Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan.
Pathophysiology and Bioregulation, St. Marianna University Graduate School of Medicine, Kawasaki, Japan.
J Obstet Gynaecol Res. 2024 Jan;50(1):75-85. doi: 10.1111/jog.15811. Epub 2023 Oct 18.
Gynecologic cancer chemotherapy impacts the quality of life (QOL) of patients, with lasting adverse events that may require treatment adjustments or discontinuation. Consequently, real-time symptom monitoring before outpatient visits has resulted in improved QOL for patients and extended survival times. This study investigated whether there are differences between electronic patient-reported outcomes (e-PRO-CTCAE) and physician-assessed outcomes (NCI-CTCAE) evaluated in an outpatient setting in gynecologic cancer chemotherapy.
The study was conducted on 50 patients who received their first chemotherapy treatment at St. Marianna University Hospital Obstetrics and Gynecology from July 1, 2021 to December 31, 2022. PRO-CTCAE and NCI-CTCAE were evaluated at each instance of chemotherapy and 2 weeks after. The PRO-CTCAE was additionally collected weekly using e-PRO.
The values for "Joint Pain," "Nausea," "Taste Disturbance," "Constipation," "Insomnia," "Fatigue," "Limb Edema," and "Concentration Impairment" were consistently higher in PRO-CTCAE than in NCI-CTCAE, indicating that physicians underestimated the severity of adverse events. In contrast, there was no significant difference in "Peripheral Neuropathy," demonstrating that physicians had a good understanding of this condition in patients. The weekly responses obtained from e-PRO revealed that symptom exacerbations peaked outside of clinic visits.
This study demonstrated physicians tend to underestimate most adverse events. Moreover, the responses using e-PRO revealed peak symptom deterioration occurred outside of outpatient visits. This suggested that e-PRO and actions taken in response to them can improve patients' QOL.
妇科癌症化疗会影响患者的生活质量（QOL），且会产生持久的不良反应，这可能需要调整或停止治疗。因此，在门诊就诊前进行实时症状监测，可改善患者的 QOL 并延长生存时间。本研究旨在探讨妇科癌症化疗门诊环境中电子患者报告结局（e-PRO-CTCAE）和医生评估结局（NCI-CTCAE）是否存在差异。
该研究纳入了 2021 年 7 月 1 日至 2022 年 12 月 31 日在圣玛丽安娜大学医院妇产科接受首次化疗的 50 例患者。在每次化疗时和化疗后 2 周评估 PRO-CTCAE 和 NCI-CTCAE。此外，每周还通过 e-PRO 额外收集 PRO-CTCAE。
与 NCI-CTCAE 相比，PRO-CTCAE 中的“关节痛”、“恶心”、“味觉障碍”、“便秘”、“失眠”、“乏力”、“肢体水肿”和“注意力障碍”的评分更高，表明医生低估了不良反应的严重程度。相比之下，“周围神经病变”的评分无显著差异，表明医生对患者的这种情况有较好的了解。e-PRO 每周的应答显示，症状恶化在就诊之外的时间达到峰值。
本研究表明，医生往往会低估大多数不良反应。此外，e-PRO 的应答结果显示，就诊之外的时间症状恶化达到峰值。这表明 e-PRO 及其应对措施可改善患者的 QOL。
