Gotay Carolyn C, Ransom Sean, Pagano Ian S
Prevention and Control Program, Cancer Research Center of Hawaii, University of Hawaii at Manoa, Honolulu, Hawaii 96822, USA.
Cancer. 2007 Nov 1;110(9):2101-9. doi: 10.1002/cncr.23005.
Cancer survivors may develop additional cancers after their first diagnosis, but to the authors' knowledge the quality of life (QOL) consequences of a second cancer are not known. The current study assessed QOL and its correlates after a second cancer diagnosis.
QOL was compared between 487 survivors of second-order and higher-order primary cancer diagnoses, and a matched group of 589 survivors of a single cancer diagnosis. Outcome measures included standardized questionnaires that assessed depressive symptoms, perceived stress, vitality, post-traumatic growth, existential well-being, sexual adjustment, and global QOL.
Survivors of multiple primary cancer diagnoses had significantly lower global QOL (t (792) = 5.42; P < .001), vitality (Student t test [t] (794) = 2.41; P < .01), and existential well-being (t (775) = 2.78; P < .01), and higher intrusive stress symptoms (t (775) = -1.93; P < .05). Controlling for demographic, medical, and trait-like psychosocial characteristics (eg, optimism and resilience), having multiple primary cancer diagnoses explained small, although significant, variances in global QOL (coefficient of determination [R(2)] = .04; P < .001), vitality (R(2) = .01; P < .05), and existential well-being (R(2) = .01; P < .05), with patients in the multiple primary cancer group faring worse on all of these measures.
The results of the current study suggest that the typical survivor of multiple primary cancers experiences modest but lasting QOL deficits.
癌症幸存者在首次确诊后可能会患上其他癌症，但据作者所知，二次患癌对生活质量（QOL）的影响尚不清楚。本研究评估了二次癌症诊断后的生活质量及其相关因素。
对487例二阶及以上原发性癌症诊断的幸存者与589例单次癌症诊断的匹配幸存者进行生活质量比较。结果测量包括评估抑郁症状、感知压力、活力、创伤后成长、生存幸福感、性适应和总体生活质量的标准化问卷。
多次原发性癌症诊断的幸存者的总体生活质量（t（792）=5.42；P<.001）、活力（学生t检验[t]（794）=2.41；P<.01）和生存幸福感（t（775）=2.78；P<.01）显著较低，而侵入性应激症状较高（t（775）=-1.93；P<.05）。在控制了人口统计学、医学和特质性心理社会特征（如乐观和恢复力）后，多次原发性癌症诊断解释了总体生活质量（决定系数[R（2）]=.04；P<.001）、活力（R（2）=.01；P<.05）和生存幸福感（R（2）=.01；P<.05）中虽小但显著的差异，多次原发性癌症组的患者在所有这些指标上的情况更差。
本研究结果表明，多次原发性癌症的典型幸存者经历了适度但持久的生活质量缺陷。
