Epstein Health, LLC, Woodcliff Lake, NJ, USA.
Clinique de Genolier, Genolier, Switzerland.
Adv Ther. 2020 Aug;37(8):3606-3618. doi: 10.1007/s12325-020-01419-6. Epub 2020 Jul 8.
Chemotherapy-induced myelosuppression (CIM) is one of the most common dose-limiting complications of cancer treatment, and is associated with a range of debilitating symptoms that can significantly impact patients' quality of life. The purpose of this study was to understand patients' perspectives on how the side effects of CIM are managed in routine clinical practice.
An online survey was conducted of participants with breast, lung, or colorectal cancer who had received chemotherapy treatment within the past 12 months, and had experienced at least one episode of myelosuppression in the past year. The survey was administered with predominantly close-ended questions, and lay definitions of key terms were provided to aid response selection.
Of 301 participants who completed the online survey, 153 (51%) had breast cancer, 100 (33%) had lung cancer, and 48 (16%) had colorectal cancer. Anemia, neutropenia, lymphopenia, and thrombocytopenia were reported by 61%, 59%, 37%, and 34% of participants, respectively. Most participants (79%) reported having received treatment for CIM, and 64% of participants recalled chemotherapy dose modifications as a result of CIM. Although most participants believed their oncologist was aware of the side effects of CIM, and treated them quickly, 30% of participants felt their oncologists did not understand how uncomfortable they were due to the side effects of CIM. Overall, 88% of participants considered CIM to have a moderate or major impact on their lives.
The data highlight that despite the various methods used to address CIM, and the patient-focused approach of oncologists, the real-world impact of CIM on patients is substantial. Improving communication between patients and health care providers may help improve patients' understanding of CIM, and foster shared decision-making in terms of treatment. Additional insights from patients should be obtained to further elucidate the totality of life burden associated with CIM.
化疗引起的骨髓抑制(CIM)是癌症治疗中最常见的剂量限制并发症之一,与一系列使人虚弱的症状有关,这些症状会严重影响患者的生活质量。本研究旨在了解患者对 CIM 副作用在常规临床实践中管理的看法。
对过去 12 个月内接受过化疗且过去一年中至少经历过一次骨髓抑制的乳腺癌、肺癌或结直肠癌患者进行了在线调查。该调查主要采用封闭式问题,并提供了关键术语的通俗定义,以帮助选择答案。
在完成在线调查的 301 名参与者中,153 名(51%)患有乳腺癌,100 名(33%)患有肺癌,48 名(16%)患有结直肠癌。分别有 61%、59%、37%和 34%的参与者报告出现贫血、中性粒细胞减少症、淋巴细胞减少症和血小板减少症。大多数参与者(79%)报告接受了 CIM 治疗,64%的参与者因 CIM 而调整了化疗剂量。尽管大多数参与者认为他们的肿瘤医生了解 CIM 的副作用,并迅速对其进行了治疗,但仍有 30%的参与者认为他们的肿瘤医生不了解他们因 CIM 的副作用而感到的不适程度。总的来说,88%的参与者认为 CIM 对他们的生活有中度或重大影响。
这些数据表明,尽管采用了各种方法来解决 CIM 问题,并且肿瘤医生采取了以患者为中心的方法,但 CIM 对患者的实际影响仍然很大。改善患者与医疗保健提供者之间的沟通,可能有助于提高患者对 CIM 的认识,并促进治疗方面的共同决策。应从患者那里获得更多的见解,以进一步阐明与 CIM 相关的全部生活负担。