脊柱转移瘤手术后和/或放射治疗的患者对治疗效果的满意度。
Patient satisfaction with treatment outcomes after surgery and/or radiotherapy for spinal metastases.
机构信息
Department of Orthopedics, University Medical Center Utrecht, Utrecht, the Netherlands.
Department of Radiation Oncology, Sunnybrook Odette Cancer Centre and University of Toronto, Toronto, Ontario, Canada.
出版信息
Cancer. 2019 Dec 1;125(23):4269-4277. doi: 10.1002/cncr.32465. Epub 2019 Sep 6.
BACKGROUND
Patient satisfaction is infrequently investigated despite its importance in assessing efficacy and patient comprehension. The purpose of this study was to investigate patient satisfaction with treatment outcomes after surgery and/or radiotherapy for spinal metastases and to evaluate how health-related quality of life (HRQOL) is related to patient satisfaction.
METHODS
Patients with spinal metastases treated with surgery and/or radiotherapy were enrolled in a prospective, international, observational study. Demographic, histologic, treatment, and HRQOL data were collected. HRQOL was evaluated with the Numeric Rating Scale pain score, the 3-level version of the EuroQol 5-Dimension (EQ-5D-3L) instrument, and the Spine Oncology Study Group Outcomes Questionnaire (SOSGOQ2.0). Patient satisfaction was derived from the SOSGOQ2.0 at 6, 12, and 26 weeks after treatment. Patients were classified as satisfied, neutral, or dissatisfied.
RESULTS
Twelve weeks after treatment, 183 of the surgically treated patients (84%) were satisfied, and only 11 (5%) were dissatisfied; in contrast, 101 of the patients treated with radiotherapy alone (77%) were satisfied, and only 7 (5%) were dissatisfied. Significant improvements in pain, physical function, mental health, social function, leg function, and EQ-5D were associated with satisfaction after surgery. Satisfaction after radiotherapy was associated with significant improvements in pain, mental health, and overall SOSGOQ2.0 scores. Dissatisfaction after treatment was associated with lower baseline values for leg strength and lower social functioning scores for surgically treated patients and with lower social functioning scores and being single for patients treated with radiotherapy.
CONCLUSIONS
High levels of satisfaction with treatment outcomes are observed after surgery and/or radiotherapy for spinal metastases. Posttreatment satisfaction is associated with significant improvements in pain and different dimensions of HRQOL.
背景
尽管评估疗效和患者理解度时患者满意度很重要，但对其进行调查的情况却并不常见。本研究旨在调查脊柱转移瘤患者接受手术和/或放疗后的治疗结局满意度，并评估健康相关生活质量（HRQOL）与患者满意度的关系。
方法
纳入了接受手术和/或放疗治疗的脊柱转移瘤患者进行前瞻性、国际性、观察性研究。收集了人口统计学、组织学、治疗和 HRQOL 数据。使用数字评分量表疼痛评分、欧洲五维健康量表 3 级版本（EQ-5D-3L）和脊柱肿瘤研究组结局问卷（SOSGOQ2.0）评估 HRQOL。在治疗后 6、12 和 26 周时，根据 SOSGOQ2.0 得出患者满意度。患者满意度分为满意、中立和不满意。
结果
在治疗后 12 周，183 例接受手术治疗的患者（84%）表示满意，仅 11 例（5%）不满意；而单独接受放疗的 101 例患者（77%）中，101 例表示满意，仅 7 例（5%）不满意。手术治疗后满意度与疼痛、身体机能、心理健康、社会功能、腿部功能和 EQ-5D 显著改善相关。放疗后满意度与疼痛、心理健康和总体 SOSGOQ2.0 评分的显著改善相关。治疗后不满意与腿部力量基线值较低和手术治疗患者社会功能评分较低，以及接受放疗的患者社会功能评分较低和单身相关。
结论
脊柱转移瘤患者接受手术和/或放疗后对治疗结局满意度较高。治疗后满意度与疼痛和 HRQOL 不同维度的显著改善相关。
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