Sun Charlotte, Brown Alaina J, Jhingran Anuja, Frumovitz Michael, Ramondetta Lois, Bodurka Diane C
Departments of *Gynecologic Oncology and Reproductive Medicine and †Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
Int J Gynecol Cancer. 2014 Jul;24(6):1077-84. doi: 10.1097/IGC.0000000000000149.
The aim of this study was to assess patient preferences regarding side effects associated with cervical cancer treatment.
METHODS/MATERIALS: The visual analog scale (VAS) and modified standard gamble (SG) were used to elicit preferences of women with no evidence of disease after primary treatment of cervical cancer. Higher scores on VAS and SG indicated more favorable ratings for a given health state. Health states (HS) included vaginal shortening, diarrhea, dietary changes, menopause, moderate nausea/vomiting, rectal bleeding, sexual dysfunction, and urinary self-catheterization. Descriptive statistics, Kruskal-Wallis, Mann-Whitney U, and Wilcoxon signed-ranks tests and correlation coefficients were used for statistical analysis.
Seventy-eight patients participated in the study. Median age was 44.1 years (range, 24.9-67.8 years). Median time since treatment completion was 31.2 months (range, 1.0-113.3 months). The HSs rated as most favorable by VAS were also rated as most favorable by SG. Increasing age was associated with higher VAS scores for menopause and vaginal shortening (P = 0.04 and 0.036). African Americans had higher VAS scores for dietary changes (P = 0.05), sexual dysfunction (P = 0.028), and diarrhea (P = 0.05) when compared with Hispanic and non-Hispanic white patients. Women receiving radiation had more favorable VAS scores for menopause compared with women undergoing radical hysterectomy (P = 0.05). Women receiving chemotherapy rated urinary self-catheterization less favorably by VAS score compared with those not receiving chemotherapy (P = 0.045).
Multiple demographic and clinical factors influence the severity of treatment-related adverse effects perceived by women surviving cervical cancer. A better understanding of factors influencing patient preferences regarding treatment side effects will allow providers to formulate care better tailored to the individual desires of each patient.
本研究旨在评估患者对宫颈癌治疗相关副作用的偏好。
方法/材料：采用视觉模拟量表（VAS）和改良标准博弈法（SG）来获取宫颈癌初次治疗后无疾病证据的女性的偏好。VAS和SG得分越高表明对特定健康状态的评价越有利。健康状态（HS）包括阴道缩短、腹泻、饮食改变、绝经、中度恶心/呕吐、直肠出血、性功能障碍和自行导尿。采用描述性统计、Kruskal-Wallis检验、Mann-Whitney U检验、Wilcoxon符号秩检验和相关系数进行统计分析。
78名患者参与了本研究。中位年龄为44.1岁（范围24.9 - 67.8岁）。治疗结束后的中位时间为31.2个月（范围1.0 - 113.3个月）。VAS评定为最有利的健康状态在SG中也被评定为最有利。年龄增加与绝经和阴道缩短的VAS得分较高相关（P = 0.04和0.036）。与西班牙裔和非西班牙裔白人患者相比，非裔美国人在饮食改变（P = 0.05）、性功能障碍（P = 0.028）和腹泻（P = 0.05）方面的VAS得分更高。与接受根治性子宫切除术的女性相比，接受放疗的女性在绝经方面的VAS得分更有利（P = 0.05）。与未接受化疗的女性相比，接受化疗的女性对自行导尿的VAS评分较低（P = 0.045）。
多种人口统计学和临床因素影响宫颈癌存活女性所感知的治疗相关不良反应的严重程度。更好地了解影响患者对治疗副作用偏好的因素将使医疗服务提供者能够制定更符合每位患者个人需求的护理方案。
