Expert review of quality of life in cancer care最新文献

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Expert review of quality of life in cancer care

Pub Date : 2016-01-02 DOI: 10.1080/23809000.2016.1136793

L. Dirven, J. Koekkoek, J. Reijneveld, M. Taphoorn

ABSTRACT Health-related quality of life (HRQoL) plays a role as a (secondary) endpoint in clinical trials for brain tumor patients as well as in daily clinical practice. HRQoL can be classified as a patient-centered endpoint, assessing a direct clinical benefit for the patient. Although HRQoL is a meaningful endpoint because it reflects the patient’s perspective, several methodological concerns raise doubt over the appropriateness of HRQoL as an endpoint in trials. HRQoL could possibly be considered as co-primary endpoint in future trial designs, together with a surrogate endpoint such as progression-free survival, to ensure that both a direct treatment effect and a direct clinical benefit for the patient will be assessed. Routine assessment of HRQoL has proven to be feasible in clinical practice and was found to facilitate the communication between patients and physicians. However, despite discussion of HRQoL issues, so far this did not have an impact on patient management and clinical decisions.

健康相关生活质量(HRQoL)在脑肿瘤患者的临床试验和日常临床实践中扮演着(次要)终点的角色。HRQoL可归类为以患者为中心的终点，评估患者的直接临床获益。虽然HRQoL是一个有意义的终点，因为它反映了患者的观点，但一些方法学上的问题对HRQoL作为试验终点的适宜性提出了质疑。在未来的试验设计中，HRQoL可能会被视为共同的主要终点，以及替代终点，如无进展生存期，以确保对患者的直接治疗效果和直接临床获益进行评估。HRQoL的常规评估在临床实践中已被证明是可行的，并被发现有助于患者与医生之间的沟通。然而，尽管讨论了HRQoL问题，但到目前为止，这还没有对患者管理和临床决策产生影响。

引用次数: 14

Opioid induced constipation in cancer patients: pathophysiology, diagnosis and treatment 阿片类药物致癌症患者便秘:病理生理、诊断与治疗

Expert review of quality of life in cancer care

Pub Date : 2016-01-02 DOI: 10.1080/23809000.2016.1131595

A. Rumman, Z. Gallinger, L. Liu

ABSTRACT Opioid-induced constipation (OIC) has emerged as a major contributor to morbidity in cancer patients. OIC is common, difficult to treat and causes significant reductions in the quality-of-life of cancer patients. It results from opioid action on gut mu-receptors, which leads to the disruption of bowel motility, mucosal transport and defecation reflexes. Laxatives are cornerstone in the management of OIC despite their relatively limited effectiveness and lack of strong evidence supporting their use. In the past few years, novel therapeutics have emerged for the management of OIC. These include; prokinetic agents, peripherally-acting mu-opioid receptor antagonists (PAMORAs), secretagogues and opioid receptor agonist/antagonist combination tablets. This article will review the mechanism of OIC in cancer patients and describe the novel therapeutic options for its prevention and management.

阿片类药物引起的便秘(OIC)已成为癌症患者发病率的主要因素。OIC很常见，难以治疗，并导致癌症患者的生活质量显著下降。它是由阿片类药物作用于肠道受体，导致肠蠕动、粘膜运输和排便反射的破坏引起的。泻药是OIC管理的基石，尽管其有效性相对有限且缺乏强有力的证据支持其使用。在过去的几年里，新的治疗方法出现了OIC的管理。这些包括;促动力剂，外周作用mu-阿片受体拮抗剂(PAMORAs)，促分泌剂和阿片受体激动剂/拮抗剂联合片。本文将回顾癌症患者OIC的发生机制，并介绍其预防和管理的新治疗方案。

引用次数: 19

Improving quality-of-life questionnaires in head and neck cancer 改进头颈癌患者的生活质量调查问卷

Expert review of quality of life in cancer care

Pub Date : 2016-01-02 DOI: 10.1080/23809000.2016.1142357

S. Rogers

ABSTRACT Questionnaires are an established means of quantifying health-related quality of life (HRQOL) following head and neck cancer. Questionnaires have evolved over many decades. Validated measures are now readily available to assess the physical/functional, emotional, and social impact of cancer and its treatment. The purpose of this article is to briefly reflect upon the current position and potential future improvements in questionnaire design and clinical utility. The basis for the observations stem from the literature between 1982 and 2014 as contained at the ‘Handle on QOL’ website. Advances over the next five years will relate to the how, when, where and frequency of questionnaire completion, in addition to improved sophistication of analysis and data presentation, underpinned by the improved use of information technology.

问卷调查是量化头颈癌患者健康相关生活质量(HRQOL)的一种既定方法。调查问卷已经发展了几十年。现在已经有了有效的措施来评估癌症及其治疗对身体/功能、情感和社会的影响。本文的目的是简要地反映目前的地位和潜在的未来改进的问卷设计和临床应用。这些观察的基础来自1982年至2014年间的文献，这些文献包含在“生活质量处理”网站上。今后五年的进展将涉及完成调查表的方式、时间、地点和频率，以及在改进使用信息技术的基础上提高分析和数据提出的复杂性。

引用次数: 21

Physical activity and quality of life after colorectal cancer: overview of evidence and future directions 结直肠癌后的身体活动和生活质量:证据综述和未来方向

Expert review of quality of life in cancer care

Pub Date : 2016-01-02 DOI: 10.1080/23809000.2016.1129902

B. Lynch, E. V. van Roekel, J. Vallance

ABSTRACT Physical activity has been demonstrated to be a safe, feasible and efficacious intervention to improve quality of life in cancer survivors. For colorectal cancer survivors, specifically, the evidence is less clear. Whilst observational studies suggest that physical activity is positively associated with quality of life in this population, the findings from intervention trials have predominantly been null. Methodological limitations of the intervention trials to date may partially explain these findings. Future research will benefit from the use of objective activity monitoring, which will allow researchers to examine the contributions towards quality of life across the full activity spectrum (from sedentary behaviour to vigorous-intensity physical activity). Future research should also consider effects within population subgroups and study underlying biological mechanisms.

体育活动已被证明是一种安全、可行和有效的干预措施，可改善癌症幸存者的生活质量。具体来说，对于结直肠癌幸存者来说，证据还不太清楚。虽然观察性研究表明，体育活动与这一人群的生活质量呈正相关，但干预试验的结果基本上是无效的。迄今为止干预试验的方法学局限性可能部分解释了这些发现。未来的研究将受益于客观活动监测的使用，这将使研究人员能够检查整个活动范围(从久坐行为到高强度体育活动)对生活质量的贡献。未来的研究还应考虑人口亚群内的影响，并研究潜在的生物学机制。

引用次数: 30

Expert review of quality of life in cancer care

Pub Date : 2016-01-02 DOI: 10.1080/23809000.2016.1134259

E. Hahn, E. Segawa, K. Kaiser, D. Cella, Benjamin D. Smith

ABSTRACT Objectives: To examine the reliability and validity of the Functional Assessment of Cancer Therapy-Breast (FACT-B) Version 4. Methods: Women ≥ 40 years with DCIS or early invasive breast cancer treated with whole breast irradiation (n=280) completed patient-reported outcome measures at three time points. Results: Most internal consistency reliability coefficients were 0.70 or greater. At baseline and 6 months, mean FACT-B scores were comparable between physician-reported cosmetic outcome subgroups; at 12 months, most scores were higher (better) for the “excellent” cosmesis group compared to “poor/fair/good” (p<0.05). Most mean FACT-B scores were higher for those with Grade 0-1 CTCAE toxicities versus Grade 2-3 (p<0.05). There were medium to large correlations between the FACT-B and the Body Image Scale. Most FACT-B mean scores were significantly different across BIS change groups (p<0.05). Conclusions: The FACT-B exhibited good reliability and validity in this sample of 280 women treated for DCIS and early invasive breast cancer.

目的:检验Cancer Therapy-Breast功能评估(FACT-B) Version 4的信度和效度。方法:年龄≥40岁的DCIS或早期浸润性乳腺癌接受全乳照射治疗的女性(n=280)在三个时间点完成了患者报告的结果测量。结果:大部分内部一致性信度系数大于等于0.70。在基线和6个月时，医生报告的美容结果亚组之间的平均FACT-B评分具有可比性;在12个月时，“优秀”化妆组的大多数评分高于“差/一般/良好”化妆组(p<0.05)。0-1级CTCAE毒性患者的平均FACT-B评分高于2-3级CTCAE毒性患者(p<0.05)。在FACT-B和身体形象量表之间存在中等到较大的相关性。大多数FACT-B平均评分在BIS变化组之间差异有统计学意义(p<0.05)。结论:在280名接受DCIS和早期浸润性乳腺癌治疗的女性样本中，FACT-B显示出良好的信度和效度。

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引用次数: 18

The role of interventional oncology in the palliative care of cancer patients 介入肿瘤学在癌症患者姑息治疗中的作用

Expert review of quality of life in cancer care

Pub Date : 2016-01-02 DOI: 10.1080/23809000.2016.1142358

David Li, Syed Hussaini, Josephine Kang, D. Madoff

ABSTRACT Interventional oncologists have expertise in delivery of state of the art, minimally invasive, image-guided procedures. As such, interventional oncologists are well-suited to provide palliative options for cancer patients, who often have complex comorbidities precluding them from more invasive options. The broad spectrum of procedures developed into clinical practice highlight the integral role of interventional oncology in the palliation of cancer patients. This review will focus on several of the more common procedures performed by interventional oncologists to provide symptomatic relief: 1. Tunneled peritoneal or pleural catheter placement for fluid drainage; Peritoneovenous shunt placement for fluid drainage; 2. Ablation with focus on metastatic bone ablation for pain control; 3. Neurolysis with focus on celiac neurolysis for pain control; 4. Decompressive gastrostomies or cecostomies for gastric and bowel obstruction; 5. Trans-arterial embolization for uncontrolled hemorrhage. A description of each procedure and its relative efficacy in providing palliation will be summarized.

介入肿瘤学家在提供最先进的、微创的、图像引导的手术方面具有专业知识。因此，介入肿瘤学家非常适合为癌症患者提供姑息治疗选择，这些患者通常有复杂的合并症，使他们无法进行更有侵略性的选择。广泛的程序发展到临床实践中，突出了介入肿瘤学在缓解癌症患者方面不可或缺的作用。本综述将重点介绍介入肿瘤学家为缓解症状而进行的几种更常见的手术:放置隧道式腹膜或胸膜导尿管引流液体;放置腹膜静脉分流液引流;2. 消融，重点转移性骨消融治疗疼痛控制;3.神经松解术，重点是乳糜泻神经松解术的疼痛控制;4. 减压胃造口术或腹腔造口术治疗肠梗阻;5. 经动脉栓塞治疗无法控制的出血。每个程序的描述及其在提供姑息方面的相对功效将被总结。

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引用次数: 5

The management of malignant ascites and impact on quality of life outcomes in women with ovarian cancer. 卵巢癌妇女恶性腹水的处理及其对生活质量的影响。

Expert review of quality of life in cancer care

Pub Date : 2016-01-01 Epub Date: 2016-05-27 DOI: 10.1080/23809000.2016.1185369

Larissa Meyer, Rudy Suidan, Charlotte Sun, Shannon Westin, Robert L Coleman, Gordon B Mills

Malignant ascites is one of the most common sequela of epithelial ovarian cancer. It causes significant symptoms and can have a detrimental impact on patient quality of life, especially in women with recurrent ovarian cancer. The management of symptomatic ascites consists of both mechanical treatments that aim to drain the peritoneal cavity, and medical therapies that prevent and diminish the development of ascites. Mechanical options include serial paracentesis, peritoneal catheters, and peritoneovenous shunts. Pharmaceutical treatments include diuretics, angiogenesis inhibitors, and other targeted agents. There is a perception, without formal analysis, that intractable ascites is less common in the taxane era of therapy. In this review paper, we highlight current and emerging therapeutic strategies, complications and contraindications, and their effects on patient quality of life.

恶性腹水是上皮性卵巢癌最常见的后遗症之一。它会导致严重的症状，对患者的生活质量产生不利影响，尤其是对于复发性卵巢癌患者。无症状腹水的治疗包括旨在排出腹腔积水的机械治疗和预防及减少腹水发生的药物治疗。机械疗法包括连续腹腔穿刺术、腹膜导管和腹腔静脉分流术。药物治疗包括利尿剂、血管生成抑制剂和其他靶向药物。有一种未经正式分析的观点认为，难治性腹水在紫杉类药物治疗时代并不常见。在这篇综述论文中，我们将重点介绍当前和新出现的治疗策略、并发症和禁忌症，以及它们对患者生活质量的影响。

引用次数: 0

The Etiology and management of radiotherapy-induced fatigue. 放射治疗性疲劳的病因及处理。

Expert review of quality of life in cancer care

Pub Date : 2016-01-01 Epub Date: 2016-06-07 DOI: 10.1080/23809000.2016.1191948

Chao-Pin Hsiao, Barbara Daly, Leorey N Saligan

Fatigue is one of the most common side-effects accompanying radiotherapy, but arguably the least understood. Radiotherapy-induced fatigue (RIF) is a clinical subtype of cancer treatment-related fatigue. It is described as a pervasive, subjective sense of tiredness persisting over time, interferes with activities of daily living, and is not relieved by adequate rest or sleep. RIF is one of the early side-effects and long-lasting for cancer patients treated with localized radiation. Although the underlying mechanisms of fatigue have been studied in several disease conditions, the etiology, mechanisms, and risk factors of RIF remain elusive, and this symptom remains poorly managed. The purpose of this paper is to review and discuss recent articles that defined, proposed biologic underpinnings and mechanisms to explain the pathobiology of RIF, as well as articles that proposed interventions to manage RIF. Understanding the mechanisms of RIF can describe promising pathways to identify at-risk individuals and identify potential therapeutic targets to alleviate and prevent RIF using a multimodal, multidisciplinary approach.

疲劳是伴随放射治疗的最常见的副作用之一，但可以说是最不为人所知的。放射治疗性疲劳(RIF)是癌症治疗相关性疲劳的临床亚型。它被描述为一种普遍的、主观的疲劳感，持续一段时间，干扰日常生活活动，并且不能通过充分的休息或睡眠来缓解。RIF是局部放射治疗的癌症患者的早期副作用之一，并且持续时间长。虽然疲劳的潜在机制已经在几种疾病条件下进行了研究，但RIF的病因、机制和危险因素仍然难以捉摸，而且这种症状仍然管理不善。本文的目的是回顾和讨论最近的文章，这些文章定义了RIF，提出了生物学基础和机制来解释RIF的病理生物学，以及提出干预措施来管理RIF的文章。了解RIF的机制可以描述有希望的途径来识别高危个体，并通过多模式、多学科的方法确定潜在的治疗靶点，以减轻和预防RIF。

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引用次数: 26

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