Tong H, Isenring E, Yates P
Queensland University of Technology, Brisbane, Queensland, 4059, Australia.
Support Care Cancer. 2009 Jan;17(1):83-90. doi: 10.1007/s00520-008-0472-7. Epub 2008 Jun 13.
The aims of this secondary analysis were to determine the prevalence of nutrition impact symptoms in medical oncology patients at 1, 6, and 12 months after commencement of chemotherapy and to investigate the relationship of these symptoms to quality of life (QoL) and performance status.
A prospective longitudinal survey was conducted in 219 medical oncology patients who had commenced chemotherapy in the past month. The Rotterdam Symptom Assessment scale assessed the number and distress level of symptoms. The association between symptoms and global QoL and performance status as measured by the Life Satisfaction Scale was investigated.
Symptom prevalence as determined by the proportion of patients experiencing at least one nutrition impact symptom was 79% and 72% at 1 and 6 months after starting chemotherapy. Even at 12 months, symptom prevalence was 46%. The most common symptoms included dry mouth, nausea, and constipation with the most distressing symptoms reported as dry mouth, diarrhea, and stomach pain. A higher number of symptoms was associated with lower QoL (T1: r = -0.35, n = 217, P < 0.05; T2: r = -0.406, n = 194, P < 0.001; T3: r = -0.353, n = 157, P < 0.001). Patients experiencing more symptoms were more likely to have lower performance status at T2 and T3 (T2: n = 189, P = 0.019; T3: n = 143, P = 0.003).
Nutrition impact symptoms were commonly experienced, even 12 months following commencement of chemotherapy, and were associated with poorer QoL and performance status. This highlights the importance of early identification and management of nutrition impact symptoms with adequate follow-up in order to provide optimal care for people with cancer.
本次二次分析的目的是确定化疗开始后1个月、6个月和12个月时,肿瘤内科患者营养影响症状的发生率,并研究这些症状与生活质量(QoL)和体能状态之间的关系。
对过去一个月内开始化疗的219名肿瘤内科患者进行了一项前瞻性纵向调查。使用鹿特丹症状评估量表评估症状的数量和困扰程度。研究了症状与通过生活满意度量表测量的总体生活质量和体能状态之间的关联。
以至少出现一种营养影响症状的患者比例确定的症状发生率在化疗开始后1个月和6个月时分别为79%和72%。即使在12个月时,症状发生率仍为46%。最常见的症状包括口干、恶心和便秘,报告中最令人困扰的症状是口干、腹泻和胃痛。症状数量较多与较低的生活质量相关(T1:r = -0.35,n = 217,P < 0.05;T2:r = -0.406,n = 194,P < 0.001;T3:r = -0.353,n = 157,P < 0.001)。在T2和T3时,出现更多症状的患者更有可能具有较低的体能状态(T2:n = 189,P = 0.019;T3:n = 143,P = 0.003)。
即使在化疗开始12个月后,营养影响症状仍很常见,并且与较差的生活质量和体能状态相关。这凸显了早期识别和管理营养影响症状并进行充分随访的重要性,以便为癌症患者提供最佳护理。