Han Claire J, Yang Gee S, Syrjala Karen
Author Affiliations: Department of Public Health, University of Washington, Seattle (Drs Han and Syrjala); College of Nursing, University of Florida, Gainesville (Dr Yang); and Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, Washington (Drs Han and Syrjala).
Cancer Nurs. 2020 May/Jun;43(3):E132-E158. doi: 10.1097/NCC.0000000000000785.
With improved survivorship rates for colorectal cancer (CRC), more CRC survivors are living with long-term disease and treatment side effects. Little research exists on CRC symptoms or symptom management guidelines to support these individuals after cancer treatments.
The aims of this study were to systematically review symptom experiences, risk factors, and the impact of symptoms and to examine the pooled frequency and severity of symptoms via meta-analyses in CRC survivors after cancer treatments.
Relevant studies were systematically searched in 7 databases from 2009 to 2019. Meta-analysis was conducted for pooled estimates of symptom frequency and severity.
Thirty-five studies met the inclusion criteria. Six studies assessed multiple CRC symptoms, whereas 29 focused on a single symptom, including peripheral neuropathy, psychological distress, fatigue, body image distress, cognitive impairment, and insomnia. The pooled mean frequency was highest for body image distress (78.5%). On a scale of 0 to 100, the pooled mean severity was highest for fatigue (50.1). Gastrointestinal and psychological symptoms, peripheral neuropathy, and insomnia were also major problems in CRC survivors. Multiple factors contributed to adverse symptoms, such as younger age, female gender, and lack of family/social support. Symptoms negatively impacted quality of life, social and sexual functioning, financial status, and caregivers' physical and mental conditions.
Colorectal cancer survivors experienced multiple adverse symptoms related to distinct risk factors. These symptoms negatively impacted patients and caregivers' well-being.
Healthcare providers can use study findings to better assess and monitor patient symptoms after cancer treatments. More research is needed on CRC-specific symptoms and their effective management.
随着结直肠癌（CRC）生存率的提高，越来越多的CRC幸存者长期面临疾病和治疗副作用。关于CRC症状或症状管理指南以支持这些癌症治疗后的个体的研究很少。
本研究的目的是系统回顾症状体验、风险因素以及症状的影响，并通过荟萃分析检查癌症治疗后CRC幸存者症状的合并频率和严重程度。
2009年至2019年在7个数据库中系统检索相关研究。对症状频率和严重程度的合并估计进行荟萃分析。
35项研究符合纳入标准。6项研究评估了多种CRC症状，而29项研究聚焦于单一症状，包括周围神经病变、心理困扰、疲劳、身体形象困扰、认知障碍和失眠。身体形象困扰的合并平均频率最高（78.5%）。在0至100的量表上，疲劳的合并平均严重程度最高（50.1）。胃肠道和心理症状、周围神经病变和失眠也是CRC幸存者的主要问题。多种因素导致不良症状，如年龄较小、女性以及缺乏家庭/社会支持。症状对生活质量、社交和性功能、财务状况以及照顾者的身心健康产生负面影响。
CRC幸存者经历了与不同风险因素相关的多种不良症状。这些症状对患者和照顾者的幸福感产生负面影响。
医疗保健提供者可以利用研究结果更好地评估和监测癌症治疗后的患者症状。需要对CRC特异性症状及其有效管理进行更多研究。
