癌症治疗对性健康的影响 - EORTC QLQ-SH22 验证研究的临床结果。
The impact of curative cancer treatment on sexual health - clinical results from the EORTC QLQ-SH22 validation study.
机构信息
Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria.
Department of Radiotherapy, University Hospital Schleswig-Holstein, Campus Kiel, Germany.
出版信息
BMC Cancer. 2024 Nov 11;24(1):1374. doi: 10.1186/s12885-024-13123-7.
BACKGROUND
The European Organization of Research and Treatment of Cancer (EORTC) has recently developed and validated a patient-reported outcome measure (PROM) for sexual health (SH) in cancer patients. Here, we present results from a secondary analysis of the EORTC QLQ-SH22 validation study. The objective was to investigate the impact of cancer treatment on SH over the disease trajectory into survivorship in patients who underwent curative treatment.
METHODS
Participants completed the EORTC QLQ-SH22 and the EORTC QLQ-C30 assessing SH and Quality of Life. We analyzed differences in SH of patients on active cancer treatment compared to patients off-treatment (cross sectional group comparison) as well as changes in SH during the course of treatment (from pre-treatment to follow-up).
RESULTS
Our sample consisted of n = 394 (66.2% females) curatively treated cancer patients with 34% of patients being on-treatment and 66% of patients being in their follow-up after primary treatment (off-treatment group). Compared to patients off- treatment, patients on active cancer treatment experienced less sexual satisfaction (p = .021, Cohen's d = .36) and libido (p < .001, d = .60) and had higher levels of fatigue (p < .001, d = .50). Importance of sexual activity, masculinity and femininity did not differ between groups. Treatment effects on sexual activity decreased with treatment completion (p < .001, d = .50). Patients undergoing intensified treatment (chemotherapy, radiation, or endocrine treatment) reported more treatment effects (subscale EORTC QLQ-SH22) compared to patients undergoing surgery only.
CONCLUSION
Our results highlight the negative impact of oncological treatment on SH and how increasing treatment intensity further impair SH. Sexual satisfaction and libido improve after treatment completion while other aspects (e.g. masculinity/femininity) do not change during survivorship. We suggest monitoring of SH from the start of cancer treatment on and beyond into survivorship using PROMs as part of routine cancer care. Routine monitoring allows systematic identification of patient's SH problems and may improve awareness as well as target intervention for those in need of care.
背景
欧洲癌症研究与治疗组织（EORTC）最近开发并验证了一种针对癌症患者的患者报告结局测量工具（PROM），用于评估其性功能健康（SH）。在此，我们呈现 EORTC QLQ-SH22 验证研究的二次分析结果。本研究的目的是调查接受根治性治疗的患者在疾病轨迹进入生存阶段时，癌症治疗对 SH 的影响。
方法
参与者完成了 EORTC QLQ-SH22 和 EORTC QLQ-C30，以评估 SH 和生活质量。我们分析了处于活跃癌症治疗中的患者与治疗结束的患者（横断面组比较）的 SH 差异，以及在治疗过程中（从治疗前到随访）SH 的变化。
结果
我们的样本包括 n=394 名接受根治性治疗的癌症患者（66.2%为女性），其中 34%的患者正在接受治疗，66%的患者在原发性治疗后处于随访阶段（治疗结束组）。与治疗结束的患者相比，正在接受癌症治疗的患者在性满意度（p=0.021，Cohen's d=0.36）和性欲（p<0.001，d=0.60）方面的得分较低，且疲劳感较高（p<0.001，d=0.50）。两组患者在性活动的重要性、男子气概和女性气质方面没有差异。随着治疗的完成，治疗对性活动的影响会降低（p<0.001，d=0.50）。接受强化治疗（化疗、放疗或内分泌治疗）的患者比仅接受手术治疗的患者报告的治疗影响（EORTC QLQ-SH22 子量表）更多。
结论
我们的研究结果强调了肿瘤治疗对 SH 的负面影响，以及治疗强度的增加如何进一步损害 SH。治疗完成后，性满意度和性欲会有所改善，而其他方面（如男子气概/女性气质）在生存阶段不会改变。我们建议使用 PROM 从癌症治疗开始监测 SH，并将其延伸到生存阶段，作为常规癌症护理的一部分。常规监测可以系统地识别患者的 SH 问题，并可能提高对需要护理的患者的认识和针对性干预。
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