Schmidt Martina E, Goldschmidt Siri, Hermann Silke, Steindorf Karen
Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany.
Medical Faculty of the University of Heidelberg, Heidelberg, Germany.
Int J Cancer. 2022 Oct 15;151(8):1280-1290. doi: 10.1002/ijc.34152. Epub 2022 Jun 17.
Great efforts are being made in cancer treatment, with impressive improvement in survival. The situation concerning research and care for long-term problems and late effects in the growing population of cancer survivors, however, is unsatisfactory. Therefore, in the FiX survey 1348 disease-free survivors about 4 years after diagnosis of different cancer types were asked to rate existing burdens and support received for them along a list of 36 potential problems. Health-related quality of life (HRQoL) was assessed with the EORTC QLQ-C30. Determinants of burdens were explored using logistic regression analysis. While cancer survivors' global HRQoL, physical and role function ratings were comparable or better than age- and sex-matched reference values of the general population, emotional and cognitive function was worse, especially among women (P < .01). Most frequently reported problems with at least moderate burden were loss of physical performance (36.3%), fatigue (35.1%), sexual problems (34.7%), sleep problems (34.1%), arthralgia (33.8%), anxiety (28.0%), neuropathy (25.6%), memory problems (23.0%) and concentration problems (21.9%). Burdened survivors often rated received support as poor, especially regarding support for problems that physicians might consider medically nonthreatening, or for which no effective pharmacologic or medical treatment is known. Determinants for burden included higher age, female gender, having ever received chemotherapy and overweight/obesity. In conclusion, a significant number of cancer survivors suffer from long-term or late effects and have unmet care needs. Awareness of health care professionals should be increased for these issues. The results of our study can contribute to the development of targeted survivorship plans.
癌症治疗正在付出巨大努力，生存率有了显著提高。然而，在不断增加的癌症幸存者群体中，针对长期问题和晚期效应的研究与护理状况并不令人满意。因此，在FiX调查中，我们询问了1348名在诊断出不同癌症类型约4年后无疾病的幸存者，让他们根据一份包含36个潜在问题的清单，对现有负担以及针对这些负担所获得的支持进行评分。使用欧洲癌症研究与治疗组织核心问卷（EORTC QLQ-C30）评估健康相关生活质量（HRQoL）。通过逻辑回归分析探索负担的决定因素。虽然癌症幸存者的总体HRQoL、身体和角色功能评分与年龄和性别匹配的一般人群参考值相当或更好，但情绪和认知功能较差，尤其是女性（P <.01）。报告负担至少为中度的最常见问题是身体机能丧失（36.3%）、疲劳（35.1%）、性问题（34.7%）、睡眠问题（34.1%）、关节痛（33.8%）、焦虑（28.0%）、神经病变（25.6%）、记忆问题（23.0%）和注意力不集中问题（21.9%）。负担较重的幸存者通常认为所获得的支持很差，特别是对于医生可能认为医学上无威胁的问题，或者对于尚无有效药物或医学治疗方法的问题所获得的支持。负担的决定因素包括年龄较大、女性、曾接受化疗以及超重/肥胖。总之，相当数量的癌症幸存者患有长期或晚期效应，且护理需求未得到满足。医疗保健专业人员应提高对这些问题的认识。我们的研究结果可为制定有针对性的幸存者计划做出贡献。
