Iwase Satoru, Kawaguchi Takashi, Tokoro Akihiro, Yamada Kimito, Kanai Yoshiaki, Matsuda Yoshinobu, Kashiwaya Yuko, Okuma Kae, Inada Shuji, Ariyoshi Keisuke, Miyaji Tempei, Azuma Kanako, Ishiki Hiroto, Unezaki Sakae, Yamaguchi Takuhiro
Department of Palliative Medicine, Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
Department of Practical Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan.
PLoS One. 2015 Aug 5;10(8):e0134022. doi: 10.1371/journal.pone.0134022. eCollection 2015.
Cancer-related fatigue greatly influences quality of life in cancer patients; however, no specific treatments have been established for cancer-related fatigue, and at present, no medication has been approved in Japan. Systematic research using patient-reported outcome to examine symptoms, particularly fatigue, has not been conducted in palliative care settings in Japan. The objective was to evaluate fatigue, pain, and quality of life in cancer patients at the point of intervention by palliative care teams.
Patients who were referred to palliative care teams at three institutions and met the inclusion criteria were invited to complete the Brief Fatigue Inventory, Brief Pain Inventory, and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 15-Palliative.
Of 183 patients recruited, the majority (85.8%) were diagnosed with recurrence or metastasis. The largest group (42.6%) comprised lung cancer patients, of whom 67.2% had an Eastern Cooperative Oncology Group Performance Status of 0-1. The mean value for global health status/quality of life was 41.4, and the highest mean European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 15-Palliative symptom item score was for pain (51.0). The mean global fatigue score was 4.1, and 9.8%, 30.6%, 38.7%, and 20.8% of patients' fatigue severity was classified as none (score 0), mild (1-3), moderate (4-6), and severe (7-10), respectively.
Cancer-related fatigue, considered to occur more frequently in cancer patients, was successfully assessed using patient-reported outcomes with the Brief Fatigue Inventory for the first time in Japan. Results suggested that fatigue is potentially as problematic as pain, which is the main reason for palliative care.
癌症相关疲劳对癌症患者的生活质量有很大影响;然而,尚未确立针对癌症相关疲劳的具体治疗方法,目前在日本尚无药物获批。日本的姑息治疗环境中尚未开展使用患者报告结局来检查症状,尤其是疲劳的系统研究。目的是评估姑息治疗团队进行干预时癌症患者的疲劳、疼痛和生活质量。
邀请在三家机构被转介至姑息治疗团队且符合纳入标准的患者完成简明疲劳量表、简明疼痛量表和欧洲癌症研究与治疗组织生活质量问卷核心15项-姑息治疗版。
在招募的183例患者中,大多数(85.8%)被诊断为复发或转移。最大的一组(42.6%)为肺癌患者,其中67.2%的东部肿瘤协作组体能状态为0-1。全球健康状况/生活质量的平均值为41.4,欧洲癌症研究与治疗组织生活质量问卷核心15项-姑息治疗版症状项目得分最高的是疼痛(51.0)。全球疲劳平均得分为4.1,患者疲劳严重程度分别有9.8%、30.6%、38.7%和20.8%被分类为无(得分0)、轻度(1-3)、中度(4-6)和重度(7-10)。
在日本首次使用简明疲劳量表通过患者报告结局成功评估了被认为在癌症患者中更频繁出现的癌症相关疲劳。结果表明,疲劳可能与作为姑息治疗主要原因的疼痛一样成问题。