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参与高危儿童癌症精准医学试验的儿童和青少年的生活质量

Quality of Life (QoL) of Children and Adolescents Participating in a Precision Medicine Trial for High-Risk Childhood Cancer.

作者信息

Hetherington Kate, Wakefield Claire E, Kunalan Kavitha P K, Donoghoe Mark W, McGill Brittany C, Fardell Joanna E, Daly Rebecca, Deyell Rebecca J, Ziegler David S

机构信息

Discipline of Paediatrics, School of Clinical Medicine, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia.

Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW 2031, Australia.

出版信息

Cancers (Basel). 2022 Oct 28;14(21):5310. doi: 10.3390/cancers14215310.

Abstract

Precision medicine is changing the treatment of childhood cancer globally, however little is known about quality of life (QoL) in children and adolescents participating in precision medicine trials. We examined QoL among patients enrolled in PRISM, the Zero Childhood Cancer Program's precision medicine trial for high-risk childhood cancer. We assessed patient QoL via self-report (aged 12-17 years) and parent-proxy (aged 4-17 years) completion of the EQ-5D-Y. We analysed data using descriptive statistics and regression models. Patients ( = 23) and parents ( = 136) provided data after trial enrolment and following receipt of trial results and treatment recommendations ( = 8 patients, = 84 parents). At enrolment, most patients were experiencing at least some difficulty across more than one QoL domain (81% patient self-report, 83% parent report). We did not find strong evidence of a change in QoL between timepoints, or of demographic or disease factors that predicted parent-reported patient QoL (EQ-VAS) at enrolment. There was strong evidence that receiving a treatment recommendation but not a change in cancer therapy was associated with poorer parent-reported patient QoL (EQ-VAS; Mdiff = -22.5, 95% CI: -36.5 to -8.5, = 0.006). Future research needs to better understand the relationship between treatment decisions and QoL and would benefit from integrating assessment of QoL into routine clinical care.

摘要

精准医疗正在全球范围内改变儿童癌症的治疗方式,然而,对于参与精准医疗试验的儿童和青少年的生活质量(QoL)却知之甚少。我们研究了参与PRISM(零儿童癌症计划针对高危儿童癌症的精准医疗试验)的患者的生活质量。我们通过自我报告(年龄在12 - 17岁)和家长代理报告(年龄在4 - 17岁)完成EQ - 5D - Y量表来评估患者的生活质量。我们使用描述性统计和回归模型分析数据。患者(n = 23)和家长(n = 136)在试验入组后以及收到试验结果和治疗建议后提供了数据(8名患者,84名家长)。入组时,大多数患者在不止一个生活质量领域至少经历了一些困难(81%患者自我报告,83%家长报告)。我们没有发现强有力的证据表明不同时间点之间生活质量有变化,也没有发现人口统计学或疾病因素能够预测入组时家长报告的患者生活质量(EQ - VAS)。有强有力的证据表明,收到治疗建议但癌症治疗没有改变与家长报告的患者生活质量较差相关(EQ - VAS;M差异=-22.5,95%置信区间:-36.5至-8.5,p = 0.006)。未来的研究需要更好地理解治疗决策与生活质量之间的关系,并且将生活质量评估纳入常规临床护理会有所助益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae37/9656810/ccfae542a6bc/cancers-14-05310-g002.jpg

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