Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
J Cancer Surviv. 2021 Aug;15(4):526-535. doi: 10.1007/s11764-020-00946-z. Epub 2020 Nov 2.
The objective of this review was to assess the efficacy of non-pharmacological interventions on endometrial cancer (EC) survivors' QOL, and their use of patient-reported outcome measures (PROMs).
We conducted a systematic review of randomized controlled trials (RCTs) of non-pharmacological interventions that assessed the impact of intervention on EC survivors' general and domain-specific QOL (i.e., physical, psychological, and social well-being) using PROMs.
Of the 3178 studies identified, 28 full-text articles were reviewed, and 10 were included in the review. Nine RCTs assessed at least one PROM as a primary outcome and six assessed a PROM as a secondary outcome, but few studies used validated PROMs. Significant improvements in general QOL were found in two studies, domain-specific QOL in three studies, and both general and domain-specific QOL in three studies; however, effect sizes ranged from small to large and no significant effects were found for social well-being and few were found for psychological well-being.
Few non-pharmacological interventions for EC survivors targeted QOL, even though QOL was assessed as either a primary or secondary outcome of the RCT. Despite this, findings suggest that non-pharmacological interventions for EC survivors hold promise for improving general and domain-specific QOL. Use of validated PROMs would greatly enhance outcome reporting and facilitate comparisons across studies. More interventions are also needed that address social and psychological functioning in this population.
Our review highlights a need to (1) expand non-pharmacological RCTs for EC survivors, (2) increase the use of validated PROMs measuring QOL, and (3) address psychosocial domains of QOL when developing interventions for this population.
本综述旨在评估非药物干预措施对子宫内膜癌（EC）幸存者生活质量（QOL）的疗效，以及它们对患者报告结局测量（PROM）的使用。
我们对非药物干预的随机对照试验（RCT）进行了系统评价，这些试验评估了干预对 EC 幸存者使用 PROM 评估的一般和特定领域 QOL（即身体、心理和社会健康）的影响。
在 3178 项研究中，有 28 篇全文文章进行了审查，其中 10 篇被纳入综述。9 项 RCT 评估了至少一项 PROM 作为主要结局，6 项评估了 PROM 作为次要结局，但很少有研究使用经过验证的 PROM。有两项研究发现一般 QOL 有显著改善，三项研究发现特定领域 QOL 有改善，三项研究发现一般和特定领域 QOL 都有改善；然而，效应大小从小到大不等，社会健康方面没有显著效果，心理健康方面也很少有显著效果。
尽管 QOL 被评估为 RCT 的主要或次要结局，但针对 EC 幸存者的非药物干预措施很少针对 QOL。尽管如此，研究结果表明，针对 EC 幸存者的非药物干预措施有希望改善一般和特定领域的 QOL。使用经过验证的 PROM 将极大地增强结果报告，并促进研究之间的比较。还需要更多的干预措施来解决这一人群的社会和心理功能。
我们的综述强调需要（1）扩大针对 EC 幸存者的非药物 RCT，（2）增加使用测量 QOL 的经过验证的 PROM，（3）在为这一人群开发干预措施时解决 QOL 的心理社会领域。
