Department of Oncology, Rigshospitalet, Blegdamsvej 9, section 5073, 2100, Copenhagen Ø, Denmark.
Unit of Survivorship, Danish Cancer Society, Strandboulevarden 49, 2100, Copenhagen Ø, Denmark.
Health Qual Life Outcomes. 2019 Jan 22;17(1):20. doi: 10.1186/s12955-018-1077-6.
Previous quality of life (QoL) literature in bladder cancer (BC) patients has focused on finding the preferred urinary diversion while little is known about the QoL of patients in medical oncological treatment (MOT). We performed a systematic review to assess the existing literature on QoL in patients with muscle-invasive BC (MIBC) undergoing MOT.
A systematic search of Pubmed and Embase was performed. Inclusion criteria were studies containing QoL data for patients undergoing chemo- and/or radiotherapy. We extracted all QoL scorings at different time intervals and on the six most prevalent domains: overall QoL, urinary, bowel sexual symptoms, pain and fatigue. The study was carried out according to PRISMA guidelines for systematic reviews and GRADE was used to rate the quality of evidence from the included studies.
Of 208 papers reviewed, 21 papers were included. Twenty-one different QoL instruments were applied. The only data on QoL during chemotherapy was from patients in clinical trials investigating new treatments. No studies were found for patients in neoadjuvant treatment. The level of evidence at each time point was graded as very low to moderate. From the studies included the overall QoL seemed inversely related to the organ-specific impairment from sexual and urinary symptoms and increased with decreasing organ-specific symptoms for long term survivors > 6 months after treatment.
Collection of data on QoL from patients with MIBC disease undergoing MOT has been sparse and diverse. The present data can act as a summary but prompts for more prospective collection of QoL data from BC patients.
既往膀胱癌（BC）患者生存质量（QoL）文献主要集中在寻找首选的尿路改道，而对于接受医学肿瘤治疗（MOT）的患者的 QoL 知之甚少。我们进行了一项系统评价，以评估接受 MOT 的肌层浸润性膀胱癌（MIBC）患者 QoL 的现有文献。
对 Pubmed 和 Embase 进行了系统检索。纳入标准为包含接受化疗和/或放疗的患者 QoL 数据的研究。我们提取了不同时间间隔和 6 个最常见领域的所有 QoL 评分：总体 QoL、尿、肠、性症状、疼痛和疲劳。该研究按照 PRISMA 系统评价指南进行，并使用 GRADE 对纳入研究的证据质量进行评级。
在 208 篇综述中，有 21 篇被纳入。21 项不同的 QoL 工具被应用。唯一关于化疗期间 QoL 的数据来自于正在研究新疗法的临床试验中的患者。没有发现新辅助治疗患者的研究。每个时间点的证据水平被评为从极低到中度。从纳入的研究中可以看出，总体 QoL 似乎与性和尿症状的器官特异性损害呈负相关，并且随着器官特异性症状的减少，长期生存者（治疗后>6 个月）的 QoL 增加。
对接受 MOT 的 MIBC 患者进行 QoL 数据的收集一直较为稀疏且多样化。目前的数据可以作为一个总结，但需要从 BC 患者中更前瞻性地收集 QoL 数据。
