Rapid Response Radiotherapy Program, Department of Radiation Oncology, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
J Palliat Med. 2011 Jun;14(6):708-14. doi: 10.1089/jpm.2010.0491. Epub 2011 May 9.
To examine the reported rates and predictive factors for sleep disturbance in patients with bone metastases.
Patients with symptomatic bone metastases treated with palliative radiotherapy (RT) were eligible. At initial consultation, demographic information, baseline Brief Pain Inventory (BPI) questionnaire, and analgesic consumption were recorded. The BPI functional interference sleep item was categorized into none (0), mild (1-3), moderate (4-6), and severe (7-10). Follow-up BPI was collected in person or via telephone post-RT at week 4, 8, and 12. Subgroup analysis for BPI between responders and nonresponders was performed. Ordinal logistic regression analysis was used to search for the relationship between sleep disturbance and other covariates.
Four hundred patients were enrolled between May 2003 and June 2007. Two hundred thirty-five males (59%) were accrued. The median age was 68 years old (range, 30-91). Within the study population, primary cancer sites included breast (25%), lung (25%), prostate (24%), bladder (4%), pancreas/gastric (3%), and other primaries (18%). In the BPI functional interference items, the mean baseline score for sleep disturbance was 4.8. When categorized in terms of severity, 99 (25%) patients had moderate sleep disturbance and 144 (36%) patients had severe sleep disturbance, respectively. There was an improvement in sleep scores for both responders and nonresponders at week 4 and 8, but scores worsened for nonresponders at week 12.
Age, Karnofsky Performance Scale (KPS), pain score, and lung primary were the significant variables associated with sleep disturbance. The scores for sleep disturbance improved significantly post-RT in responders at week 4 and 12.
调查伴有骨转移的患者睡眠障碍的报告发生率和预测因素。
纳入接受姑息性放疗（RT）治疗的有症状骨转移患者。在初始咨询时，记录人口统计学信息、基线简明疼痛量表（BPI）问卷和镇痛药的使用情况。BPI 功能障碍睡眠项目分为无（0）、轻度（1-3）、中度（4-6）和重度（7-10）。在 RT 后 4、8 和 12 周时，通过亲自或电话进行随访 BPI 采集。对 BPI 应答者和无应答者进行亚组分析。使用有序逻辑回归分析来寻找睡眠障碍与其他协变量之间的关系。
2003 年 5 月至 2007 年 6 月期间共纳入 400 例患者，其中 235 例男性（59%）。中位年龄为 68 岁（范围，30-91）。在研究人群中，原发癌部位包括乳腺（25%）、肺（25%）、前列腺（24%）、膀胱（4%）、胰腺/胃（3%）和其他原发灶（18%）。在 BPI 功能障碍项目中，基线睡眠障碍的平均评分为 4.8。按严重程度分类，99 例（25%）患者有中度睡眠障碍，144 例（36%）患者有重度睡眠障碍。在第 4 周和第 8 周，无论是应答者还是无应答者，睡眠评分均有改善，但无应答者在第 12 周时评分恶化。
年龄、卡氏行为状态量表（KPS）、疼痛评分和肺部原发灶是与睡眠障碍相关的显著变量。在应答者中，RT 后睡眠障碍评分在第 4 周和第 12 周显著改善。
