Frick Melissa A, Vachani Carolyn C, Hampshire Margaret K, Bach Christina, Arnold-Korzeniowski Karen, Metz James M, Hill-Kayser Christine E
Department of Radiation Oncology, Perelman Center for Academic Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Cancer. 2017 May 15;123(10):1860-1868. doi: 10.1002/cncr.30527. Epub 2017 Jan 5.
There is significant need for quality follow-up care to optimize long-term outcomes for the growing population of lower gastrointestinal (GI) cancer survivors. Patient-reported outcomes (PROs) provide valuable information regarding late and long-term effects (LLTEs).
A convenience sample from 1129 colon, rectal, and anal cancer survivors (n = 792; 218, and 119, respectively) who participated in an Internet-based survivorship care plan (SCP) tool between May 2010 and October 2014 was used to examine patient-reported demographics, treatment, and toxicity data. Responses from a follow-up survey were reviewed.
The median age of diagnosis was 51 years, and 81% of survivors were Caucasian. The most commonly reported LLTEs for all survivors were neuropathy, fatigue, cognitive changes, changes in GI function, urogenital and sexual dysfunction, and dermatologic effects. The prevalence of these effects varied with time since diagnosis, treatment modality, and treatment center. Individuals who had survived anal cancer reported a high prevalence of sexual dysfunction and radiation-induced dermatologic effects. Over 87% of users reported satisfaction levels of good to excellent using the SCP tool, and 69% reported that they intend to share the SCP with their health care team.
For lower GI cancer survivors, it is feasible to obtain PROs from an Internet-based survivorship tool. Survivors report a wide spectrum of LLTEs, and these can be used to inform counseling at the time of diagnosis and to help anticipate and respond to disease-related and treatment-related sequelae during follow-up. The authors are among the first to report on PROs in anal cancer survivors. Further investigation on the impact of SCPs on health care communication and use is needed. Cancer 2017;123:1860-1868. © 2017 American Cancer Society.
对于日益增多的下消化道（GI）癌症幸存者而言，迫切需要高质量的后续护理以优化长期预后。患者报告结局（PROs）可提供有关晚期和长期影响（LLTEs）的宝贵信息。
采用便利抽样法，选取了2010年5月至2014年10月期间参与基于互联网的生存护理计划（SCP）工具的1129名结肠癌、直肠癌和肛管癌幸存者（分别为792例、218例和119例），以检查患者报告的人口统计学、治疗及毒性数据。对随访调查的回复进行了审查。
诊断时的中位年龄为51岁，81%的幸存者为白种人。所有幸存者最常报告的LLTEs为神经病变、疲劳、认知改变、胃肠功能改变、泌尿生殖系统和性功能障碍以及皮肤影响。这些影响的患病率随诊断后的时间、治疗方式和治疗中心而有所不同。肛管癌幸存者报告性功能障碍和放疗引起的皮肤影响的患病率较高。超过87%的用户报告对SCP工具的满意度为良好至优秀，69%的用户表示他们打算与医疗团队分享SCP。
对于下消化道癌症幸存者，从基于互联网的生存工具中获取PROs是可行的。幸存者报告了广泛的LLTEs，这些可用于在诊断时提供咨询信息，并有助于在随访期间预测和应对与疾病及治疗相关的后遗症。作者是首批报告肛管癌幸存者PROs的人员之一。需要进一步研究SCPs对医疗保健沟通和使用的影响。《癌症》2017年；第｡123｡卷：1860 - 1868页。© 2017美国癌症协会
