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患者和临床变量对结直肠癌治疗结果中与健康相关的生活质量和症状负担变化的影响:一项纵向研究

Patient and clinical variables account for changes in health- related quality of life and symptom burden as treatment outcomes in colorectal cancer: a longitudinal study.

作者信息

Hung Hsiu-Chi, Chien Tsui-Wei, Tsay Shiow-Luan, Hang Hewi-Ming, Liang Shu-Yuan

机构信息

Department of Nursing, Hung Kuang University, Taichung, Taiwan.

出版信息

Asian Pac J Cancer Prev. 2013;14(3):1905-9. doi: 10.7314/apjcp.2013.14.3.1905.

Abstract

OBJECTIVE

The aim of the current study was to evaluate changes in treatment outcomes in terms of health- related quality of life (HRQoL) and symptom burden at zero, one, three, and six months after an initial diagnosis of colorectal cancer. The demographic and clinical characteristics that account for outcome changes in patients were investigated using a repeated measures framework.

METHODS AND MATERIALS

A cohort study was performed of 134 colorectal cancer patients followed from diagnosis to 6 months post-treatment in Central Taiwan. HRQoL and symptoms were assessed at diagnosis and one, three, and six months thereafter. The Functional Assessment of Cancer Therapy-Colon (FACT-C) questionnaire, VAS pain, and the Memorial Symptom Assessment Scale (MSAS) were used for data collection. A generalized estimating equation (GEE) was applied for statistical analysis.

RESULTS

The majority of the patients were male (55%) and married (91.5%). The mean age was 60.4 years (SD = 11.71). Most were diagnosed stage III and IV colorectal cancer (54.5%). All underwent surgery; some also received chemotherapy (CT) or concurrent chemoradiation therapy (CCRT). The results of the GEE showed that overall, the HRQoL, pain, and symptoms of the patients significantly improved over the treatment period. Patients with stage IV disease who had received surgery and CCRT showed the worst HRQoL. Females, patients with comorbidity, and stage IV patients had higher pain scores over time. Female and stage IV patients had more severe physical symptoms, whereas stage II and IV patients had worse psychological symptoms over time.

CONCLUSION

The patients' HRQoL, pain, and symptoms significantly improved over the 6-month treatment period. Certain patient and clinical variables accounted for changes in treatment outcomes regarding HRQoL and symptom burden in colorectal cancer patients.

摘要

目的

本研究旨在评估在结直肠癌初次诊断后的零个月、一个月、三个月和六个月时,与健康相关的生活质量(HRQoL)和症状负担方面的治疗结果变化。使用重复测量框架研究了导致患者结果变化的人口统计学和临床特征。

方法和材料

对台湾中部134例结直肠癌患者进行了一项队列研究,从诊断开始随访至治疗后6个月。在诊断时以及之后的1个月、3个月和6个月评估HRQoL和症状。使用癌症治疗功能评估 - 结肠(FACT - C)问卷、视觉模拟评分法(VAS)疼痛评分和纪念症状评估量表(MSAS)收集数据。应用广义估计方程(GEE)进行统计分析。

结果

大多数患者为男性(55%)且已婚(91.5%)。平均年龄为60.4岁(标准差 = 11.71)。大多数患者被诊断为III期和IV期结直肠癌(54.5%)。所有患者均接受了手术;一些患者还接受了化疗(CT)或同步放化疗(CCRT)。GEE结果显示,总体而言,患者的HRQoL、疼痛和症状在治疗期间显著改善。接受手术和CCRT治疗的IV期疾病患者的HRQoL最差。随着时间推移,女性、合并症患者和IV期患者的疼痛评分更高。女性和IV期患者有更严重的躯体症状,而II期和IV期患者随着时间推移有更差的心理症状。

结论

在6个月的治疗期间,患者的HRQoL、疼痛和症状显著改善。某些患者和临床变量解释了结直肠癌患者在HRQoL和症状负担方面治疗结果的变化。

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