San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California.
University of California, San Diego Moores Cancer Center, San Diego, California.
Psychooncology. 2019 Jan;28(1):11-21. doi: 10.1002/pon.4906. Epub 2018 Oct 25.
The objectives of this systematic review were to (a) identify supportive-care (psychosocial/behavioral, pharmacological, complementary, or alternative) interventions that have been evaluated via randomized controlled trials (RCTs) to improve patient-reported health-related quality of life (HRQoL) among adults with brain tumors, (b) evaluate the quality of the intervention studies, and (c) evaluate if developed interventions have been efficacious at improving HRQoL, as compared with control conditions in RCTs.
This systematic review was conducted using preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Four databases were searched for RCTs of supportive-care interventions for adults with brain tumors, primary or metastatic, that included a patient-reported HRQoL outcome. Quality of the included studies was assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies.
Ten RCTs involving 640 patients with either a primary or metastatic brain tumor investigating supportive-care interventions with a HRQoL outcome were identified. In terms of quality, three of the studies received a "strong" rating, three received a "moderate" rating, and four of the studies received a "weak" rating. Only two of the interventions (ie, a home-based psychosocial intervention and individualized acupuncture with standard rehabilitation) demonstrated improvements in HRQoL over control conditions.
HRQoL is of the utmost importance when treating patients with brain tumors. Yet there is a notable paucity of research to inform clinical decisions and evidence-based practice. More high-quality studies of interventions aimed at improving HRQoL are needed.
本系统评价的目的是:(a) 确定已通过随机对照试验 (RCT) 评估的支持性护理(心理社会/行为、药理学、补充或替代)干预措施,以改善脑肿瘤成人患者报告的健康相关生活质量 (HRQoL);(b) 评估干预研究的质量;(c) 评估与 RCT 中的对照条件相比,是否开发的干预措施在改善 HRQoL 方面有效。
本系统评价按照系统评价和荟萃分析的首选报告项目 (PRISMA) 指南进行。对四个数据库进行了搜索,以寻找针对脑肿瘤成人患者(原发性或转移性)的支持性护理干预 RCT,这些研究包括患者报告的 HRQoL 结果。使用有效公共卫生实践项目质量评估工具对纳入研究的质量进行了评估。
共确定了 10 项 RCT,涉及 640 名原发性或转移性脑肿瘤患者,这些 RCT 研究了具有 HRQoL 结果的支持性护理干预措施。就质量而言,三项研究获得了“强”评级,三项研究获得了“中”评级,四项研究获得了“弱”评级。只有两种干预措施(即家庭为基础的心理社会干预和个体化针灸结合标准康复)在 HRQoL 方面优于对照条件。
在治疗脑肿瘤患者时,HRQoL 至关重要。然而,为了告知临床决策和循证实践,仍需要大量高质量的研究。需要更多针对改善 HRQoL 的干预措施的高质量研究。