Akezaki Yoshiteru, Nakata Eiji, Kikuuchi Masato, Sugihara Shinsuke, Katayama Yoshimi, Katayama Haruyoshi, Hamada Masanori, Ozaki Toshifumi
Division of Physical Therapy, Kochi Professional University of Rehabilitation, Tosa 781-1102, Kochi, Japan.
Department of Orthopaedic Surgery, Okayama University Hospital, Okayama 700-8558, Okayama, Japan.
Healthcare (Basel). 2022 Feb 11;10(2):350. doi: 10.3390/healthcare10020350.
This study aimed to investigate the association between overall survival (OS) and activities of daily living (ADL) in patients with skeletal-related events. In this study, 265 patients whose clinical parameters were available before radiotherapy were investigated. Age, sex, ADL, pain, the primary site, spinal level of bone metastases, spinal instability, treatment strategy, including chemotherapy or palliative treatment, and OS were investigated. ADL patients with a Barthel index of ≥90 were classified as the high ADL group, while those with a score < 90 were classified as the low ADL group. For OS, patients surviving ≥160 days were classified as the non-poor prognosis group, and those who survived <160 days were classified as the poor prognosis group. Age, sex, ADL, pain, the primary site, and treatment strategy for OS were different between the two groups ( < 0.1). Logistic regression analysis revealed that ADL, the primary site, and treatment strategy were significant predictors of OS ( < 0.05). High ADL, breast cancer, and chemotherapy had a positive effect on OS. It is suggested that improvements may be obtained by performing rehabilitation interventions to maintain and improve ADL, by constructing a system for monitoring spinal bone metastases with images before ADL decreases, and by performing interventions such as changes in treatment methods such as RT or surgery at appropriate times.
本研究旨在调查骨相关事件患者的总生存期（OS）与日常生活活动能力（ADL）之间的关联。在本研究中，对265例放疗前临床参数可用的患者进行了调查。调查了年龄、性别、ADL、疼痛、原发部位、骨转移的脊柱节段、脊柱不稳定情况、治疗策略（包括化疗或姑息治疗）以及OS。Barthel指数≥90的ADL患者被分类为高ADL组，而得分<90的患者被分类为低ADL组。对于OS，存活≥160天的患者被分类为非不良预后组，而存活<160天的患者被分类为不良预后组。两组之间的年龄、性别、ADL、疼痛、原发部位和OS治疗策略不同（<0.1）。逻辑回归分析显示，ADL、原发部位和治疗策略是OS的显著预测因素（<0.05）。高ADL、乳腺癌和化疗对OS有积极影响。建议通过进行康复干预以维持和改善ADL、在ADL下降之前构建图像监测脊柱骨转移的系统以及在适当时间进行如放疗或手术等治疗方法的改变等干预措施来获得改善。
