Patient-Reported Symptoms for Esophageal Cancer Patients Undergoing Curative Intent Treatment

被引:18
|
作者
Gupta, Vaibhav
Allen-Ayodabo, Catherine
Davis, Laura
Zhao, Haoyu
Hallet, Julie
Mahar, Alyson L.
Ringash, Jolie
Kidane, Biniam
Darling, Gail
Coburn, Natalie G.
机构
[1] Univ Toronto, Div Gen Surg, Dept Surg, Toronto, ON, Canada
[2] Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada
[3] Sunnybrook Res Inst, Evaluat Clin Sci, Toronto, ON, Canada
[4] ICES, Toronto, ON, Canada
[5] Univ Manitoba, Dept Community Hlth Sci, Manitoba Ctr Hlth Policy, Winnipeg, MB, Canada
[6] Univ Toronto, Dept Radiat Oncol, Toronto, ON, Canada
[7] Univ Manitoba, Sect Thorac Surg, Dept Surg, Winnipeg, MB, Canada
[8] Univ Toronto, Div Thorac Surg, Dept Surg, Toronto, ON, Canada
来源
ANNALS OF THORACIC SURGERY | 2020年 / 109卷 / 02期
关键词
QUALITY-OF-LIFE; ASSESSMENT SYSTEM; NEOADJUVANT CHEMORADIOTHERAPY; ASSESSMENT SCALE; OUTCOMES; SCORES; SURVIVAL; ANXIETY; CARE;
D O I
10.1016/j.athoracsur.2019.08.030
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. Esophageal cancer (EC) patients experience considerable symptom burden from treatment. This study utilized population-level patient-reported Edmonton Symptom Assessment System (ESAS) scores collected as part of standard clinical care to describe symptom trajectories and characteristics associated with severe symptoms for patients undergoing curative intent EC treatment. Methods. EC patients treated with curative intent at regional cancer centers and affiliates between 2009 and 2016 and assessed for symptoms in the 12 months after diagnosis were included. The ESAS measures 9 common patient-reported cancer symptoms. The outcome was report of a severe symptom score (score >= 7 our of 10). Multivariable analyses were used to identify characteristics associated with severe symptom scores. Results. A total of 1751 patients reported a median of 7 (interquartile range, 4-12) ESAS assessments in the year after diagnosis, for a total of 14,953 unique ESAS assessments included in the analysis. The most frequently reported severe symptoms were lack of appetite (n = 918, 52%), tiredness (n = 787, 45%), and poor well-being (n = 713, 41%). The highest symptom burden was within the first 5 months after diagnosis, with moderate improvement in symptom burden in the second half of the first year. Characteristics associated with severe scores for all symptoms included female sex, high comorbidity, lower socioeconomic status, urban residence, and symptom assessment temporally close to diagnosis. Conclusions. This study demonstrates a high symptom burden for EC patients undergoing curative intent therapy. Targeted treatment of common severe symptoms and increased support for patients at risk for severe symptoms may enhance patient quality of life. (C) 2020 by The Society of Thoracic Surgeons
引用
收藏
页码:367 / 374
页数:8
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