Knowles Gillian, Haigh Rachel, McLean Catriona, Phillips Hamish
Edinburgh Cancer Centre, Lothian University Hospitals Division, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, UK.
Eur J Oncol Nurs. 2015 Oct;19(5):479-85. doi: 10.1016/j.ejon.2015.02.007. Epub 2015 Apr 22.
The aim of this study was to evaluate the late effects and quality of life of patients following chemo-radiation treatment for anal cancer.
All surviving anal cancer patients treated within NHS Lothian between 1990 and 2007 were invited to participate. Data were collected using the EORTC QLQ-C30, the EORTC QLQ-CR38 and the Memorial Sloan-Kettering Cancer Centre Bowel Function Instrument (MSKCC).
Overall response rate was 46% (n = 42); mean age 54.7 years and with a median time interval of 63.8 months between treatment and completion of the questionnaires. Thirty-five percent of the participants were 'rarely' or 'never' able to wait 15 min to get to the toilet; 50% were 'rarely' or 'never' able to control the passage of gas; 35% limited the types of solid foods they eat; 22% had leakage of stool during the day; 39% required to use a protective pad and 29% altered their daily activities because of bowel function 'always' or 'most of the time'. Seventeen percent of patients reported financial difficulties ('quite a bit' and 'very much'). Both men and women reported high symptomology for sexual problems with a median score of 83.3 (50.0. 100.0).
This study has shown that in a sub-set of patients treated with chemo-radiation for anal cancer, persistent treatment related issues are reported at a medium time interval of 5.3 years. Further work is now required to understand the impact of symptoms on day-to-day life and the challenges that people face in managing these inter-related and complex problems.
本研究旨在评估肛管癌患者接受放化疗后的远期影响及生活质量。
邀请1990年至2007年间在NHS洛锡安接受治疗的所有存活肛管癌患者参与。使用欧洲癌症研究与治疗组织生活质量核心问卷(EORTC QLQ-C30)、欧洲癌症研究与治疗组织直肠癌特异性问卷(EORTC QLQ-CR38)以及纪念斯隆-凯特琳癌症中心肠道功能量表(MSKCC)收集数据。
总体缓解率为46%(n = 42);平均年龄54.7岁,从治疗到完成问卷调查的中位时间间隔为63.8个月。35%的参与者“很少”或“从未”能够等待15分钟去上厕所;50%的参与者“很少”或“从未”能够控制排气;35%的参与者限制了所吃固体食物的种类;22%的参与者白天有大便渗漏;39%的参与者需要使用护垫,29%的参与者因肠道功能“总是”或“大部分时间”而改变日常活动。17%的患者报告有经济困难(“相当多”和“非常多”)。男性和女性均报告性问题的症状严重,中位评分为83.3(50.0,100.0)。
本研究表明,在接受放化疗的肛管癌患者亚组中,在中位时间间隔5.3年时报告了持续存在的与治疗相关的问题。现在需要进一步开展工作,以了解症状对日常生活的影响以及人们在管理这些相互关联且复杂的问题时所面临的挑战。