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通过骨转移癌委会评估保守治疗的骨转移患者日常生活活动能力和生活质量的变化。

Evaluation of Changes in Activities of Daily Living and Quality of Life of Patients with Bone Metastasis Who Underwent Conservative Therapy through Bone Metastasis Cancer Boards.

机构信息

Department of Physical Medicine and Rehabilitation, Kobe University Hospital 7-5-2, Kusunoki-cho, Chuo-ku, Kobe 650-0017, Hyogo, Japan.

Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine 7-5-2, Kusunoki-cho, Chuo-ku, Kobe 650-0017, Hyogo, Japan.

出版信息

Medicina (Kaunas). 2024 May 29;60(6):906. doi: 10.3390/medicina60060906.

Abstract

: Changes in activities of daily living (ADL) and quality of life (QOL) of patients with bone metastasis who underwent surgical treatment through Bone Metastasis Cancer Boards (BMCBs), a recent multidisciplinary approach for managing bone metastases, have been reported; however, no reports exist on patients who undergo conservative treatment. In this study, we aimed to evaluate these patients' ADL and QOL and examine the factors influencing changes in these parameters. : We retrospectively reviewed 200 patients with bone metastases who underwent conservative therapy through BMCBs between 2013 and 2021. A reassessment was conducted within 2-8 weeks after the initial assessment. Patients' background and changes in performance status (PS), Barthel Index (BI), EuroQol five-dimension (EQ-5D) scores, and Numerical Rating Scale (NRS) scores were initially assessed. Furthermore, we categorized patients into two groups based on improvements or deteriorations in ADL and QOL and performed comparative analyses. : Significant improvements in EQ-5D (0.57 ± 0.02 versus [vs.] 0.64 ± 0.02), NRS max (5.21 ± 0.24 vs. 3.56 ± 0.21), and NRS average (2.98 ± 0.18 vs. 1.85 ± 0.13) scores were observed between the initial assessment and reassessment (all < 0.001). PS (1.84 ± 0.08 vs. 1.72 ± 0.08) and BI (83.15 ± 1.68 vs. 84.42 ± 1.73) also showed improvements ( = 0.06, and 0.054, respectively). In addition, spinal cord paralysis (odds ratio [OR]: 3.69, = 0.049; OR: 8.42, < 0.001), chemotherapy (OR: 0.43, = 0.02; OR: 0.25, = 0.007), and NRS average scores (OR: 0.38, = 0.02; OR: 0.14, < 0.001) were independent factors associated with ADL and QOL. : Patients with bone metastases who underwent conservative treatment through BMCBs exhibited an increase in QOL without a decline in ADL. The presence of spinal cord paralysis, absence of chemotherapy, and poor pain control were associated with a higher risk of deterioration in ADL and QOL.

摘要

患者的日常生活活动(ADL)和生活质量(QOL)变化的骨转移,谁接受了手术治疗,通过骨转移癌症委员会(BMCBs),最近的多学科方法来管理骨转移,已经报道;然而,没有报告的患者谁接受保守治疗。在这项研究中,我们旨在评估这些患者的 ADL 和 QOL,并研究影响这些参数变化的因素。

我们回顾性分析了 200 例 2013 年至 2021 年期间通过 BMCBs 接受保守治疗的骨转移患者。在初始评估后 2-8 周内进行了重新评估。评估了患者的背景以及表现状态(PS)、Barthel 指数(BI)、EuroQol 五维(EQ-5D)评分和数字评定量表(NRS)评分的变化。此外,我们根据 ADL 和 QOL 的改善或恶化将患者分为两组,并进行了比较分析。

在初始评估和重新评估之间,EQ-5D(0.57 ± 0.02 对 [vs.] 0.64 ± 0.02)、NRS max(5.21 ± 0.24 对 3.56 ± 0.21)和 NRS 平均(2.98 ± 0.18 对 1.85 ± 0.13)评分均显著改善(均 < 0.001)。PS(1.84 ± 0.08 对 1.72 ± 0.08)和 BI(83.15 ± 1.68 对 84.42 ± 1.73)也有所改善(= 0.06 和 0.054)。此外,脊髓瘫痪(优势比[OR]:3.69,= 0.049;OR:8.42,< 0.001)、化疗(OR:0.43,= 0.02;OR:0.25,= 0.007)和 NRS 平均评分(OR:0.38,= 0.02;OR:0.14,< 0.001)是与 ADL 和 QOL 相关的独立因素。

接受 BMCBs 保守治疗的骨转移患者 QOL 提高而 ADL 无下降。脊髓瘫痪、无化疗和疼痛控制不良与 ADL 和 QOL 恶化的风险增加相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e494/11205938/8e05b34b779c/medicina-60-00906-g001.jpg

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