Davis Aileen M, Dische Stanley, Gerber Lynn, Saunders Michelle, Leung Sing Fai, O'Sullivan Brian
Toronto Rehabilitation Institute, University of Toronto, Toronto, Canada.
Semin Radiat Oncol. 2003 Jul;13(3):203-13. doi: 10.1016/S1053-4296(03)00022-5.
Clinician-based rating scales and quantitative instruments used to quantify the severity of soft-tissue fibrosis were reviewed to determine if they were reliable and valid measures for clinical and research use. Existing clinician-based measures, the Medical Research Council (MRC) and European Organization for Research and Treatment of Cancer/Radiation Therapy Oncology Group (EORTC/RTOG), have preliminary testing of reliability and validity such that they provided a basis for the development of a revised measure. The revised measure, designed for use in National Cancer Institute-Common Toxicity Criteria for Adverse Events v3.0, evaluates subcutaneous and deep-tissue fibrosis separately and each is graded on a 5-point scale. The revised measure needs to be tested for reliability and validity, and it is recommended that it be used in concert with the MRC and/or EORTC/RTOG scales until such evidence is available and its utility can be determined. Quantitative measures, although attractive from a research perspective, will have limited clinical and multisite utility because of the apparatus required and the associated costs. Finally, a framework for evaluating fibrosis and the consequences of fibrosis is presented.
对用于量化软组织纤维化严重程度的基于临床医生的评级量表和定量工具进行了综述，以确定它们是否是用于临床和研究的可靠且有效的测量方法。现有的基于临床医生的测量方法，即医学研究理事会（MRC）和欧洲癌症研究与治疗组织/放射治疗肿瘤学组（EORTC/RTOG），已经进行了可靠性和有效性的初步测试，从而为修订后的测量方法的开发提供了基础。修订后的测量方法专为美国国立癌症研究所不良事件通用毒性标准第3.0版设计，分别评估皮下和深部组织纤维化，并且每种都按5分制进行分级。修订后的测量方法需要进行可靠性和有效性测试，建议在获得此类证据并确定其效用之前，将其与MRC和/或EORTC/RTOG量表一起使用。定量测量方法虽然从研究角度来看很有吸引力，但由于所需的设备和相关成本，其临床和多中心效用将受到限制。最后，提出了一个评估纤维化及其后果的框架。
