Oregon Health & Science University School of Nursing, 3455 SW US Veterans Hospital Road, Portland, OR, 97239, USA.
Division of Clinical Psychology, Oregon Health & Science University, 3314 SW US Veterans Hospital Road, Portland, OR, 97239, USA.
J Cancer Surviv. 2020 Aug;14(4):504-517. doi: 10.1007/s11764-020-00869-9. Epub 2020 Mar 11.
Cancer survivors are now living longer giving rise to a new concept-chronic cancer as survivors continue to face long-term consequences of cancer and its treatment. For these survivors, QOL becomes a vital consideration in understanding their survivorship and the long-term impact of cancer and its treatment. The primary aim of this review is to describe QOL in cancer survivors two or more years from diagnosis.
A meta-analysis was completed of relevant studies assessing QOL in long-term cancer survivorship using PubMed, CINHAL, and PsycINFO. A total of 64 articles met inclusion criteria and included in the analysis. Standardized effect sizes and errors were calculated using previously published standard QOL pass rates to compare QOL across measurement tools and calculate cumulative effect sizes (CES). Fixed-effect or random-effects models were used based on the presence of significant heterogeneity of ≤ 0.10.
Physical health (CES = - 0.894; CI, - 1.472, - 0.316), role-physical health (CES = - 2.039; CI, - 2.643, - 1.435), and mental health (CES = - 0.870; CI, - 1.447, - 0.292) had large, negative cumulative effect sizes signifying worse QOL compared with acceptable QOL rates. Tested moderators, cancer type, average age, country of origin, time since diagnosis, or decade of diagnosis, were not significant to explain heterogeneity between included studies.
QOL is significantly impacted 2 to 26 years after cancer diagnosis. More research is needed to determine possible moderators of QOL in long-term cancer survivors.
QOL continues to be significantly impacted in long-term cancer survivorship. More research is needed to understand the impact of these findings on care needs for survivors with chronic cancer.
癌症幸存者的寿命越来越长，由此产生了一个新概念——慢性癌症，因为幸存者仍在面临癌症及其治疗带来的长期后果。对于这些幸存者来说，生活质量（QOL）成为理解他们的生存状况以及癌症及其治疗的长期影响的一个重要考虑因素。本综述的主要目的是描述癌症诊断两年或两年以上的幸存者的 QOL。
使用 PubMed、CINHAL 和 PsycINFO 对评估长期癌症生存者 QOL 的相关研究进行了荟萃分析。共有 64 篇文章符合纳入标准，并纳入了分析。使用先前发表的 QOL 合格标准，计算了标准化效应大小和误差，以比较不同测量工具的 QOL，并计算累积效应大小（CES）。根据是否存在≤0.10 的显著异质性，使用固定效应或随机效应模型。
身体状况（CES=-0.894；CI，-1.472，-0.316）、角色身体状况（CES=-2.039；CI，-2.643，-1.435）和心理健康（CES=-0.870；CI，-1.447，-0.292）具有较大的负累积效应大小，表明与可接受的 QOL 率相比，QOL 更差。测试的调节因素，如癌症类型、平均年龄、原籍国、诊断后时间或诊断年代，对解释纳入研究之间的异质性没有意义。
癌症诊断后 2 至 26 年，QOL 受到显著影响。需要更多的研究来确定长期癌症幸存者 QOL 的可能调节因素。
长期癌症幸存者的 QOL 仍受到显著影响。需要更多的研究来了解这些发现对患有慢性癌症的幸存者的护理需求的影响。
