Frick Melissa A, Vachani Carolyn C, Bach Christina, Hampshire Margaret K, Arnold-Korzeniowski Karen, Metz James M, Hill-Kayser Christine E
Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania.
Cancer. 2017 Nov 1;123(21):4268-4276. doi: 10.1002/cncr.30862. Epub 2017 Jun 27.
The survivorship needs of patients living with chronic cancer (CC) and their use of survivorship care plans (SCPs) have been overlooked and underappreciated.
A convenience sample of 39,088 SCPs completed for cancer survivors with an Internet-based SCP tool was examined; it included 5847 CC survivors (15%; CC was defined as chronic leukemia and/or recurrent/metastatic cancer of another nature). Patient-reported treatment effects and follow-up care patterns were compared between CC survivors and survivors treated with curative intent (CI). Responses from a follow-up survey regarding SCP satisfaction and use were reviewed.
CC survivors had greater odds of experiencing multiple treatment-related effects than survivors treated with CI; these effects included fatigue, cognitive changes, dyspnea, peripheral neuropathy, lymphedema, and erectile dysfunction. Nearly half of CC survivors were managed by an oncologist alone, and they were less likely than CI patients to be comanaged by a primary care provider and an oncologist. Fewer SCPs were generated by health care providers (HCPs) for CC survivors versus CI survivors. A smaller proportion of CC users versus CI users rated their experience and satisfaction with the SCP tool as very good or excellent, and CC users were less likely to share the HCP summary with their health care team.
A substantial number of CC survivors, often considered incurable but treatable, seek survivorship support. Tools to facilitate participation, communication, and coordination of care are valuable for these patients, and future iterations of SCPs should be designed to address the particular circumstances of living with CC. Cancer 2017;123:4268-4276. © 2017 American Cancer Society.
慢性癌症（CC）患者的生存需求及其对生存护理计划（SCP）的使用一直被忽视和低估。
对通过基于互联网的SCP工具为癌症幸存者完成的39088份SCP的便利样本进行了检查；其中包括5847名CC幸存者（15%；CC被定义为慢性白血病和/或其他类型的复发性/转移性癌症）。比较了CC幸存者与接受根治性治疗（CI）的幸存者之间患者报告的治疗效果和后续护理模式。审查了关于SCP满意度和使用情况的随访调查的回复。
与接受CI治疗的幸存者相比，CC幸存者经历多种与治疗相关影响的几率更高；这些影响包括疲劳、认知改变、呼吸困难、周围神经病变、淋巴水肿和勃起功能障碍。近一半的CC幸存者仅由肿瘤学家管理，与CI患者相比，他们由初级保健提供者和肿瘤学家共同管理的可能性较小。与CI幸存者相比，医疗保健提供者（HCP）为CC幸存者生成的SCP较少。与CI用户相比，CC用户中认为他们对SCP工具的体验和满意度非常好或优秀的比例较小，并且CC用户与他们的医疗团队分享HCP总结的可能性较小。
大量CC幸存者，通常被认为无法治愈但可治疗，寻求生存支持。促进参与、沟通和护理协调的工具对这些患者很有价值，SCP的未来版本应设计用于解决CC患者的特殊情况。《癌症》2017年；123:4268 - 4276。©2017美国癌症协会。
