晚期肺癌姑息放疗过程中患者症状自我管理经验的描述和影响因素:系统综述

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS ACS Applied Bio Materials Pub Date : 2024-08-22 DOI:10.1016/j.apjon.2024.100577
Saengrawee Thanthong , Grigorios Kotronoulas , Bridget Johnston
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引用次数: 0

摘要

目的姑息性胸部放疗是晚期肺癌症状控制的关键治疗方案。持续的症状监测对于确保最佳治疗效果和保护患者健康至关重要。本系统性综述旨在探讨晚期肺癌姑息胸腔放疗期间患者的症状体验。方法根据 PRISMA 指南,我们对 MEDLINE、EMBASE、CINAHL、Cochrane 和 PsycINFO 进行了全面检索,检索时间从数据库开始至 2023 年 8 月 31 日。符合条件的研究包括那些对接受晚期肺癌姑息性胸部放疗的成年患者所经历的症状和副作用的发生率和严重程度进行研究的研究,无论治疗时间长短或剂量大小。采用标准化的 QualSyst 工具对方法学质量进行评估,并对数据进行综合叙述。放疗前共报告了13种症状,其中咳嗽最为常见(62%)。症状严重程度从轻微到严重不等,呼吸困难的平均得分最高。在这一阶段,没有对窘迫感进行测量。放疗后,疲劳是最常见的症状(69%),其次是咳嗽(64%)和呼吸困难(50%)。不同研究的症状严重程度各不相同,咳嗽、呼吸困难、胸痛和咯血症状有所改善。影响症状发生率和变化的调节因素包括表现状态、体重减轻、癌症分期、客观肿瘤反应和辐射引起的肺部变化。系统性监测对于识别持续性症状和确定是否需要更有针对性的支持性护理干预措施至关重要。
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Descriptors and factors affecting patients’ symptom experiences for symptom self-management throughout palliative radiotherapy for advanced lung cancer: A systematic review

Objective

Palliative thoracic radiotherapy is a key treatment option for symptom management in advanced lung cancer. Continuous symptom monitoring is critical to ensuring optimal therapeutic outcomes and preserving patients’ well-being. This systematic review aimed to explore patients’ symptom experiences during palliative thoracic radiotherapy for advanced lung cancer.

Methods

Following PRISMA guidelines, we conducted a comprehensive search of MEDLINE, EMBASE, CINAHL, Cochrane, and PsycINFO from database inception through August 31, 2023. Eligible studies included those examining the prevalence and severity of symptoms and side effects experienced by adult patients undergoing palliative thoracic radiotherapy for advanced lung cancer, regardless of treatment duration or dosage. Methodological quality was assessed using the standardized QualSyst tool, and data were synthesized narratively.

Results

A total of 8 studies met the inclusion criteria. Thirteen symptoms were reported prior to radiotherapy, with cough being the most common (62%). Symptom severity ranged from mild to severe, with dyspnoea recording the highest average score. Distress was not measured during this phase. Post-radiotherapy, fatigue was the most prevalent symptom (69%), followed by cough (64%) and dyspnoea (50%). Symptom severity varied across studies, with improvements noted in cough, dyspnoea, chest pain, and haemoptysis. Moderating factors influencing symptom prevalence and variation included performance status, weight loss, cancer stage, objective tumour response, and radiation-induced pulmonary changes.

Conclusions

Symptom control through palliative thoracic radiotherapy demonstrates variability in both frequency and severity of symptoms. Systematic monitoring is essential for identifying persistent symptoms and determining the need for more targeted supportive care interventions.
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来源期刊
ACS Applied Bio Materials
ACS Applied Bio Materials Chemistry-Chemistry (all)
CiteScore
9.40
自引率
2.10%
发文量
464
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