Effect of Quality of Life on Radiation Adherence for Patients With Cervical Cancer in an Urban Safety Net Health System.
Effect of Quality of Life on Radiation Adherence for Patients With Cervical Cancer in an Urban Safety Net Health System.
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DOI：
10.1016/j.ijrobp.2022.10.013
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发表时间：
2023-05-01
影响因子：
7
通讯作者：
Ludwig, Michelle S.
中科院分区：
文献类型：
--
作者：
Yoder, Alison K.;Dong, Elizabeth;Yu, Xiaoman;Echeverria, Alfredo;Sharma, Shelly;Montealegre, Jane;Ludwig, Michelle S.
宫颈癌患者接受放化疗的结果取决于放射治疗（RT）的依从性。在其他疾病中，生活质量（QoL）与治疗依从性相关，但宫颈癌患者的生活质量与RT依从性之间的关系尚不清楚。这项前瞻性研究包括2017-2021年在城市安全网医院接受宫颈癌放疗的患者。使用Cancer therapy Functional Assessment - cervical Cancer Version 4 （FACT-Cx）基于5个亚量表（Physical, Functional, Social, and Emotional，以及子宫颈癌特异性）来评估QoL。这项调查在放射咨询时进行，然后在放射治疗和随访期间每周进行一次。病人信息是从病历中提取出来的。放射不依从被定义为缺失≤2天的外束放射治疗（EBRT）。比较依从性和非依从性患者的FACT-Cx总分和亚量表得分。采用多变量逻辑回归控制混杂变量。93名患者入组，完成522项调查。诊断时的中位年龄为46岁（IQR 40-51）；76%的患者是西班牙裔，12%是黑人。只有30%的患者没有坚持rt。精神合并症（p=0.012）和症状表现（p=0.027）与依从性降低有关。治疗依从组的基线总生活质量高于非治疗依从组（中位数为124.86[范围48-160]，108.9 [46-150];p=0.01）。较高的基线功能和身体亚量表得分与依从性相关（p<0.05）。治疗期间情绪量表从基线到最低评分的变化也与患者的依从性有关（p<0.05）。在多变量分析中，较高的基线物理、基线总分和情绪量表得分的变化与依从性相关（p<0.05）。宫颈癌放化疗期间生活质量差与错过治疗有关。在接受放射治疗时，医生对患者健康状况的评估对于提高治疗依从性至关重要。
Outcomes for patients undergoing chemoradiation for cervical cancer are dependent on adherence to radiation therapy (RT). In other diseases, quality of life (QoL) is associated with treatment adherence, but the association between QoL and RT compliance for patients with cervical cancer remains unclear. This prospective study included patients undergoing RT for cervical cancer from 2017–2021 at an urban safety-net hospital. The Functional Assessment of Cancer Therapy–Cervical Cancer Version 4 (FACT-Cx) was used to assess QoL based on 5 subscales (Physical, Functional, Social, and Emotional, and Cervical-cancer specific). The survey was administered at radiation consult, then weekly during RT and follow-up. Patient information was abstracted from the medical record. Radiation non-adherence was defined as missing ≤ 2 days of external beam radiation therapy (EBRT). FACT-Cx total and subscale scores were compared between adherent and non-adherent patients. Multivariable logistic regression was performed to control for confounding variables. Ninety-three patients were enrolled, completing 522 surveys. Median age at diagnosis was 46 years (IQR 40–51); 76% of patients were Hispanic, and 12% were Black. Only 30% of patients were non-adherent with RT. A psychiatric comorbidity (p=0.012) and symptomatic presentation (p=0.027) were associated with decreased adherence. Baseline total QoL was higher in treatment-adherent than non-adherent patients (median 124.86 [range 48–160], 108.9 [46–150]; p=0.01). Higher baseline functional and physical subscale scores were associated with adherence (p<0.05). Change from baseline to lowest score during treatment in the emotional subscale was also associated with patient adherence (p<0.05). In multivariable analysis higher baseline physical, baseline total score, and change in emotional subscale score were associated with adherence (p<0.05). Poor QoL during chemoradiation for cervical cancer is associated with missed treatments. Physician assessment of a patient’s well-being while they are undergoing RT is of utmost importance to improve adherence to treatment.
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DOI：
10.1016/0360-3016(94)00635-x
发表时间：
1995-07-30
影响因子：
7
作者：
PETEREIT, DG;SARKARIA, JN;BUCHLER, DA
通讯作者：
BUCHLER, DA
影响因子：
8.4
作者：
Bjelic-Radisic, Vesna;Jensen, Pernille T.;Greimel, Elfriede
通讯作者：
Greimel, Elfriede
影响因子：
34.3
作者：
Arbyn, Marc;Weiderpass, Elisabete;Bray, Freddie
通讯作者：
Bray, Freddie
影响因子：
4.7
作者：
Legge, F.;Chiantera, V.;Ferrandina, G.
通讯作者：
Ferrandina, G.
影响因子：
4.7
作者：
Ashing-Giwa, Kimlin T.;Lim, Jung-won;Tang, Julia
通讯作者：
Tang, Julia