Rietman J S, Dijkstra P U, Hoekstra H J, Eisma W H, Szabo B G, Groothoff J W, Geertzen J H B
Department of Surgery, University Hospital Groningen, P.O. Box 30001, NL-9700 RB, Groningen, The Netherlands.
Eur J Surg Oncol. 2003 Apr;29(3):229-38. doi: 10.1053/ejso.2002.1403.
Breast cancer treatment may result in long-term upper limb morbidity: reduced range of motion of the shoulder, muscle weakness of the arm and hand, lymph edema, pain and numbness. Relationship of this late morbidity with activities of daily life (ADL) and quality of life (QOL) is infrequently described and the strength of this relationship is not clear.
A systematic review was performed to evaluate the results of studies, analyzing late morbidity of breast cancer treatment in relationship with ADL and/or QOL. A literature search over the last 20 years (1980-2000) was performed in the databases MEDLINE, EMBASE, PSYCHLIT and CANCERLIT. Methodological quality of selected articles was assessed and additional, aspects of treatment related late morbidity and the relationship to ADL and/or QOL were summarized.
From the 1642 yielded articles 15 fulfilled our primary selection criteria. Only six articles could be selected due to the inappropriate methodological quality. There was high variation in prevalence of pain (12-51%), impairments in range of motion (2-51%), edema (6-43%) and decreased muscle strength (17-33%). Four articles reported significant relationships between late morbidity of the upper limb and perceived disabilities in ADL/QOL. The strength of these relationships was rather low.
Few studies investigated the relationship between late morbidity of the upper limb after treatment of early breast cancer and ADL/QOL. Significant relationship between late morbidity and restrictions of daily activities and poorer QOL was reported, however, the strength of this relationship was rather low.
乳腺癌治疗可能导致长期上肢疾病，如肩部活动范围减小、手臂和手部肌肉无力、淋巴水肿、疼痛和麻木。这种晚期疾病与日常生活活动（ADL）和生活质量（QOL）之间的关系鲜有描述，且这种关系的强度尚不清楚。
进行了一项系统评价，以评估研究结果，分析乳腺癌治疗的晚期疾病与ADL和/或QOL的关系。在MEDLINE、EMBASE、PSYCHLIT和CANCERLIT数据库中对过去20年（1980 - 2000年）的文献进行了检索。评估了所选文章的方法学质量，并总结了与治疗相关的晚期疾病的其他方面以及与ADL和/或QOL的关系。
在检索出的1642篇文章中，有15篇符合我们的主要选择标准。由于方法学质量不合适，仅能选出6篇文章。疼痛患病率（12% - 51%）、活动范围受损（2% - 51%）、水肿（6% - 43%）和肌肉力量下降（17% - 33%）存在很大差异。4篇文章报道了上肢晚期疾病与ADL/QOL中感知到的残疾之间存在显著关系。这些关系的强度相当低。
很少有研究调查早期乳腺癌治疗后上肢晚期疾病与ADL/QOL之间的关系。报道了晚期疾病与日常活动受限和较差的QOL之间存在显著关系，然而，这种关系的强度相当低。
