Ho Peh Joo, Gernaat Sofie A M, Hartman Mikael, Verkooijen Helena M
Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
BMJ Open. 2018 Apr 20;8(4):e020512. doi: 10.1136/bmjopen-2017-020512.
To summarise the evidence on determinants of health-related quality of life (HRQL) in Asian patients with breast cancer.
Systematic review conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations and registered with PROSPERO (CRD42015032468).
According to the PRISMA guidelines, databases of MEDLINE (PubMed), Embase and PsycINFO were systematically searched using the following terms and synonyms: breast cancer, quality of life and Asia. Articles reporting on HRQL using EORTC-QLQ-C30, EORTC-QLQ-BR23, FACT-G and FACT-B questionnaires in Asian patients with breast cancer were eligible for inclusion. The methodological quality of each article was assessed using the quality assessment scale for cross-sectional studies or the Newcastle-Ottawa Quality Assessment Scale for cohort studies.
Fifty-seven articles were selected for this qualitative synthesis, of which 43 (75%) were cross-sectional and 14 (25%) were longitudinal studies. Over 75 different determinants of HRQL were studied with either the EORTC or FACT questionnaires. Patients with comorbidities, treated with chemotherapy, with less social support and with more unmet needs have poorer HRQL. HRQL improves over time. Discordant results in studies were found in the association of age, marital status, household income, type of surgery, radiotherapy and hormone therapy and unmet sexuality needs with poor global health status or overall well-being.
In Asia, patients with breast cancer, in particular those with other comorbidities and those treated with chemotherapy, with less social support and with more unmet needs, have poorer HRQL. Appropriate social support and meeting the needs of patients may improve patients' HRQL.
总结亚洲乳腺癌患者健康相关生活质量（HRQL）决定因素的证据。
根据系统评价和Meta分析的首选报告项目（PRISMA）建议进行系统评价，并在国际前瞻性系统评价注册库（PROSPERO）注册（CRD42015032468）。
根据PRISMA指南，使用以下术语和同义词系统检索MEDLINE（PubMed）、Embase和PsycINFO数据库：乳腺癌、生活质量和亚洲。报道亚洲乳腺癌患者使用欧洲癌症研究与治疗组织生活质量核心问卷（EORTC-QLQ-C30）、欧洲癌症研究与治疗组织乳腺癌特异性问卷（EORTC-QLQ-BR23）、癌症治疗功能评价系统通用量表（FACT-G）和癌症治疗功能评价系统乳腺癌量表（FACT-B）评估HRQL的文章符合纳入标准。使用横断面研究质量评估量表或队列研究的纽卡斯尔-渥太华质量评估量表评估每篇文章的方法学质量。
57篇文章被选入本定性综合分析，其中43篇（75%）为横断面研究，14篇（25%）为纵向研究。使用EORTC或FACT问卷研究了75多种不同的HRQL决定因素。患有合并症、接受化疗、社会支持较少且未满足需求较多的患者HRQL较差。HRQL随时间改善。在年龄、婚姻状况、家庭收入、手术类型、放疗和激素治疗以及未满足的性需求与全球健康状况差或总体幸福感之间的关联方面，研究结果存在不一致。
在亚洲，乳腺癌患者，尤其是那些患有其他合并症、接受化疗、社会支持较少且未满足需求较多的患者，HRQL较差。适当的社会支持和满足患者需求可能会改善患者的HRQL。
