内容紹介
Summary
Lung cancer as progressive disease is often associated with a poor quality of life(QOL)which is related to a poor prognosis. We review the impact of patient-reported outcome(PRO)as an indicator of health-related QOL on the management of lung cancer patients. Cancer-specific PRO measures, which are primarily applied in scientific research for the past 30 years to compare the therapy outcomes and in drug development with adverse events. Among several PRO measures developed, the EORTC QLQ-C30 and its lung cancer-specific module QLQ-LC13 are the most frequently used instruments in clinical trials with lung cancer patients. Interestingly, cancer-specific PRO measures have been also increasingly used as daily practice, which may provide positive effects on the communication with the patient, mutual decision making and the monitoring and managing of the patient. Moreover, PRO measures have an independent prognostic value to predict survival in lung cancer patients. PRO measures have also the potential to improve the quality of care. Electronic platforms are expected to simplify the implementation of PRO measure in the daily clinic. Nevertheless, the PRO measures have not been properly implemented in Japan.
要旨
非小細胞性肺がん患者のquality of life(QOL)は多くのがん種のなかでも頻度的に悪いことが多く,治療法選択や予後の推測に重要な情報としてpatient-reported outcome(PRO)評価法が多くのがん臨床試験で使用され,日常のがん診療や緩和ケアにおいてもQOL状態の把握は注目されている。4種類のPRO評価方法があるが,European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 Module(EORTC QLQ-C30)が最も使われている。肺がんに対するQOL評価には疾患特異的に項目追加されたQLQ-LC13が介入研究の副次的エンドポイントとして汎用されており,適切な治療選択や緩和ケアの質を改善する上でも役立っている。しかし実臨床での肺がん診療にPRO評価をいかに役立てるかは今後の重要な課題でもある。
目次
Lung cancer as progressive disease is often associated with a poor quality of life(QOL)which is related to a poor prognosis. We review the impact of patient-reported outcome(PRO)as an indicator of health-related QOL on the management of lung cancer patients. Cancer-specific PRO measures, which are primarily applied in scientific research for the past 30 years to compare the therapy outcomes and in drug development with adverse events. Among several PRO measures developed, the EORTC QLQ-C30 and its lung cancer-specific module QLQ-LC13 are the most frequently used instruments in clinical trials with lung cancer patients. Interestingly, cancer-specific PRO measures have been also increasingly used as daily practice, which may provide positive effects on the communication with the patient, mutual decision making and the monitoring and managing of the patient. Moreover, PRO measures have an independent prognostic value to predict survival in lung cancer patients. PRO measures have also the potential to improve the quality of care. Electronic platforms are expected to simplify the implementation of PRO measure in the daily clinic. Nevertheless, the PRO measures have not been properly implemented in Japan.
要旨
非小細胞性肺がん患者のquality of life(QOL)は多くのがん種のなかでも頻度的に悪いことが多く,治療法選択や予後の推測に重要な情報としてpatient-reported outcome(PRO)評価法が多くのがん臨床試験で使用され,日常のがん診療や緩和ケアにおいてもQOL状態の把握は注目されている。4種類のPRO評価方法があるが,European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 Module(EORTC QLQ-C30)が最も使われている。肺がんに対するQOL評価には疾患特異的に項目追加されたQLQ-LC13が介入研究の副次的エンドポイントとして汎用されており,適切な治療選択や緩和ケアの質を改善する上でも役立っている。しかし実臨床での肺がん診療にPRO評価をいかに役立てるかは今後の重要な課題でもある。