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Quality of life, pain, and psychological factors in patients undergoing surgery for primary tumors of the spine.

脊柱原发性肿瘤手术患者的生活质量、疼痛和心理因素。

  • 影响因子:2.83
  • DOI:10.1007/s00520-019-04965-0
  • 作者列表:"Luzzati F","Giusti EM","Scotto GM","Perrucchini G","Cannavò L","Castelnuovo G","Colonna Cottini A
  • 发表时间:2020-03-01
Abstract

PURPOSE:Knowledge about quality of life (QOL), pain, and psychological factors in patients with primary tumors of the spine is limited, but is important in planning rehabilitation after surgery. Aims of this study were to assess the preoperative levels and improvement after surgery of these factors, and to identify the predictors of postoperative pain and QOL. METHODS:Patients with primary tumors undergoing spine surgery were matched for sex and age with patients with metastatic tumors. QOL was measured at baseline and three months after surgery with the physical (PCS) and mental (MCS) components SF-12 subscales, pain intensity with a numeric rating scale (NRS), depression with the Beck Depression Inventory (BDI). Preoperative SF-12, NRS, and BDI levels and differences in follow-up improvement in SF-12 and NRS were compared across samples. LASSO regressions were performed to find predictors of follow-up SF-12 and NRS. RESULTS:Patients with primary tumors showed better PCS and NRS, and similar BDI and MCS than patients with metastatic tumors. At follow-up, they showed stronger improvement in the MCS and no improvement in the PCS. All QOL scores were below those of the general population. Follow-up PCS was predicted by baseline PCS and BDI; MCS by baseline MCS; pain intensity by baseline pain intensity and BDI. CONCLUSION:Patients with primary tumors of the spine suffer from moderate levels of physical and mental impairment. Depression influences surgical outcomes.

摘要

目的: 脊柱原发性肿瘤患者的生活质量 (QOL) 、疼痛和心理因素知识有限,但在计划术后康复中很重要。本研究的目的是评估这些因素的术前水平和术后改善情况,并确定术后疼痛和QOL的预测因素。 方法: 对接受脊柱手术的原发性肿瘤患者进行性别、年龄与转移性肿瘤患者的配对。QOL在基线和术后 3 个月用物理 (PCS) 和精神 (MCS) 成分SF-12 分量表、疼痛强度和数字评定量表 (NRS) 进行测量。抑郁症与贝克抑郁量表 (BDI)。比较样本间术前SF-12 、NRS和BDI水平以及SF-12 和NRS随访改善的差异。进行套索回归分析,寻找随访SF-12 和NRS的预测因素。 结果: 原发肿瘤患者的PCS和NRS较好,BDI和MCS与转移性肿瘤患者相似。随访时,他们显示MCS有更强的改善,PCS没有改善。所有QOL评分均低于普通人群。随访PCS由基线PCS和BDI预测; MCS由基线MCS预测; 疼痛强度由基线疼痛强度和BDI预测。 结论: 脊柱原发肿瘤患者存在中等程度的身心损害。抑郁影响手术结果。

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DOI:10.1259/bjr.20180883
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影响因子:1.41
发表时间:2020-03-01
DOI:10.1177/1078155219842277
作者列表:["Gyori DJ","Bullington SM","Crawford BS","Vernon VP"]

METHODS:BACKGROUND:National guidelines recommend screening and treatment for cancer-related bone disease and continued monitoring of bone-modifying agents. It is unclear whether a standardized screening tool is utilized to identify eligible patients and ensure appropriate supportive care is implemented. The purpose of this study was to evaluate current prescribing practices and optimize management of bone-modifying agents. METHODS:A retrospective chart review was performed to identify patients who received hormone deprivation therapy or had bone metastases through Hematology/Oncology or Urology clinics from 1 November 2016 to 31 October 2017. The primary endpoints of this study were the incidence of completed baseline dual-energy X-ray absorptiometry (DEXA) scan for patients on hormone deprivation therapy and percent of patients started on a bone-modifying agent for the prevention of skeletal-related events secondary to bone metastasis. Secondary endpoints included percent of patients with dental examinations prior to initiation, adequate calcium and vitamin D supplementation, incidence of osteonecrosis of the jaw or flu-like symptoms and education, and percent of bisphosphonate doses appropriately adjusted based on renal function. RESULTS:A total of 375 patients were assessed for baseline DEXA scans and bone-modifying therapy. Of the 226 patients on hormone deprivation therapy, 111 (49%) patients were appropriately screened with a DEXA scan prior to initiation of hormone deprivation therapy. Among the 149 patients with bone metastases, only 94 (63.1%) patients were started on a bone-modifying agent. CONCLUSIONS:Opportunities have been identified to optimize management of patients with cancer-related bone disease. Implementation of standardized tools may increase the rate of appropriate screening and initiation of bone-modifying therapy when warranted.

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影响因子:2.83
发表时间:2020-01-01
DOI:10.1007/s00520-019-04843-9
作者列表:["Dohzono S","Sasaoka R","Takamatsu K","Hoshino M","Nakamura H"]

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骨肿瘤方向

骨肿瘤是发生于骨骼或其附属组织的肿瘤。有良性,恶性之分,良性骨肿瘤易根治,预后良好,恶性骨肿瘤发展迅速,预后不佳,死亡率高。

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