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癌症症状群、心血管风险与接受化疗癌症患者的生活质量:一项纵向初步研究。

Cancer symptom clusters, cardiovascular risk, and quality of life of patients with cancer undergoing chemotherapy: A longitudinal pilot study.

机构信息

Graduate Program in Nutrition and Health, Health Sciences Center at the Federal University of Espírito Santo (UFES), Vitoria, ES, Brazil.

Graduate Program in Public Health, Health Sciences Center at the Federal University of Espírito Santo (UFES), Vitoria, ES, Brazil.

出版信息

Medicine (Baltimore). 2024 Apr 19;103(16):e37819. doi: 10.1097/MD.0000000000037819.

Abstract

Patients with cancer undergoing chemotherapy may have different cancer symptom clusters (CSC) that negatively impact their quality of life (QoL). These symptoms can sometimes arise from the disease itself or as a result of their cancer treatment. This study aimed to: examine the feasibility of longitudinal testing of CSC pattern and QoL in a sample of adult cancer patients undergoing outpatient chemotherapy; to identify the cardiovascular risk of patients with cancer undergoing outpatient chemotherapy; and to investigate the most prevalent CSC and their impact on the QoL of these patients. A longitudinal pilot study was conducted with eleven participants with a mean age of 56.09 years (range: 27-79) diagnosed with malignant neoplasm and undergoing outpatient chemotherapy treatment were evaluated during 6 cycles of chemotherapy. The CSC, cardiovascular risk, and QoL were assessed using the MSAS, FRS, and EQ-5D-3L™, respectively. Descriptive statistical and non-parametric bivariate analyses were performed. Patients who started chemotherapy treatment generally had a low to moderate cardiovascular risk and were likely to have a family history of hypertension, acute myocardial infarction, and stroke. Cardiovascular risk was found to be correlated with patient age (Rhos = 0.64; P = .033). In addition, the results showed a reduction in the QoL scoring over the 6 chemotherapy sessions. Regarding the most prevalent CSC, 2 clusters were identified: the neuropsychological symptom cluster (difficulty concentrating-sadness-worry) and the fatigue-difficulty sleeping cluster. Between the first and sixth chemotherapy sessions, there was a decrease in the perception of "mild" severity (P = .004) and an increase in the perception of "severe" and "very severe" (P = .003) for all symptoms. Adequate attention to CSC should be the basis for the accurate planning of effective interventions to manage the symptoms experienced by cancer patients.

摘要

正在接受化疗的癌症患者可能会出现不同的癌症症状群(CSC),这些症状群会对他们的生活质量(QoL)产生负面影响。这些症状有时可能是由疾病本身引起的,也可能是由于癌症治疗引起的。本研究旨在:在接受门诊化疗的成年癌症患者样本中,检验 CSC 模式和 QoL 的纵向测试的可行性;确定接受门诊化疗的癌症患者的心血管风险;并调查最常见的 CSC 及其对这些患者生活质量的影响。采用纵向试点研究,对 11 名平均年龄为 56.09 岁(范围:27-79)的恶性肿瘤诊断和接受门诊化疗治疗的患者进行了评估,在 6 个化疗周期中进行了评估。使用 MSAS、FRS 和 EQ-5D-3L™ 分别评估 CSC、心血管风险和 QoL。进行了描述性统计和非参数双变量分析。开始化疗治疗的患者一般具有低至中度的心血管风险,并且可能有高血压、急性心肌梗死和中风的家族史。心血管风险与患者年龄相关(Rhos = 0.64;P = 0.033)。此外,结果表明在 6 个化疗疗程中 QoL 评分降低。关于最常见的 CSC,确定了 2 个聚类:神经心理症状聚类(注意力集中困难-悲伤-忧虑)和疲劳-睡眠困难聚类。在第 1 次和第 6 次化疗期间,所有症状的“轻度”严重程度均降低(P = 0.004),“重度”和“非常重度”的严重程度增加(P = 0.003)。应充分关注 CSC,为准确规划有效干预措施提供依据,以管理癌症患者所经历的症状。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9697/11029927/a4cfffb0b9a2/medi-103-e37819-g001.jpg

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