Division of Oncology and Dermatological Oncology, Istituto Dermopatico dell'Immacolata, Istituto di Ricerca e Cura a Carattere Scientifico, IDI-IRCCS, Rome, Italy.
Support Care Cancer. 2012 Oct;20(10):2553-7. doi: 10.1007/s00520-011-1354-y. Epub 2012 Jan 21.
Cancer leads to a complicated pattern of change in quality of life (QoL).
The aims of this study were to assess the impact of treatment-related side effects on QoL in cancer patients and to explore which other factors, and to what extent, contribute to explain low QoL scores.
One hundred twenty-three cancer patients receiving chemotherapy completed the self-administered questionnaires (Medical Outcomes Short-Form-36 (SF-36) and 12-item General Health Questionnaire). Multiple regression analyses were conducted with the SF-36 physical component summary (PCS) and SF-36 mental component summary (MCS) scores as the dependent variables and demographic and clinical factors as independent variables.
Seventy-two percent of patients experienced treatment-related side effects, and 32% resulted positive for psychiatric diseases. Two multivariate analyses showed that worse PCS scores, like worse MCS scores, were significantly and independently predicted by treatment-related side effects (odds ratio (OR) = 5.00, 95%CI 1.29-19.45; OR = 8.08, 95%CI 2.03-32.22, respectively) and changes in health over the last 12 months (OR =2.34, 95%CI 1.47-3.76; OR = 3.21, 95%CI 1.90-5.41, respectively), after adjustment for age, gender, years of school, time from cancer diagnosis, and psychiatric disease.
Given the new emphasis on QoL, we suggest that physicians have a responsibility to openly discuss therapy efficacy, prognosis as well as the potential for adverse events with their patients. Changes in health, as perceived by patient, should also be monitored at follow-up.
癌症会导致生活质量(QoL)发生复杂的变化模式。
本研究旨在评估治疗相关副作用对癌症患者 QoL 的影响,并探讨哪些其他因素以及在多大程度上有助于解释 QoL 评分较低的原因。
123 名接受化疗的癌症患者完成了自我管理的问卷(医疗结局短期式 36 项健康调查简表(SF-36)和 12 项一般健康问卷)。使用多元回归分析,SF-36 生理成分综合评分(PCS)和 SF-36 心理成分综合评分(MCS)作为因变量,人口统计学和临床因素作为自变量。
72%的患者经历了治疗相关的副作用,32%的患者患有精神疾病。两项多元分析表明,PCS 评分越差,MCS 评分也越差,这与治疗相关的副作用(比值比(OR)=5.00,95%CI 1.29-19.45;OR=8.08,95%CI 2.03-32.22)以及过去 12 个月健康状况的变化(OR=2.34,95%CI 1.47-3.76;OR=3.21,95%CI 1.90-5.41)显著相关,调整年龄、性别、受教育年限、癌症诊断时间和精神疾病后。
鉴于对 QoL 的新重视,我们建议医生有责任与患者公开讨论治疗效果、预后以及潜在的不良反应。还应在随访中监测患者感知到的健康变化。