Current dyspnea among long-term survivors of early-stage non-small cell lung cancer.
Current dyspnea among long-term survivors of early-stage non-small cell lung cancer.
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DOI：
10.1097/jto.0b013e3181df61c8
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发表时间：
2010-08
期刊：
影响因子：
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通讯作者：
Ostroff JS
中科院分区：
文献类型：
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作者：
Feinstein MB;Krebs P;Coups EJ;Park BJ;Steingart RM;Burkhalter J;Logue A;Ostroff JS
呼吸困难在肺癌患者中很常见。由于大多数呼吸困难的研究都是对活动性癌症患者或治疗后立即进行的，因此一旦治疗完成，其在长期内的患病率尚未得到很好的表征。这项研究量化了肺癌幸存者中呼吸困难的患病率，并确定了可能适合干预的潜在相关因素。对342例无病I期非小细胞肺癌患者进行横断面调查，评估手术切除后1至6年。使用基线呼吸困难指数量化呼吸困难。使用Godin休闲时间运动问卷测量任何中度/剧烈的身体活动。使用医院焦虑和抑郁量表评估情绪障碍症状。多元回归分析被用来检查人口统计学，医疗和健康相关的呼吸困难。平均年龄为68.9岁。术前1秒用力呼气量平均预测值为89.0%。205例（60%）患者目前存在呼吸困难，定义为基线呼吸困难指数评分≤ 9。其中133例（65%）患者术前无呼吸困难。当前呼吸困难的多变量相关因素包括术前呼吸困难（比值比[OR] = 5.31）、术前弥散能力（OR = 0.98）、缺乏中度/剧烈体力活动（OR = 0.41）和存在临床显著抑郁症状（OR = 4.10）。肺癌切除术后1至6年常见呼吸困难，与术前呼吸困难、弥散能力下降、临床上明显的抑郁症状和缺乏体力活动有关。需要进一步的研究来测试识别和治疗患有这些疾病的患者的策略是否会减轻肺癌幸存者的呼吸困难。
Dyspnea is common among lung cancer patients. As most studies of dyspnea have reviewed patients with active cancer or immediately after treatment, its prevalence during the longer-term period once treatment has been completed is not well characterized. This study quantifies the prevalence of dyspnea among lung cancer survivors and identifies potential correlates that may be amenable to intervention. Cross-sectional survey of 342 patients with disease-free, stage I, non-small cell lung cancer, assessed 1 to 6 years after surgical resection. Dyspnea was quantified using the Baseline Dyspnea Index. Any moderate/strenuous physical activity was measured using the Godin Leisure-Time Exercise Questionnaire. Mood disorder symptoms were assessed using the Hospital Anxiety and Depression Scale. Multiple regression analyses were used to examine demographic, medical, and health-related correlates of dyspnea. Mean age was 68.9 years. Average predicted preoperative forced expiratory volume in 1 second was 89.0%. Current dyspnea, defined by a Baseline Dyspnea Index score of 9 or less, existed among 205 (60%) individuals. For 133 (65%) of these patients, dyspnea was absent preoperatively. Multivariate correlates of current dyspnea included preoperative dyspnea (odds ratio [OR] = 5.31), preoperative diffusing capacity (OR = 0.98), lack of moderate/strenuous physical activity (OR = 0.41), and the presence of clinically significant depression symptoms (OR = 4.10). Dyspnea is common 1 to 6 years after lung cancer resection, and is associated with the presence of preoperative dyspnea, reduced diffusing capacity, clinically significant depression symptoms, and lack of physical activity. Further research is needed to test whether strategies that identify and treat patients with these conditions attenuate dyspnea among lung cancer survivors.