Mustafa Ali Moaath, Moeller Machelle, Rybicki Lisa, Moore Halle C F
Internal Medicine, Cleveland Clinic, Cleveland, OH, USA.
Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute, 9500 Euclid Ave, R35, Cleveland, OH, 44195, USA.
J Cancer Surviv. 2017 Dec;11(6):743-750. doi: 10.1007/s11764-017-0612-5. Epub 2017 Mar 10.
Survivorship care is an essential component in the management of cancer patients. Optimal delivery of survivorship care requires an understanding of patient concerns and factors associated with treatment-related symptoms and comorbidities.
We conducted a retrospective cohort study evaluating 34 patient-reported conditions (symptoms and comorbidities) as well as self-reported health habits of stage 0-III breast cancer patients using a questionnaire completed at the time of the initial survivorship visit (SV). Logistic regression analysis was used to assess effects of treatment, age, body mass index, health habits, and timing of SV on these 34 conditions.
Data from 1126 patients seen between April 2009 and November 2015 were analyzed. Hot flashes/night sweats (44%) and numbness/tingling (34%) were the most commonly reported conditions. Significant associations (P < 0.05) were observed with chemotherapy and increased prevalence of 26 conditions, as well as higher BMI and increased prevalence of 10 conditions. Age and timing of SV were associated (P < 0.05) with 20 and 17 conditions, and the direction of associations varied. Exercise was associated (P < 0.05) with reduced reporting of 8 conditions.
Symptom burden is high in this group of breast cancer survivors, particularly following chemotherapy and in those who are overweight or obese. Health concerns vary by patient age and time since treatment. Exercise appears to attenuate patient-reported concerns.
Survivorship care models should account for a variety of patient needs. Survivors who are overweight or obese and those who received chemotherapy appear to be at higher risk for adverse consequences of treatment.
癌症幸存者护理是癌症患者管理的重要组成部分。提供最佳的幸存者护理需要了解患者的担忧以及与治疗相关症状和合并症相关的因素。
我们进行了一项回顾性队列研究，使用在初次幸存者随访（SV）时填写的问卷，评估34种患者报告的情况（症状和合并症）以及0-III期乳腺癌患者的自我报告健康习惯。采用逻辑回归分析评估治疗、年龄、体重指数、健康习惯和SV时间对这34种情况的影响。
分析了2009年4月至2015年11月期间1126例患者的数据。潮热/盗汗（44%）和麻木/刺痛（34%）是最常报告的情况。观察到化疗与26种情况的患病率增加之间存在显著关联（P<0.05），以及较高的BMI与10种情况的患病率增加之间存在显著关联。年龄和SV时间与20种和17种情况相关（P<0.05），且关联方向各不相同。运动与8种情况的报告减少相关（P<0.05）。
这组乳腺癌幸存者的症状负担较高，尤其是在化疗后以及超重或肥胖者中。健康问题因患者年龄和治疗后的时间而异。运动似乎可以减轻患者报告的担忧。
幸存者护理模式应考虑各种患者需求。超重或肥胖的幸存者以及接受化疗的幸存者似乎面临更高的治疗不良后果风险。
