Cognitive and Affective Symptoms Experienced by Cancer Patients Receiving High-Dose Intravenous Interleukin 2 Therapy: An Integrative Literature Review.
Cognitive and Affective Symptoms Experienced by Cancer Patients Receiving High-Dose Intravenous Interleukin 2 Therapy: An Integrative Literature Review.
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DOI：
10.1097/ncc.0000000000000317
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发表时间：
2016-09
期刊：
影响因子：
2.6
通讯作者：
Bailey DE Jr
中科院分区：
文献类型：
--
作者：
Mann TK;Dail RB;Bailey DE Jr
认知/情感功能的改变是80%接受高剂量白细胞介素-2（IL-2）治疗的转移性黑色素瘤和转移性肾细胞癌患者经历的最具挑战性的副作用之一。本文献综述的目的是描述什么是已知的IL-2诱导的认知/情感症状，其患病率和严重程度，并综合研究结果，以确定未来的研究领域，以解决症状管理的挑战。本综述描述了IL-2患者的经验，以及导致这些变化的病理生理学。使用PubMed进行在线电子检索，以识别1992年至2015年期间发表的相关文献。在最初的113篇手稿中，信息是从9篇关于认知症状，情感症状，样本量，研究设计，可靠性和有效性的文章中提取的。我们的审查表明，认知/情感症状的轨迹、广度和深度尚未得到描述。尽管干预研究旨在解决IL-2的心理社会并发症，但对IL-2患者所经历的认知/情感症状改变水平的理解仍不清楚。我们的文献回顾显示，缺乏标准化的评估，报告和管理认知/情感症状。患者/家庭成员报告认知/情感症状是最令人担忧和最困难的症状，但这些症状没有得到充分筛查，患者也没有被告知潜在的变化。评估患者的认知/情感改变对于减少焦虑同时改善结局非常重要。关于疾病轨迹的教育（治疗期间/治疗后的期望）可以帮助护理伙伴/患者设定现实的共同期望，并增加应对能力。
Alterations in cognitive/affective functioning are among the most challenging side effects experienced by 80% of patients with metastatic melanoma and metastatic renal cell carcinoma undergoing high-dose Interleukin-2 (IL-2) therapy. The purpose of this literature review is to describe what is known about IL-2—induced cognitive/affective symptoms, their prevalence and level of severity, and synthesize findings to determine areas for future research to address symptom management challenges. This review describes the IL-2 patient experience, and the pathophysiology leading to these changes. An online electronic search using PubMed was performed to identify relevant literature published between 1992 and 2015. Of the original 113 manuscripts, information was extracted from nine articles regarding cognitive symptoms, affective symptoms, sample size, research design, reliability and validity. Our review suggests that the trajectories, breadth and depth of cognitive/affective symptoms have yet to be described. Despite intervention studies designed to address the psychosocial complications of IL-2, an understanding of the level of altered cognitive/affective symptoms experienced by IL-2 patients remains unclear. Our literature review reveals a lack of standardization when assessing, reporting and managing cognitive/affective symptoms. Patients/family members have reported cognitive/affective symptoms to be the most alarming and difficult symptoms, yet these symptoms are not adequately screened for and patients were not informed about potential changes. Assessing patients for cognitive/affective alterations is important to reduce anxiety while improving outcomes. Education about the illness trajectory (what to expect during/after treatment) can help care partners/patients set realistic shared expectations, and increase coping.