Kunni Kristin, Langegård Ulrica, Ohlsson-Nevo Emma, Kristensen Ingrid, Sjövall Katarina, Fessé Per, Åkeflo Linda, Ahlberg Karin, Fransson Per
Skandion Clinic, Uppsala, Sweden.
Department of Nursing, Umeå University, Umeå, Sweden.
Tech Innov Patient Support Radiat Oncol. 2024 Aug 16;31:100269. doi: 10.1016/j.tipsro.2024.100269. eCollection 2024 Sep.
Since patients with primary brain tumor are expected to become long-term survivors, the prevention of long-term treatment-induced side effects is particularly important. This study aimed to explore whether symptom experience and symptom distress change over five years in adults with primary brain tumors treated with proton therapy. An additional aim was to explore whether symptom experience and symptom distress correlate.
The study had a longitudinal observational design. Adult (≥18 years) patients (n = 170) with primary brain tumors treated with proton therapy were followed over five years. Symptom experience and symptom distress were evaluated using the patient-reported Radiotherapy-Related Symptom Assessment Scale. Data from baseline, 1, 12, and 60 months were analyzed using non-parametric tests.
Of the 170 patients, the levels of symptoms and symptom distress were low. Fatigue increased at 1 (p=0.005) and 12 months (p=0.025) and was the most frequent symptom from baseline to 60 months' follow-up. Cognitive impairment increased at 12 (p=0.027) and 60 months (p<0.001) and was the most distressing symptom at 60 months' follow-up. There were significant, moderate to strong, correlations at all time points between symptom experience and symptom distress of fatigue, insomnia, pain, dyspnea, cognitive impairment, worry, anxiety, nausea, sadness, constipation, and skin reactions.
Symptom experience and symptom distress changed in intensity over time with cognitive impairment as the most distressing symptom at 60 months. Future research should focus on identifying effective interventions aimed at alleviating these symptoms and reducing symptom distress for this vulnerable group of patients.
鉴于原发性脑肿瘤患者有望成为长期幸存者，预防长期治疗引起的副作用尤为重要。本研究旨在探讨接受质子治疗的原发性脑肿瘤成年患者在五年内症状体验和症状困扰是否发生变化。另一个目的是探讨症状体验与症状困扰是否相关。
本研究采用纵向观察设计。对170例接受质子治疗的成年（≥18岁）原发性脑肿瘤患者进行了为期五年的随访。使用患者报告的放疗相关症状评估量表评估症状体验和症状困扰。使用非参数检验分析基线、1个月、12个月和60个月的数据。
在170例患者中，症状和症状困扰水平较低。疲劳在1个月（p = 0.005）和12个月（p = 0.025）时增加，并且从基线到60个月随访期间是最常见的症状。认知障碍在12个月（p = 0.027）和60个月（p < 0.001）时增加，并且在60个月随访时是最令人困扰的症状。在所有时间点，疲劳、失眠、疼痛、呼吸困难、认知障碍、担忧、焦虑、恶心、悲伤、便秘和皮肤反应的症状体验与症状困扰之间存在显著的、中度到高度的相关性。
症状体验和症状困扰的强度随时间变化，认知障碍是60个月时最令人困扰的症状。未来的研究应侧重于确定有效的干预措施，以减轻这些症状并减少这一弱势群体患者的症状困扰。
