接受联合模式治疗的直肠癌患者健康相关生活质量的时间进程

IF 2.7 3区 医学 Q3 ONCOLOGY Clinical and Translational Radiation Oncology Pub Date : 2024-07-26 DOI:10.1016/j.ctro.2024.100824
Valentina Tesio , Agata Benfante , Pierfrancesco Franco , Annunziata Romeo , Francesca Arcadipane , Giuseppe Carlo Iorio , Sara Bartoncini , Lorys Castelli
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引用次数: 0

摘要

背景和目的这项探索性前瞻性观察研究调查了直肠癌患者(RCPs)从确诊到术后一年随访期间健康相关生活质量(HRQoL)的变化,并探讨了不同时间点身体症状和心理因素对 HRQoL 的影响。材料和方法我们在三个不同的评估时间点:诊断(T0)、术前治疗结束后一个月(T1)、切除手术后一个月(T2)和随访(T3),评估了 43 名接受术前(化疗)放疗和手术治疗的 RCP 的 HRQoL、心理困扰、应对、情感、自闭症和社会支持。结果数据显示,HRQoL 在积极治疗期间下降,尤其是在 T1 和 T2 之间(p = 0.005),然后在随访时再次上升(p = 0.002)。T1时的基线疼痛(p < 0.001)、肠道症状(p = 0.003)和泌尿系统症状(p = 0.009)对T1时的HRQoL有明显的预测作用。T1 时的宿命应对方式(p = 0.013)、T2 时的心理困扰(p = 0.003)和口腔症状(p = 0.001)可显著预测 T2 时的 HRQoL。同样,T1 时的宿命论应对方式(p = 0.006)、T3 时的心理困扰(p = 0.004)、口腔症状(p = 0.002)和疼痛症状(p = 0.002)也能显著预测 T3 时的 HRQoL。这些数据强调了积极筛查、早期诊断和诊断后立即进行预防性心理干预对改善 HRQoL 和心理健康结果的重要性。
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The time course of health-related Quality of Life in rectal cancer patients undergoing combined modality treatment

Background and purpose

This exploratory prospective observational study investigated the changes in Health-related Quality of Life (HRQoL) in rectal cancer patients (RCPs), from diagnosis to one-year-post-surgery follow-up and explored the role of physical symptoms and psychological determinants on HRQoL at the different time points.

Materials and methods

We assessed HRQoL, psychological distress, coping, affectivity, alexithymia and social support in 43 RCPs treated with preoperative (chemo)radiation and surgery, at three different assessment time points: diagnosis (T0), one month after the end of preoperative treatment (T1), one month after resection surgery (T2), and at follow-up (T3).

Results

The data showed that HRQoL decreased during active treatments, especially between T1 and T2 (p = 0.005), before increasing again at follow-up (p = 0.002).

Baseline intestinal symptoms (p < 0.001) and negative affectivity trait (p = 0.03) significantly predicted HRQoL at T0. Baseline pain (p < 0.001), intestinal (p = 0.003) and urinary (p = 0.009) symptoms at T1 significantly predicted HRQoL at T1. A fatalistic coping style at T1 (p = 0.013), psychological distress (p = 0.003), mouth symptoms (p = 0.001) at T2 significantly predicted HRQoL at T2. Similarly, a fatalistic coping style at T1 (p = 0.006), psychological distress (p = 0.004), mouth (p = 0.002) and pain symptoms (p = 0.002) at T3 significantly predicted HRQoL at T3.

Conclusion

Several physical and psychological factors are involved in the changes occurring after diagnosis in RCPs’ HRQoL. While cancer-related symptoms and treatment-related physical side effects are the main predictors of HRQoL at diagnosis and during active treatments, early psychological reactions have a higher predictive weight in post-treatment HRQoL.

These data emphasise the importance of active screening, early diagnosis, and preventive psychological interventions immediately after diagnosis to improve HRQoL and psychological health outcomes.

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来源期刊
Clinical and Translational Radiation Oncology
Clinical and Translational Radiation Oncology Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
5.30
自引率
3.20%
发文量
114
审稿时长
40 days
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