Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Champaign, Illinois, United States of America.
School of Population Health, University of Toledo, Toledo, Ohio, United States of America.
PLoS One. 2020 Feb 24;15(2):e0229222. doi: 10.1371/journal.pone.0229222. eCollection 2020.
The number of cancer survivors is projected to increase to 22.1 million by 2030. Late effects incorporate the full domains of cancer survivorship (e.g., physiologic, psychosocial, economic). They are numerous, complex, and potentially alter the life trajectories of cancer survivors. Currently, research is missing on the impact of late effects (e.g., cardiomyopathy, fertility, lymphedema, anxiety) on cancer survivors.
The goal of this study is to present a systematic review of existing instruments for identifying, diagnosing, and managing late effects within cancer survivors.
Using PRISMA guidelines, a systematic search was conducted using the electronic databases of PubMed and Web of Science to identify relevant papers. Articles considered eligible for this review met the following criteria: 1) written in English, 2) published until September 30, 2019, and 3) containing instruments with questions on late effects. Hypothesis, study design, study sample, questionnaire domains, details of late effects, results, conclusions, and advantages/disadvantages of each article were assessed using a modified version of the NHLBI quality assessment tool.
An exhaustive literature review revealed 576 publications in PubMed, 628 in Web of Science, and 260 from additional sources. After removing duplicates, articles without late-effects questionnaires, and publications using identical questionnaires, 11 studies fulfilled the eligibility criteria. Study quality assessment was measured on a scale of 0-6 (0 = poor quality; 6 = highest quality). Only one study was rated with a score of 5 (Rocque).
Taken in totality, none of the studies adequately addressed the prevalence, etiology, characteristics, management, and prevention of late effects. There is currently no comprehensive questionnaire that captures all of the relevant details of late effects across the cancer survivorship continuum nor that tracks the interrelatedness of multiple late effects. Hence, it is difficult to identify, diagnose, manage, and ultimately prevent late effects.
预计到 2030 年，癌症幸存者人数将增至 2210 万。晚期效应包含癌症生存者的所有领域（例如，生理，心理社会，经济）。它们数量众多，复杂，并且可能改变癌症幸存者的生活轨迹。目前，有关晚期效应（例如，心肌病，生育力，淋巴水肿，焦虑）对癌症幸存者的影响的研究还很缺乏。
本研究旨在系统地综述现有的用于识别，诊断和管理癌症幸存者晚期效应的工具。
使用 PRISMA 指南，通过 PubMed 和 Web of Science 的电子数据库进行了系统搜索，以确定相关论文。符合本综述标准的文章符合以下标准：1）用英语书写，2）发表至 2019 年 9 月 30 日，3）包含有关晚期效应问题的工具。使用 NHLBI 质量评估工具的修改版本评估了每篇文章的假设，研究设计，研究样本，问卷领域，晚期效应的详细信息，结果，结论以及优缺点。
彻底的文献综述在 PubMed 中发现了 576 篇出版物，在 Web of Science 中发现了 628 篇出版物，并且从其他来源中发现了 260 篇出版物。去除重复项，没有晚期效应问卷的文章以及使用相同问卷的出版物后，有 11 项研究符合入选标准。研究质量评估的得分为 0-6 分（0 =质量差；6 =质量高）。只有一项研究的评分达到 5 分（Rocque）。
总的来说，没有一项研究充分解决了晚期效应的流行，病因，特征，管理和预防问题。目前尚无全面的问卷可以捕获整个癌症生存者连续体的所有相关晚期效应细节，也无法跟踪多个晚期效应的相互关系。因此，难以识别，诊断，管理，最终预防晚期效应。
