Dept of Radiation Oncology, Norris Comprehensive Cancer Center, University of Southern California, 1441 Eastlake Ave., Los Angeles, CA, 90033, USA.
Biostatistics Core, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, 90033, USA.
Support Care Cancer. 2020 Jan;28(1):309-316. doi: 10.1007/s00520-019-04820-2. Epub 2019 May 2.
It is not known which side effects (SEs) cancer patients undergoing definitive radiotherapy (RT) perceive as worse than others. Our objectives were to (1) identify the worst SEs in patients receiving definitive RT-predominant treatment using patient-reported outcomes and (2) investigate the prominence of physical SEs relative to psychosocial SEs.
In a single-center outpatient radiation oncology clinic, patients were surveyed on the final day of definitive RT. Sixty-seven cards listed SEs (40 physical and 27 psychosocial), and patients ranked the five most severe. Fifteen points were assigned to the top five selected SEs with descending scores of 5, 4, 3, 2, and 1.
Fifty-five patients completed ≥ 4 weeks of RT with or without concurrent chemotherapy and had not received ≥ 4 weeks of neoadjuvant chemotherapy. Patients with head and neck and pelvis cancers perceived physical SEs as worse relative to psychosocial SEs; physical SEs filled 78% and 69% of the 15 points, respectively. In breast cancer patients, however, psychosocial SEs filled 45% of the 15 points in breast cancer patients (anxiety, depression, and sequelae), compared to 25% in others (P = 0.007). Affects my work, home duties, a SE not associated with the treatment itself, was the most frequently cited psychosocial SE (20% of cohort) and was ranked ninth overall.
Perceptions of SEs of cancer RT are dominated by physical quality of life (QoL) concerns and are influenced by the anatomic area receiving RT. Psychosocial QoL concerns are significantly more frequent in breast cancer patients.
ClinicalTrials.gov Identifier: NCT02978846.
目前尚不清楚正在接受根治性放疗（RT）的癌症患者认为哪些副作用（SEs）比其他副作用更严重。我们的目标是：（1）使用患者报告的结果确定接受以根治性 RT 为主的治疗的患者中最严重的 SEs；（2）调查身体 SEs 相对于心理社会 SEs 的突出程度。
在单中心门诊放疗诊所，在根治性 RT 的最后一天对患者进行了调查。67 张卡片列出了 SEs（40 种身体和 27 种心理社会），患者对其中五种最严重的 SEs 进行了排名。前五名选择的 SEs 分别被赋予 15 分，得分分别为 5、4、3、2 和 1。
55 名患者完成了≥4 周的 RT 治疗，无论是否同时接受化疗，并且没有接受≥4 周的新辅助化疗。头颈部和骨盆癌症患者认为身体 SEs 比心理社会 SEs 更严重；身体 SEs 分别占 15 分的 78%和 69%。然而，在乳腺癌患者中，心理社会 SEs 占乳腺癌患者 15 分的 45%（焦虑、抑郁和后遗症），而其他患者占 25%（P=0.007）。影响我的工作、家庭责任、与治疗本身无关的 SEs 是最常被提及的心理社会 SEs（占队列的 20%），总体排名第九。
癌症 RT 的 SEs 感知主要受身体生活质量（QoL）问题的影响，并受接受 RT 的解剖区域的影响。乳腺癌患者的心理社会 QoL 问题明显更为频繁。
ClinicalTrials.gov 标识符：NCT02978846。
