沙利度胺治疗肿瘤相关厌食症的临床研究

Clincal Study of Thalidomide for Cancer-associated Anorexia

目的探讨沙利度胺治疗肿瘤相关的厌食症的疗效及毒副作用。方法食欲评估采用数值评定量表评分35例符合条件的患者,给予沙利度胺起始50 mg,每晚1次的剂量,治疗两周后评价无反应者增加剂量至100 mg,每晚1次,两周后评价食欲、疲乏、睡眠、盗汗、疼痛、QOL。结果入组的35例患者中,33例完成了14天的治疗,64%的患者食欲得到改善,食欲、失眠、QOL的CAT评分显著提高。5例患者由于毒副作用退出试验。结论沙利度胺能显著改善肿瘤相关的厌食,减轻进展期患者失眠,并提高生活质量。

Objective To assess appetite response to thaidomide in cancer-associated anorexia. Methods Loss of appetite was assessed by numerical rating scale（NRS）. Pretreament screening included medical history, nrurologic examination,and symptoms by NRS and categorical scale （CAT）. Patients received 50mg of thalidomide by mouth at bedtime for two weeks. Individuals who did not respond were dose escalated to 100mg at night for two weeks.Assessment of appetite, tatigue, insomnia, night sweats, pain and quality of life （QOL）occurred at two-week intervas.Toxicity also was assessed. Results Thity-five patients entered the study; 33completed 14 days of therapy and weie analyzed for efficacy and toxicity. Sixty-four percent who completed at least two weeks of thalidomide had improved appetite.The CAT scores for appetite,insomnia,and QOL improved significantly. Conclusion Thalidomide reduced multiple symptoms commonly associated with cancer-related anorexia, such as appetite/insomnia/pain et al, and improved QOL.