Burkett V Shannon, Cleeland Charles S
The Department of Symptom Research, The University of Texas M. D. Anderson Cancer Center, 1100 Holcombe Blvd., Unit 221, Houston, TX 77030, USA.
J Cancer Surviv. 2007 Jun;1(2):167-75. doi: 10.1007/s11764-007-0017-y.
The subjective experience of cancer survivorship can be assessed by various patient-reported outcome (PRO) methods, including measures of symptom burden and health-related quality of life (HRQOL). Symptom burden includes the presence and severity of multiple symptoms and the level of distress caused by symptoms that go untreated or unrelieved. The concept of symptom burden is more limited in scope than HRQOL but may provide information that better describes the status of various stages of survivorship. This paper contrasts symptom burden with general HRQOL and addresses the importance of including symptom burden as research tool throughout the trajectory of cancer survivorship.
We summarized studies that illustrate both HRQOL and symptoms as outcomes of treatment and of descriptive studies of cancer survivorship. Survivorship was operationally defined as beginning at the completion of primary anticancer treatment.
HRQOL and symptom burden measures both provide meaningful but conceptually different data. Both types of measures are important in portraying aspects of cancer survivorship over time, although symptom burden may provide sufficient information to inform treatment decisions and identify long-term effects of cancer therapies.
Cancer survivors are at risk for multiple severe and persistent symptoms, and assessing and monitoring the severity and impact of these multiple symptoms is critical to understanding the survivorship experience. The inclusion of multiple symptom measures along with the development of new and better methods of long-term symptom tracking in survivors is a critical step in improving the heath status of survivors.
Late and long-term effects seen in cancer survivors have historically been understudied. Symptom burden is an important area of assessment that can be used to specifically describe the symptoms that distress survivors. More descriptive data in this growing population may help identify biological processes in symptom production and maintenance, and facilitate in the development of better treatment and prevention to enhance cancer survivorship.
癌症幸存者的主观体验可通过多种患者报告结局（PRO）方法进行评估，包括症状负担和健康相关生活质量（HRQOL）测量。症状负担包括多种症状的存在和严重程度，以及未治疗或未缓解症状所引起的痛苦程度。症状负担的概念范围比健康相关生活质量更有限，但可能提供能更好描述生存各阶段状况的信息。本文将症状负担与一般健康相关生活质量进行对比，并阐述在癌症幸存者的整个病程中将症状负担作为研究工具的重要性。
我们总结了一些研究，这些研究将健康相关生活质量和症状均作为治疗结局以及癌症幸存者描述性研究的内容。生存被操作性地定义为从原发性抗癌治疗完成时开始。
健康相关生活质量和症状负担测量均提供了有意义但概念上不同的数据。这两种测量类型在描绘癌症幸存者随时间推移的各个方面时都很重要，尽管症状负担可能提供足够信息以指导治疗决策并识别癌症治疗的长期影响。
癌症幸存者面临多种严重且持续症状的风险，评估和监测这些多种症状的严重程度及影响对于理解生存体验至关重要。纳入多种症状测量以及开发更好的长期症状跟踪新方法是改善幸存者健康状况的关键一步。
癌症幸存者中出现的晚期和长期影响在历史上一直未得到充分研究。症状负担是一个重要的评估领域，可用于具体描述困扰幸存者的症状。在这个不断增长的人群中获取更多描述性数据可能有助于识别症状产生和维持的生物学过程，并促进开发更好的治疗和预防方法以提高癌症生存率。
