放射性皮炎对乳腺癌患者放疗期间生活质量的影响：一项前瞻性队列研究。

The Impact of Radiodermatitis on Breast Cancer Patients' Quality of Life During Radiotherapy: A Prospective Cohort Study.

机构信息

Graduate Program in Health Science, Medical School, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil.

Division of Breast and Gynecology, Department of Clinical Oncology, Barretos Cancer Hospital, São Paulo, Brazil.

出版信息

J Pain Symptom Manage. 2019 Jul;58(1):92-99.e1. doi: 10.1016/j.jpainsymman.2019.03.017. Epub 2019 Apr 8.

DOI:10.1016/j.jpainsymman.2019.03.017

PMID:30974233

Abstract

CONTEXT

In the oncology field, quality of life (QoL) is recognized as an essential component. However, few studies have evaluated radiotherapy (RT) and its adverse events, specifically radiodermatitis.

OBJECTIVES

The objective of this study was to investigate the influence of radiodermatitis severity on QoL of women with breast cancer (BC) throughout RT.

METHODS

A prospective cohort study was conducted with 100 BC patients evaluated weekly during RT. The Dermatology Life Quality Index questionnaire and the Radiation Therapy Oncology Group scale were used. The generalized estimated equations were used to examine the association between the total score of QoL and their domains, time of RT, and the radiodermatitis score, controlled by confounding factors. Estimated marginal means and 95% CIs were compared pairwise by applying Sequential Sidak.

RESULTS

The total QoL score and their domains (work/school, leisure, daily activities, symptoms, and feelings) were significantly associated with the evaluation times of RT (P < 0.001), the radiodermatitis score (P ≤ 0.002), and the interaction between timing (T) of treatment and radiodermatitis score (P < 0.001). When assessing post hoc, it was identified that the worst QoL scores were in the presence of Grade 3 (mean = 6.00) in T3 and Grade 4 (6.50; 7.00) in T5 and T6, respectively, and this difference was statistically significant.

CONCLUSIONS

RT negatively influenced the QoL of women with BC, with the greatest impact resulting from severe radiodermatitis. Actions aimed at minimizing the impairment on QoL need to be adopted to make this exhausting process less traumatic and easier to complete.

摘要

背景

在肿瘤学领域，生活质量（QoL）被认为是一个重要组成部分。然而，很少有研究评估过放射治疗（RT）及其不良反应，特别是放射性皮炎。

目的

本研究旨在探讨放射性皮炎严重程度对接受 RT 的乳腺癌（BC）女性生活质量的影响。

方法

对 100 例接受 RT 的 BC 患者进行前瞻性队列研究，每周进行评估。使用皮肤病生活质量指数问卷和放射治疗肿瘤组量表。采用广义估计方程来检验生活质量总评分及其各领域、RT 时间和放射性皮炎评分与混杂因素之间的关系。应用顺序 Sidak 法比较估计边际均值和 95%置信区间的两两差异。

结果

生活质量总分及其各领域（工作/学校、休闲、日常活动、症状和感觉）与 RT 评估时间（P<0.001）、放射性皮炎评分（P≤0.002）以及治疗时间（T）和放射性皮炎评分之间的交互作用（P<0.001）显著相关。事后评估发现，在 T3 中出现 3 级（平均=6.00）和在 T5 和 T6 中出现 4 级（6.50；7.00）放射性皮炎时，生活质量评分最差，差异具有统计学意义。