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Severe symptoms persist for Up to one year after diagnosis of stage I-III lung cancer: An analysis of province-wide patient reported outcomes.
Lung Cancer ( IF 4.5 ) Pub Date : 2020-02-25 , DOI: 10.1016/j.lungcan.2020.02.014
Dhruvin H Hirpara 1 , Vaibhav Gupta 1 , Laura E Davis 2 , Haoyu Zhao 3 , Julie Hallet 4 , Alyson L Mahar 5 , Rinku Sutradhar 6 , Mark Doherty 7 , Alexander V Louie 8 , Biniam Kidane 9 , Gail Darling 10 , Natalie G Coburn 4
Affiliation  

OBJECTIVES Lung cancer is associated with significant disease- and treatment-related morbidity. The Edmonton Symptom Assessment System (ESAS) is a tool developed to elicit patients' own assessment of the severity of common cancer-associated symptoms. The objective of this study was to examine symptom severity in the 12 months following diagnosis of lung cancer, and to identify predictors of high symptom burden. MATERIALS AND METHODS This was a retrospective population-based cohort study, including patients with stage I-III lung cancer diagnosed between 2007-2016, and who had symptom screening in the 12 months following diagnosis. The proportion of patients reporting severe symptoms (ESAS ≥ 7) in the year following diagnosis was plotted over time. Multivariable regression models were constructed to identify factors associated with severe symptoms. RESULTS 69,440 unique symptom assessments were reported by 11,075 lung cancer patients. Tiredness was the most prevalent severe symptom (47.3 %), followed by shortness of breath (39.4 %) and poor wellbeing (36.5 %) among all disease stages. Patients diagnosed with higher stage disease reported more severe symptoms, but symptom trajectories were similar for all stages in the year following diagnosis. Disease stage (RR 1.10-2.01), comorbidity burden (RR 1.17-1.51), degree of socioeconomic marginalization (RR1.15-1.45), and female sex (RR 1.15-1.50) were associated with reporting severe symptoms in the year following diagnosis. CONCLUSION Severe physical and psychological symptoms persist throughout the first year following lung cancer diagnosis, regardless of disease stage. Those at risk of experiencing high symptom burden may benefit from targeted supportive care interventions, including psychosocial support aimed at improving health-related quality of life.

中文翻译:

在I-III期肺癌诊断后,严重症状持续长达一年:对全省范围内患者报告的结局进行了分析。

目的肺癌与明显的疾病和治疗相关的发病率有关。埃德蒙顿症状评估系统(ESAS)是一种工具,旨在引起患者自己对常见癌症相关症状的严重性进行评估。这项研究的目的是检查肺癌诊断后12个月内的症状严重程度,并确定高症状负担的预测因素。材料与方法这是一项基于人群的回顾性队列研究,包括2007-2016年间诊断为I-III期肺癌的患者,并在诊断后的12个月内进行了症状筛查。随时间绘制出诊断后一年中报告严重症状(ESAS≥7)的患者比例。构建多变量回归模型以识别与严重症状相关的因素。结果11,075例肺癌患者报告了69,440例独特的症状评估。在所有疾病阶段中,疲倦是最普遍的严重症状(47.3%),其次是呼吸急促(39.4%)和健康不佳(36.5%)。诊断为晚期疾病的患者报告的症状更为严重,但诊断后一年中所有阶段的症状轨迹均相似。疾病分期(RR 1.10-2.01),合并症负担(RR 1.17-1.51),社会经济边缘化程度(RR1.15-1.45)和女性(RR 1.15-1.50)与诊断后一年内报告严重症状相关。结论在肺癌诊断后的第一年中,严重的生理和心理症状持续存在,不论疾病阶段如何。有症状高风险的人可能会从针对性的支持治疗干预措施中受益,包括旨在改善与健康相关的生活质量的社会心理支持。
更新日期:2020-02-25
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