Course of Quality of Life After Radiation Therapy for Painful Bone Metastases: A Detailed Analysis From the Dutch Bone Metastasis Study
Course of Quality of Life After Radiation Therapy for Painful Bone Metastases: A Detailed Analysis From the Dutch Bone Metastasis Study
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DOI：
10.1016/j.ijrobp.2016.03.032
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发表时间：
2016-08-01
影响因子：
7
通讯作者：
van der Linden, Yvette M.
中科院分区：
文献类型：
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作者：
Westhoff, Paulien G.;Verdam, Mathilde G. E.;van der Linden, Yvette M.
目的：研究过程中的生活质量（QoL）放射治疗后疼痛的骨transferas.Patients和方法：荷兰骨转移研究随机1157例疼痛的骨转移瘤之间的一个单一的分数8戈伊和6个分数4戈伊在1996年和1998年。该研究显示，74%的疼痛反应相当。患者在13周内每周填写问卷，然后在2年内每月填写问卷。在这些分析中，研究了身体、心理和功能性生活质量领域评分以及一般健康状况评分。混合模型被用来模拟生活质量的过程，并研究几个特征的影响。结果：在一般情况下，生活质量稳定后1个月。治疗后心理社会生活质量改善。生活质量水平保持稳定，在生命结束时急剧恶化。对于大多数QoL领域，高疼痛评分和阿片类药物摄入与较差的QoL相关，效应量较小（0.11至0.27）。较差的表现评分与较差的功能性QoL相关，具有中等效应量（0.41）。有没有差异，患者之间的生活质量接受一个单一的分数8戈伊和6个分数4戈伊，除了暂时恶化的物理生活质量后6 fractions.Conclusion：虽然放射治疗疼痛性骨转移导致有意义的疼痛反应，生活质量的大部分领域不改善治疗后。只有心理社会生活质量略有改善治疗后。生活质量水平与实际生存期有关，在剩余的生存期内，生活质量在大部分时间内相当稳定，之后急剧下降，仅在生命结束前几周开始。与8戈伊的单次分割相比，4戈伊的六次分割导致暂时更差的身体生活质量。(C)2016由Elsevier Inc.出版
Purpose: To study the course of quality of life (QoL) after radiation therapy for painful bone metastases.Patients and Methods: The Dutch Bone Metastasis Study randomized 1157 patients with painful bone metastases between a single fraction of 8 Gy and 6 fractions of 4 Gy between 1996 and 1998. The study showed a comparable pain response of 74%. Patients filled out weekly questionnaires for 13 weeks, then monthly for 2 years. In these analyses, physical, psychosocial, and functional QoL domain scores and a score of general health were studied. Mixed modeling was used to model the course of QoL and to study the influence of several characteristics.Results: In general, QoL stabilized after 1 month. Psychosocial QoL improved after treatment. The level of QoL remained stable, steeply deteriorating at the end of life. For most QoL domains, a high pain score and intake of opioids were associated with worse QoL, with small effect sizes (0.11 to 0.27). A poor performance score was associated with worse functional QoL, with a medium effect size (0.41). There is no difference in QoL between patients receiving a single fraction of 8 Gy and 6 fractions of 4 Gy, except for a temporary worsening of physical QoL after 6 fractions.Conclusion: Although radiation therapy for painful bone metastases leads to a meaningful pain response, most domains of QoL do not improve after treatment. Only psychosocial QoL improves slightly after treatment. The level of QoL is related to the actual survival, with a rather stable course of QoL for most of the remaining survival time and afterward a sharp decrease, starting only a few weeks before the end of life. Six fractions of 4 Gy lead to a temporary worse physical QoL compared with a single fraction of 8 Gy. (C) 2016 Published by Elsevier Inc.