Miaskowski Christine, Cooper Bruce A, Melisko Michelle, Chen Lee-May, Mastick Judy, West Claudia, Paul Steven M, Dunn Laura B, Schmidt Brian L, Hammer Marilyn, Cartwright Frances, Wright Fay, Langford Dale J, Lee Kathryn, Aouizerat Bradley E
Department of Physiological Nursing, School of Nursing, University of California at San Francisco, San Francisco, California.
Cancer. 2014 Aug 1;120(15):2371-8. doi: 10.1002/cncr.28699. Epub 2014 May 2.
A large amount of interindividual variability exists in the occurrence of symptoms in patients receiving chemotherapy (CTX). The purposes of the current study, which was performed in a sample of 582 oncology outpatients who were receiving CTX, were to identify subgroups of patients based on their distinct experiences with 25 commonly occurring symptoms and to identify demographic and clinical characteristics associated with subgroup membership. In addition, differences in quality of life outcomes were evaluated.
Oncology outpatients with breast, gastrointestinal, gynecological, or lung cancer completed the Memorial Symptom Assessment Scale before their next cycle of CTX. Latent class analysis was used to identify subgroups of patients with distinct symptom experiences.
Three distinct subgroups of patients were identified (ie, 36.1% in Low class; 50.0% in Moderate class, and 13.9% in All High class). Patients in the All High class were significantly younger and more likely to be female and nonwhite, and had lower levels of social support, lower socioeconomic status, poorer functional status, and a higher level of comorbidity.
Findings from the current study support the clinical observation that some oncology patients experience a differentially higher symptom burden during CTX. These high-risk patients experience significant decrements in quality of life.
接受化疗（CTX）的患者在症状出现方面存在大量个体差异。本研究对582名接受CTX的肿瘤门诊患者进行了抽样，目的是根据患者对25种常见症状的不同体验来识别患者亚组，并确定与亚组成员身份相关的人口统计学和临床特征。此外，还评估了生活质量结果的差异。
患有乳腺癌、胃肠道癌、妇科癌或肺癌的肿瘤门诊患者在下一次CTX周期前完成了纪念症状评估量表。采用潜在类别分析来识别具有不同症状体验的患者亚组。
识别出三个不同的患者亚组（即低分组占36.1%；中分组占50.0%，全高分组占13.9%）。全高分组的患者明显更年轻，更可能为女性和非白人，社会支持水平较低，社会经济地位较低，功能状态较差，合并症水平较高。
本研究结果支持临床观察，即一些肿瘤患者在接受CTX期间经历了更高的症状负担。这些高危患者的生活质量显著下降。
