School of Psychology, Sydney Quality of Life Office, The University of Sydney, Sydney, 2006, Australia.
Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands.
J Cancer Surviv. 2024 Oct;18(5):1640-1647. doi: 10.1007/s11764-023-01403-3. Epub 2023 Jun 6.
Colorectal cancer (CRC) is prevalent in the developed world, with unhealthy lifestyles and diet contributing to rising incidence. Advances in effective screening, diagnosis, and treatments have led to improved survival rates, but CRC survivors suffer poorer long-term gastrointestinal consequences than the general population. However, the current state of clinical practice around provision of health services and treatment options remains unclear.
We aimed to identify what supportive care interventions are available to manage gastrointestinal (GI) symptoms for CRC survivors.
We searched Cochrane Central Register of Controlled Trials, Embase, MEDLINE, PsycINFO, and CINAHL from 2000 to April 2022 for resources, services, programs, or interventions to address GI symptoms and functional outcomes in CRC. We extracted information about characteristics of supportive care interventions, the study design, and sample characteristics from included studies, and performed a narrative synthesis RESULTS: Of 3807 papers retrieved, seven met the eligibility criteria. Types of interventions for managing or improving GI symptoms included two rehabilitation, one exercise, one educational, one dietary, and one pharmacological. Pelvic floor muscle exercise may help to resolve GI symptoms more quickly in the post-operative recovery phase. Survivors may also benefit from rehabilitation programs through improved self-management strategies, especially administered soon after completing primary treatment.
CONCLUSIONS/IMPLICATIONS FOR CANCER SURVIVORS: Despite a high prevalence and burden of GI symptoms post-treatment, there is limited evidence for supportive care interventions to help manage or alleviate these symptoms. More, large-scale randomized controlled trials are needed to identify effective interventions for managing GI symptoms that occur post-treatment.
结直肠癌（CRC）在发达国家较为普遍，不健康的生活方式和饮食导致发病率上升。有效的筛查、诊断和治疗方法的进步提高了生存率，但 CRC 幸存者的长期胃肠道后果比一般人群更差。然而，目前围绕提供卫生服务和治疗选择的临床实践状况尚不清楚。
我们旨在确定有哪些支持性护理干预措施可用于管理 CRC 幸存者的胃肠道（GI）症状。
我们从 2000 年到 2022 年 4 月在 Cochrane 对照试验中心注册库、Embase、MEDLINE、PsycINFO 和 CINAHL 中搜索了资源、服务、计划或干预措施，以解决 CRC 中与 GI 症状和功能结果相关的问题。我们从纳入的研究中提取了支持性护理干预措施的特征、研究设计和样本特征信息，并进行了叙述性综合。
在 3807 篇论文中，有 7 篇符合纳入标准。用于管理或改善 GI 症状的干预措施类型包括 2 种康复、1 种运动、1 种教育、1 种饮食和 1 种药理学。骨盆底肌肉运动可能有助于在术后恢复阶段更快地解决 GI 症状。幸存者也可能通过改善自我管理策略从康复计划中受益，尤其是在完成主要治疗后立即实施。
结论/对癌症幸存者的影响：尽管治疗后 GI 症状的发生率和负担很高，但支持性护理干预措施来帮助管理或缓解这些症状的证据有限。需要更多的大规模随机对照试验来确定治疗治疗后发生的 GI 症状的有效干预措施。
