Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
Clin Lung Cancer. 2012 Jan;13(1):14-23. doi: 10.1016/j.cllc.2011.03.033. Epub 2011 May 23.
Advanced lung cancer is often symptomatic; thus the goals of treatment include maintenance of function and palliation of symptoms. Symptom management requires accurate systematic symptom assessment. This study, which focused on lung cancer, is part of a larger study to obtain patient input that, in combination with previously obtained physician and nurse input, was used to develop symptom indexes for 11 advanced cancers.
Fifty patients with advanced lung cancer were recruited from National Comprehensive Cancer Network (NCCN) member institutions and community support agencies; 10 physician experts were recruited from NCCN institutions. Patients reported symptoms associated with their disease in open-ended format and then completed a checklist of symptoms, rating their 5 most important symptoms. Patient and provider ratings of symptom importance were tabulated to construct the NCCN-Functional Assessment of Cancer Therapy (FACT) Lung Symptom Index-17 (NFLSI-17). Patients also completed the Functional Assessment of Cancer Therapy-Lung (FACT-L), which was used to preliminarily validate the NFLSI-17.
Based on combined patient, physician, and nurse input, the NFLSI-17 is composed of 17 priority symptoms, 11 that are disease related, 3 that are treatment related, and 3 that are related to general functional well-being (FWB). Data on 15 of 17 NFLSI-17 symptoms showed good internal consistency (alpha = 0.74) and strong association with the FACT-L total and most subscale scores (r = 0.42-0.92). Both the NFLSI-15 (F(2,47) = 4.46; P = .017) and the NFLSI-disease related subscale (DRS) (F(2,47) = 5.56; P = .007) significantly discriminated patients among performance status groups.
The NFLSI-17 reflects the most important patient- and clinician-rated targets of chemotherapy for advanced lung cancer; further validation will follow.
晚期肺癌通常有症状，因此治疗目标包括维持功能和缓解症状。症状管理需要准确的系统症状评估。本研究重点关注肺癌，是更大规模研究的一部分，旨在获取患者的意见，这些意见与之前获得的医生和护士的意见相结合，用于为 11 种晚期癌症开发症状指标。
从 NCCN 成员机构和社区支持机构招募了 50 名晚期肺癌患者；从 NCCN 机构招募了 10 名医生专家。患者以开放式格式报告与疾病相关的症状，然后完成症状检查表，对他们的 5 个最重要症状进行评分。患者和提供者对症状重要性的评分被制表，以构建 NCCN 功能评估癌症治疗（FACT）肺癌症状指数-17（NFLSI-17）。患者还完成了功能评估癌症治疗-肺癌（FACT-L），用于初步验证 NFLSI-17。
基于患者、医生和护士的综合意见，NFLSI-17 由 17 个优先症状组成，11 个与疾病相关，3 个与治疗相关，3 个与一般功能健康（FWB）相关。17 个 NFLSI-17 症状中有 15 个症状的数据显示出良好的内部一致性（alpha = 0.74），与 FACT-L 总分和大多数子量表评分具有很强的关联（r = 0.42-0.92）。NFLSI-15（F(2,47) = 4.46；P =.017）和与疾病相关的子量表（DRS）（F(2,47) = 5.56；P =.007）都显著区分了不同表现状态组的患者。
NFLSI-17 反映了晚期肺癌化疗最重要的患者和临床医生评估目标；进一步的验证将随后进行。
