对接受口服卡培他滨治疗的结直肠癌（CRC）门诊患者癌症进展/复发恐惧（FOP/FCR）的频率和内容的新见解：在一家综合癌症中心进行的一项试点研究。
New insights into frequency and contents of fear of cancer progression/recurrence (FOP/FCR) in outpatients with colorectal carcinoma (CRC) receiving oral capecitabine: a pilot study at a comprehensive cancer center.
作者信息
Hefner Jochen, Berberich Sara, Lanvers Elena, Sanning Maria, Steimer Ann-Kathrin, Kunzmann Volker
机构信息
Section of Psychosomatic Medicine, Department of Internal Medicine II, University of Wuerzburg.
Faculty of Medicine, University of Wuerzburg, Bavaria.
出版信息
Patient Prefer Adherence. 2017 Nov 14;11:1907-1914. doi: 10.2147/PPA.S142784. eCollection 2017.
BACKGROUND
Fear of cancer progression/recurrence (FOP/FCR) is considered one of the most prevalent sources of distress in cancer survivors and associated with lower quality of life and functional impairment. Detailed measures of FOP/FCR are needed because little is known about the knowledge of FOP/FCR, its associations with the patient-doctor relationship, and the rate of adequate therapy. Colorectal cancer (CRC) is one of the most prevalent cancer entities, and oral capecitabine is widely prescribed as treatment. Therefore, we initiated a pilot study to expand the literature on FOP/FCR in CRC outpatients receiving capecitabine and to generate hypotheses for future investigations.
METHODS
This study included 58 patients treated at a comprehensive cancer center. FOP/FCR was assessed with the Fear of Progression Questionnaire (FOP-Q-SF). Satisfaction with the relationships with doctors was assessed with the Patient-Doctor Relationship Questionnaire-9 (PRDQ-9). Levels of side effects were rated by the patients on a visual analog scale. Clinical data were extracted from the charts.
RESULTS
A total of 19 out of 58 patients (36%) suffered from FOP/FCR according to our assessment. Levels of FOP/FCR seemed to be mostly moderate to high. Only four out of the 19 distressed patients (21%) were treated accordingly. Typical side effects of oncological treatment were associated with higher FOP/FCR. Satisfaction with doctor-patient relationships was not associated with FOP/FCR. Regarding single items of FOP/FCR, three out of the five most prevalent fears were associated with close relatives.
DISCUSSION
FOP/FCR occurred frequently in more than one in three patients, but was mostly untreated in this sample of consecutive outpatients with CRC receiving oral capecitabine. In detail, most fears were related to family and friends. In addition to an unmet need of patients, our data indicate sources of distress not considered thus far. If replicated in larger studies, results may help to inform intervention development and improve patient care.
背景
对癌症进展/复发的恐惧（FOP/FCR）被认为是癌症幸存者中最普遍的痛苦来源之一，与生活质量降低和功能障碍相关。由于对FOP/FCR的了解、其与医患关系的关联以及充分治疗率知之甚少，因此需要对FOP/FCR进行详细测量。结直肠癌（CRC）是最常见的癌症类型之一，口服卡培他滨是广泛使用的治疗药物。因此，我们开展了一项试点研究，以扩充关于接受卡培他滨治疗的CRC门诊患者FOP/FCR的文献，并为未来研究提出假设。
方法
本研究纳入了在一家综合癌症中心接受治疗的58例患者。使用癌症进展恐惧问卷（FOP-Q-SF）评估FOP/FCR。使用医患关系问卷-9（PRDQ-9）评估对医患关系的满意度。患者通过视觉模拟量表对副作用水平进行评分。从病历中提取临床数据。
结果
根据我们的评估，58例患者中有19例（36%）患有FOP/FCR。FOP/FCR水平似乎大多为中度至高度。19例苦恼患者中只有4例（21%）得到了相应治疗。肿瘤治疗的典型副作用与较高的FOP/FCR相关。对医患关系的满意度与FOP/FCR无关。关于FOP/FCR的单项内容，最常见的五种恐惧中有三种与近亲有关。
讨论
FOP/FCR在三分之一以上的患者中频繁出现，但在这个接受口服卡培他滨治疗的连续CRC门诊患者样本中大多未得到治疗。具体而言，大多数恐惧与家人和朋友有关。除了患者未满足的需求外，我们的数据还表明了迄今未被考虑的痛苦来源。如果在更大规模的研究中得到验证，结果可能有助于指导干预措施的制定并改善患者护理。
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