confounders that could distort this association. Given the lack of robust evidence and causal inference, we aimed to investigate the effects of targeted therapy-added regimens versus cytotoxic therapy (CyT) on QoL and components of QoL in patients with mCRC eligible for curative-intent treatment.</p><p><strong>Methods: </strong>We conducted a prospective cohort study on adults undergoing curative-intent mCRC treatment with survival prognosis of ≥ 1 year. The exposure was either CyT alone (including CAPEOX, mFOLFOX-6, mFOLFOX-7, FOLFIRI, and FOLFOXIRI) or CyT combined with targeted therapy (Cy-TaT, including CAPEOX-TaT, mFOLFOX-6-TaT, mFOLFOX-7-TaT, FOLFIRI-TaT, and FOLFOXIRI-TaT). Available targeted therapies included bevacizumab and regorafenib. The primary outcome was overall health and QoL (H/QoL), measured at month 12 using the EORTC QLQ-C30 global health status/QoL scale (in percentage point) and the EQ-5D-3L utility score. The secondary outcomes included each component of the EORTC QLQ-C30 functional scales and symptom scales/items (in percentage point), measured at month 12. Mean difference (MD) and 95% confidence interval (95% CI) were estimated using g-estimation.</p><p><strong>Results: </strong>During 12 months of follow-up, among 1143 participants (mean age 58.1, 39.4% being female, 623 in CyT group and 520 in Cy-TaT group), overall H/QoL was higher in those receiving Cy-TaT (EORTC QLQ-C30 global health status/QoL scale: MD 16.6, 95% CI 14.8 to 18.4, p < 0.001 [largest effect in CAPEOX-TaT versus CAPEOX: MD 18.7, 95% CI 15.2 to 22.2]; EQ-5D-3L utility score: MD 0.076, 95% CI 0.060 to 0.091 [largest effect in mFOLFOX-7-TaT versus mFOLFOX-7: MD 0.123, 95% CI 0.085 to 0.161]). For the EORTC QLQ-C30 functional scales and most areas of the symptom scales/items, treatment with Cy-TaT was also associated with better outcomes than with CyT, except for a contradictory association in financial difficulties. Symptoms with consistently large improvements from Cy-TaT were fatigue (MD 13.8, 95% CI 11.7 to 15.9), dyspnoea (MD 10.9, 95% CI 8.8 to 12.9), and insomnia (MD 13.0, 95% CI 10.2 to 15.7).</p><p><strong>Conclusion: </strong>Compared with those on CyT alone, patients with mCRC receiving Cy-TaT showed improved overall H/QoL, functional scales, and symptom scales/items. These benefits were consistent across most subgroups of chemotherapy, with the greatest improvements in H/QoL observed in the CAPEOX-TaT and mFOLFOX-7-TaT groups.</p>\",\"PeriodicalId\":9131,\"journal\":{\"name\":\"BMC Cancer\",\"volume\":\"25 1\",\"pages\":\"957\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-05-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117682/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMC Cancer\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12885-025-14388-2\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Cancer","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12885-025-14388-2","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

背景:据报道,转移性结直肠癌(mCRC)的靶向治疗与更好的生活质量(QoL)相关。先前的研究表明,不受控制的偏见或混杂因素可能会扭曲这种关联。鉴于缺乏强有力的证据和因果推理,我们的目的是研究靶向治疗方案与细胞毒性治疗(CyT)对符合治疗目的治疗的mCRC患者生活质量和生活质量组成部分的影响。方法:我们进行了一项前瞻性队列研究,接受治疗意图的mCRC治疗,生存预后≥1年。暴露为单用CyT(包括CAPEOX、mFOLFOX-6、mFOLFOX-7、FOLFIRI和FOLFOXIRI)或CyT联合靶向治疗(Cy-TaT,包括CAPEOX- tat、mFOLFOX-6- tat、mFOLFOX-7- tat、FOLFIRI- tat和folfolxii - tat)。可用的靶向治疗包括贝伐单抗和瑞非尼。主要结局是总体健康和生活质量(H/QoL),在第12个月使用EORTC QLQ-C30全球健康状态/生活质量量表(以百分点计)和EQ-5D-3L效用评分进行测量。次要结局包括在第12个月测量的EORTC QLQ-C30功能量表和症状量表/项目的每个组成部分(以百分点计)。使用g估计估计平均差(MD)和95%置信区间(95% CI)。结果:在12个月的随访中,1143名参与者(平均年龄58.1岁,女性39.4%,CyT组623名,Cy-TaT组520名)中,接受Cy-TaT的患者总体H/QoL更高(EORTC QLQ-C30全球健康状况/QoL量表:MD 16.6, 95% CI 14.8 ~ 18.4, p)结论:与单独接受CyT的患者相比,接受Cy-TaT的mCRC患者总体H/QoL、功能量表和症状量表/项目均有所改善。这些益处在大多数化疗亚组中是一致的,在CAPEOX-TaT和mFOLFOX-7-TaT组中观察到的H/QoL改善最大。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Quality of life in patients with metastatic colorectal cancer receiving cytotoxic and cytotoxic plus targeted therapy.

Background: Targeted therapies in the treatment of metastatic colorectal cancer (mCRC) have reportedly been associated with better quality of life (QoL). Previous studies have revealed uncontrolled sources of biases or confounders that could distort this association. Given the lack of robust evidence and causal inference, we aimed to investigate the effects of targeted therapy-added regimens versus cytotoxic therapy (CyT) on QoL and components of QoL in patients with mCRC eligible for curative-intent treatment.

Methods: We conducted a prospective cohort study on adults undergoing curative-intent mCRC treatment with survival prognosis of ≥ 1 year. The exposure was either CyT alone (including CAPEOX, mFOLFOX-6, mFOLFOX-7, FOLFIRI, and FOLFOXIRI) or CyT combined with targeted therapy (Cy-TaT, including CAPEOX-TaT, mFOLFOX-6-TaT, mFOLFOX-7-TaT, FOLFIRI-TaT, and FOLFOXIRI-TaT). Available targeted therapies included bevacizumab and regorafenib. The primary outcome was overall health and QoL (H/QoL), measured at month 12 using the EORTC QLQ-C30 global health status/QoL scale (in percentage point) and the EQ-5D-3L utility score. The secondary outcomes included each component of the EORTC QLQ-C30 functional scales and symptom scales/items (in percentage point), measured at month 12. Mean difference (MD) and 95% confidence interval (95% CI) were estimated using g-estimation.

Results: During 12 months of follow-up, among 1143 participants (mean age 58.1, 39.4% being female, 623 in CyT group and 520 in Cy-TaT group), overall H/QoL was higher in those receiving Cy-TaT (EORTC QLQ-C30 global health status/QoL scale: MD 16.6, 95% CI 14.8 to 18.4, p < 0.001 [largest effect in CAPEOX-TaT versus CAPEOX: MD 18.7, 95% CI 15.2 to 22.2]; EQ-5D-3L utility score: MD 0.076, 95% CI 0.060 to 0.091 [largest effect in mFOLFOX-7-TaT versus mFOLFOX-7: MD 0.123, 95% CI 0.085 to 0.161]). For the EORTC QLQ-C30 functional scales and most areas of the symptom scales/items, treatment with Cy-TaT was also associated with better outcomes than with CyT, except for a contradictory association in financial difficulties. Symptoms with consistently large improvements from Cy-TaT were fatigue (MD 13.8, 95% CI 11.7 to 15.9), dyspnoea (MD 10.9, 95% CI 8.8 to 12.9), and insomnia (MD 13.0, 95% CI 10.2 to 15.7).

Conclusion: Compared with those on CyT alone, patients with mCRC receiving Cy-TaT showed improved overall H/QoL, functional scales, and symptom scales/items. These benefits were consistent across most subgroups of chemotherapy, with the greatest improvements in H/QoL observed in the CAPEOX-TaT and mFOLFOX-7-TaT groups.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
BMC Cancer
BMC Cancer 医学-肿瘤学
CiteScore
6.00
自引率
2.60%
发文量
1204
审稿时长
6.8 months
期刊介绍: BMC Cancer is an open access, peer-reviewed journal that considers articles on all aspects of cancer research, including the pathophysiology, prevention, diagnosis and treatment of cancers. The journal welcomes submissions concerning molecular and cellular biology, genetics, epidemiology, and clinical trials.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信