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癌症治疗方案及其对患者报告结局指标(健康相关生活质量和认知功能感知)的影响。

Cancer treatment regimens and their impact on the patient-reported outcome measures health-related quality of life and perceived cognitive function.

作者信息

Grusdat Niklas Paul, Stäuber Alexander, Tolkmitt Marion, Schnabel Jens, Schubotz Birgit, Wright Peter Richard, Heydenreich Marc, Zermann Dirk-Henrik, Schulz Henry

机构信息

Professorship of Sports Medicine/Sports Biology, Institute of Human Movement Science and Health, Faculty of Behavioral and Social Sciences, Chemnitz University of Technology, Thüringer Weg 11, 09126, Chemnitz, Saxony/Sachsen, Germany.

Rotes Kreuz Krankenhaus, Red Cross Hospital, Chemnitz-Rabenstein, Germany.

出版信息

J Patient Rep Outcomes. 2022 Feb 21;6(1):16. doi: 10.1186/s41687-022-00422-5.

Abstract

BACKGROUND AND PURPOSE

Breast cancer can be a significant challenge for those affected. Knowledge of physical function, social-emotional challenges, and perceived cognitive function based on the cancer treatment regimens may help to inform adequate support.

METHODS

For this prospective observational pilot study, we collected data of seventy-nine women (mean age 54.6 ± 9.5 years) before (T0) and after (T1) initial breast cancer treatment. Functional Assessment of Cancer Therapy-Breast (FACT-B) and Functional Assessment of Cancer Therapy-Cognitive-Function (FACT-Cog) were used to collect data of four treatment subgroups: SCR = Surgery + Chemotherapy + Radiation Therapy; SC = Surgery + Chemotherapy; SR = Surgery + Radiation Therapy; S = Surgery. A mixed ANOVA and posthoc analysis (Tukey, Games-Howell) were used to detect interactions (group by time) and the main effect. A repeated-measures ANOVA displayed individual group differences (time).

RESULTS

Significant interaction showed more deterioration was experienced with SC and SCR than SR and S for FACT-B (p < 0.01) and FACT-Cog (p < 0.001). The longitudinal comparison between T0 and T1 indicated a significant group main effect on all subscales (p < 0.001) except for Emotional Well-Being. Significant reductions (p < 0.05) in FACT-B, (- 19%); FACT-Cog, (- 21%) with most pronounced effect in Physical Well-Being (- 30%), Functional Well-Being (- 20%), Breast Cancer Subscale (- 20%), Perceived Cognitive Impairments (- 18%) and Impact of Cognitive Impairments on Quality of Life (- 39%) were detected for SCR.

CONCLUSION

Our study showed that the extent of change in health-related quality of life (HRQoL) and perceived cognitive function (PCF) depends on the treatment regimen. Multidisciplinary support initiated early in breast cancer therapy is needed, especially for women undergoing combined cancer treatment. Routine assessment of patient-reported outcomes (PROs) in oncology practice may increase the transparency of patients' perceived circumstances, leading to personalized and optimized acute and survivorship care.

摘要

背景与目的

乳腺癌对患者来说可能是一项重大挑战。了解基于癌症治疗方案的身体功能、社会情感挑战以及认知功能感受,可能有助于提供充分的支持。

方法

在这项前瞻性观察性试点研究中,我们收集了79名女性(平均年龄54.6±9.5岁)在初次乳腺癌治疗前(T0)和治疗后(T1)的数据。使用癌症治疗功能评估 - 乳腺癌(FACT - B)和癌症治疗功能评估 - 认知功能(FACT - Cog)收集四个治疗亚组的数据:SCR = 手术 + 化疗 + 放疗;SC = 手术 + 化疗;SR = 手术 + 放疗;S = 手术。采用混合方差分析和事后分析(Tukey法、Games - Howell法)来检测交互作用(组×时间)和主效应。重复测量方差分析显示了各亚组的个体差异(时间)。

结果

显著的交互作用表明,对于FACT - B(p < 0.01)和FACT - Cog(p < 0.001),SC和SCR组比SR和S组经历了更多的恶化。T0和T1之间的纵向比较表明,除情感健康外,所有子量表上均存在显著的组主效应(p < 0.001)。SCR组的FACT - B显著降低(p < 0.05),降低了19%;FACT - Cog降低了21%,其中身体状况降低30%、功能状况降低20%、乳腺癌子量表降低20%、认知障碍感受降低18%以及认知障碍对生活质量的影响降低39%最为明显。

结论

我们的研究表明,健康相关生活质量(HRQoL)和认知功能感受(PCF)的变化程度取决于治疗方案。乳腺癌治疗早期就需要多学科支持,尤其是对于接受联合癌症治疗的女性。肿瘤学实践中对患者报告结局(PROs)的常规评估可能会提高患者感受情况的透明度,从而实现个性化和优化的急性及生存护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b34e/8861246/64b9f8e16931/41687_2022_422_Fig1_HTML.jpg

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