No abstract

BACKGROUND A set of common cancer-related and treatment-related symptoms has been proposed for quality-of-care assessment and clinical research. Using data from a large, multicenter, prospective study, we assessed effects of disease site and stage on the percentages of patients rating these proposed symptoms as moderate to severe. METHODS The severity of 13 symptoms proposed to represent “core” oncology symptoms was rated by 3106 ambulatory patients with cancer of the breast, prostate, colon/rectum, or lung, regardless of disease stage or phase of care; 2801 patients (90%) repeated the assessment 4–5 weeks later. RESULTS At the initial assessment, approximately one third of the patients reported ≥3 symptoms in the moderate-to-severe range; 11 of the 13 symptoms were rated as moderate to severe by at least 10% of all patients and 6 by at least 20% of those in active treatment. Fatigue/tiredness was the most-severe symptom, followed by disturbed sleep, pain, dry mouth, and numbness/tingling. More lung cancer patients and patients in active treatment reported moderate-to-severe symptoms. Percentages of symptomatic patients increased by disease stage, less-adequate response to therapy, and declining performance status. Percentages of patients reporting moderate-to-severe symptoms were stable across both assessments. CONCLUSIONS These results support a core set of moderate-to-severe symptoms common across outpatients with solid tumors that can guide consideration of progression-free survival as a trial outcome and that should be considered in clinical care and in assessments of quality of care and treatment benefit.

This is the first report to demonstrate the safety and efficacy of the Rituxan chimeric anti-CD20 antibody in combination with standard-dose CHOP in the treatment of aggressive B-cell lymphoma. The clinical responses are at least comparable to those achieved with CHOP alone with no significant added toxicity. The presence or absence of the bcl-2 translocation did not affect the ability of patients to achieve a CR with this regimen. The ability to achieve sustained remissions in patients with an IPI score > or = 2 warrants further investigation with a randomized study.