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