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12 jun i 2016: zie ook dit artikel: 

https://kanker-actueel.nl/NL/richtlijnen-voor-het-systemisch-behandelen-van-uitgezaaide-prostaatkanker-vastgelegd-na-meta-analyse-van-26-gerandomiseerde-studies.html

12 juni 2016: Op Asco 2016 is een meta analyse gepresenteerd die bij elkaar heeft gebracht in de meting van kwaliteit van leven en pijnervaringen hoe patienten met uitgezaaide hormoonresistente prostaatkanker hun behandelingen hebben ervaren met chemo, abiraterone, enzalutamide, Radium 223 en andere nieuwe medicijnen / behandelingen waaronder ook immuuntherapie met Provenge - sipuleucel-T. De meta analyse is gedaan bij studies met gelijk of meer deelnemers van 50 patienten waarbij de doelen, een primair doel of secondair doel de kwaliteit van leven en / of vermindering van pijn waren. 

In de conclusie wordt nadrukkelijk vermeld dat een vergelijking van de verschillende behandelingen op kwaliteit van leven en pijnvermindering niet mogelijk is en elke individuele studie zo zijn eigen resultaten laat zien. In het studierapprot verwijzen bepaalde resutlaten altijd naar de nummering van de onderzochte studies in de referentielijst.

Hier twee van de vele tabellen en grafieken. Figuur 2 geeft overzicht van middelen zoals door de onderzoekers genoemd: niet-toxische aanpak met abiraterone en enzalutamide.

De grafiek daaronder figuur 2 geeft de totaalscore van alle gemeten medicijnen en behandelingen. In het volledige studierapport staan veel meer grafieken en tabellen.

Prtostaatkanker Kwaliteit van leven en pijnervaringen voor en na chemo

Figure 2.

Proportion of patients with metastatic castration-resistant prostate cancer reporting a clinically meaningful improvement on the FACT-P subscale well-being scores after receipt of noncytotoxic therapies. AA, abiraterone acetate; ENZA, enzalutamide; FACT-P, Functional Assessment of Cancer Therapy-Prostate; PBO, placebo; PRED, prednisone. *P<0.0001 vs comparator.

prostaatkanker kwaliteit van leven en pijn met abiratone en enzalutamine en chemo

Figure 1
Risk for a clinically meaningful deterioration in (a) FACT-P total score and (b) FACT-P PCS score. AA, abiraterone acetate; CI, confidence interval; ENZA, enzalutamide; FACT-P, Functional Assessment of Cancer Therapy-Prostate total score; NR, not reported; ...

De studie geeft zoveel meer duidelijke cijfers en tabellen dat het niet zinnig is die hier nog een keer te vermelden. Het volledige studierapport: Patient experience in the treatment of metastatic castration-resistant prostate cancer: state of the science is met de tabellen en grafieken gratis in te zien. Onderaan dit artikel het abstract en bijbehorende referentielijst.

Recently published randomized clinical trials of new agents for mCRPC have captured elements of the patient experience while on treatment. Further research is required to standardize methods for measuring, quantifying and reporting on HRQoL and pain in patients with mCRPC in the clinical practice setting.

Prostate Cancer Prostatic Dis. 2016 Jun;19(2):111-21. doi: 10.1038/pcan.2015.42. Epub 2016 Feb 2.

Patient experience in the treatment of metastatic castration-resistant prostate cancer: state of the science.

Abstract

BACKGROUND:

Contemporary therapies for metastatic castration-resistant prostate cancer (mCRPC) have shown survival improvements, which do not account for patient experience and health-related quality of life (HRQoL).

METHODS:

This literature review included a search of MEDLINE for randomized clinical trials enrolling ⩾50 patients with mCRPC and reporting on patient-reported outcomes (PROs) since 2010.

RESULTS:

Nineteen of 25 publications describing seven treatment regimens (10 clinical trials and nine associated secondary analyses) met the inclusion criteria and were critically appraised. The most commonly used measures were the Functional Assessment of Cancer Therapy-Prostate (n=5 trials) and Brief Pain Inventory Short Form (n=4 trials) questionnaires. The published data indicated that HRQoL and pain status augmented the clinical efficacy data by providing a better understanding of treatment impact in mCRPC. Abiraterone acetate and prednisone, enzalutamide, radium-223 dichloride and sipuleucel-T offered varying levels of HRQoL benefit and/or pain mitigation versus their respective comparators, whereas three treatments (mitoxantrone, estramustine phosphate and docetaxel, and cabazitaxel) had no meaningful impact on HRQoL or pain. The main limitation of the data were that the PROs utilized were not developed for use in mCRPC patients and hence may not have comprehensively captured symptoms important to this population.

CONCLUSIONS:

Recently published randomized clinical trials of new agents for mCRPC have captured elements of the patient experience while on treatment. Further research is required to standardize methods for measuring, quantifying and reporting on HRQoL and pain in patients with mCRPC in the clinical practice setting.

PMID:
26832363
[PubMed - in process]
PMCID:
PMC4868871

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