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乳腺癌、结肠癌和白血病患者有临床意义的症状发生率:患者报告结局的对比分析。

Clinically significant symptoms prevalence in breast and colon cancers and leukemia patients: a comparison analysis of patient-reported outcomes.

机构信息

Research Center, King Fahad Medical City, P.O. Box. 59046, Riyadh, 11525, Kingdom of Saudi Arabia.

Pharmacy Administration, King Fahad Medical City, P.O. Box. 59046, Riyadh, 11525, Kingdom of Saudi Arabia.

出版信息

Support Care Cancer. 2022 Jan;30(1):439-446. doi: 10.1007/s00520-021-06434-z. Epub 2021 Jul 24.

Abstract

PURPOSE

To assess the prevalence and severity of clinically significant symptoms (CSSs) for breast cancer, colon cancer, and leukemia patients undergoing chemotherapy.

METHODS

A retrospective review of the Edmonton Symptom Assessment System scores reported by patients from the database of our previous large-scale study, which was collected between May 2018 and January 2019. We described the prevalence of CSSs in proportion and severity in mean ± SD.

RESULTS

Of 546 cancer patients, 209 were breast cancer, 159 were colon cancer, and 178 were leukemia. The majority of participants were females 345 (63.2%), and the mean age of the entire study sample was 49.4 ± 13.93. Diminished feeling of well-being was the most prevalent CSS across the three cancers, with a statistically significant difference (p < 0.001). Fatigue (6.59 ± 2.07), pain (6.55 ± 2.01), and loss of appetite were the most distressing CSSs (6.49 ± 1.99) across the whole sample. Loss of appetite (6.34 ± 2.05) was the most distressing CSS in breast cancer, fatigue (6.97 ± 2.07) in leukemia, and pain (7.00 ± 2.11) in colon cancer. Statistically significant differences were found in the severity between the three cancer in pain (p < 0.001), fatigue (p = 0.010), nausea (p = 0.001), and diminished feeling of well-being (p = 0.033). Cancer type, sleeping hours, dependence on caregiver, female gender, level of education, and employment were significantly associated with higher odds of CSS severity.

CONCLUSION

Breast and colon cancer and leukemia patients undergoing chemotherapy experience multiple distressing CSSs. Our study validates CSSs as a discrete set of distressing symptoms that may serve and guide quality of care assessment and cancer clinical research, particularly among patients undergoing chemotherapy.

摘要

目的

评估正在接受化疗的乳腺癌、结肠癌和白血病患者出现临床显著症状(CSSs)的患病率和严重程度。

方法

回顾性分析 2018 年 5 月至 2019 年 1 月期间我们之前的大型研究数据库中患者报告的埃德蒙顿症状评估系统(ESAS)评分。我们以比例和平均值 ± 标准差来描述 CSSs 的患病率和严重程度。

结果

546 名癌症患者中,209 名为乳腺癌患者,159 名为结肠癌患者,178 名为白血病患者。大多数参与者为女性(345 名,63.2%),整个研究样本的平均年龄为 49.4 ± 13.93 岁。三种癌症中,幸福感下降是最常见的 CSS,差异具有统计学意义(p<0.001)。疲劳(6.59 ± 2.07)、疼痛(6.55 ± 2.01)和食欲不振是整个样本中最令人痛苦的 CSS(6.49 ± 1.99)。在乳腺癌中,食欲不振(6.34 ± 2.05)是最令人痛苦的 CSS,白血病中是疲劳(6.97 ± 2.07),结肠癌中是疼痛(7.00 ± 2.11)。在疼痛(p<0.001)、疲劳(p=0.010)、恶心(p=0.001)和幸福感下降(p=0.033)方面,三种癌症之间的严重程度存在统计学差异。癌症类型、睡眠时间、对照顾者的依赖、女性性别、教育水平和就业状况与 CSS 严重程度的可能性增加显著相关。

结论

接受化疗的乳腺癌、结肠癌和白血病患者会出现多种令人痛苦的 CSSs。我们的研究验证了 CSSs 是一组离散的、令人痛苦的症状,可能在癌症患者的护理评估和临床研究中起到指导作用,尤其是在接受化疗的患者中。

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