Sergamumas piktybiniais navikais didėja. Kasmet Lietuvoje diagnozuojama po daugiau nei 17 800 naujų vėžio atvejų. Onkologinių ligonių gydyme dažnai taikoma chemoterapija, gydymas citotoksiniais preparatais. Šis gydymas sukelia eilę toksinių reiškinių, kurie pablogina paciento būklę, mitybos statusą, gydymo efektyvumą. Darbe tiriama, kaip pasikeičia pacientų, sergančių ginekologinės ir abdominalinės lokalizacijos piktybiniais navikais ir gaunančius gydymą chemoterapija, mityba, fizinė, emocinė, socialinė būsenos, kaip jos psichologiškai reaguoja į chemoterapinį gydymą. Darbo tikslas - įvertinti pacientų, sergančių vėžiu, gyvenimo kokybę ir mitybos būklę, taikant chemoterapinį gydymą. Tikslui pasiekti iškelti uždaviniai: 1. Nustatyti ligonių, sergančių onkologinėmis ligomis, gyvenimo kokybę chemoterapijos gydymo metu. 2. Išanalizuoti ligonių, sergančių onkologinėmis ligomis, laboratorinių tyrimų pokyčius chemoterapijos gydymo metu. 3. Įvertinti ligonių, sergančių onkologinėmis ligomis, mitybos būklę chemoterapijos gydymo metu. Tirti 39 pacientai, gydomi chemoterapija dėl II, III, IV stadijos abdominalinės ir ginekologinės lokalizacijos piktybinių navikų. Tiriamiesiems 2012 m. kovo mėn. – 2012 m. rugsėjo mėn. prieš ir po chemoterapijos kurso imami kraujo laboratoriniai tyrimai, matuojamas svoris, skaičiuojamas kūno masės indeksas, įvertinama gyvenimo kokybė QLQ-C30 klausimynu. Po chemoterapijos pacientams pablogėjo gyvenimo kokybės rodikliai: pablogėjo funkcinės skalės... [toliau žr. visą tekstą] / Morbidity of cancer diseases is increasing constantly. Every year over 17 800 new cancer cases are diagnosed in Lithuania. Chemotherapy is one of the mostly used treatment modality for the abdominal and gynecological cancer. This kind of treatment is highly toxic and significantly impedes the quality of life for patients receiving it. The aim of this research project was to evaluate the influence of chemotherapy on the nutritional status, physical health, emotional and social status of the patients with abdominal and gynecological cancer stage II, III, and IV. The main goal was to assess the influence of chemotherapy on the quality of life and nutritional status. The assessment was made before and after the chemotherapy. Thirty nine patients with abdominal and gynecological cancer stage II, III, and IV receiving chemotherapy were enrolled in to the study. All the patients before and after chemotherapy had blood tests, measured body weight, calculated body mass index. They were interrogated using the QLQ-C30 questionnaire. All patients were treated in the X Hospital of Lithuania. Analysis of the results of the whole study population (n=39) showed a significant decline of functional parameters, increased number of symptoms and worsening of the overall health status. The total score decreased by 19.5% in functional scale, increased by 16.3% in the symptom scale, while the global health status scale evaluation declined by 15.6%. After chemotherapy patients had lower hemoglobin... [to full text]

Electronic data capture technologies, such as interactive voice response (IVR) systems, are emerging as important alternatives for collecting self-reported data. The purpose of this research was to assess the measurement equivalence between the original paper-based versions and the adapted interactive voice response (IVR) versions of the EQ-5D and the QLQ-C30. Furthermore, we examined the test-retest reliability of two consecutive administrations of the IVR versions of the EQ-5D and the QLQ-C30. The comparison of the paper and IVR versions of the EQ-5D was conducted utilizing a crossover design with subjects randomly assigned to one of two assessment orders: 1) paper then IVR or 2) IVR then paper. A convenience sample of in-treatment outpatient cancer clinic patients (n=139) were asked to complete each assessment two days apart. For the test-retest component, outpatient cancer clinic patients (n=127) were asked to complete the IVR-based EQ-5D twice, two days apart. The analyses tested for mean differences (paired t-test) and test-retest reliability (ICC).In the crossover analysis, ten of the fifteen mean differences analyzed for the scales and items of the QLQ-C30 were within the equivalence interval set a priori. The ICCs for the scales and items of the QLQ-C30 ranged from 0.698 to 0.899. Two of the items, insomnia and appetite loss, did not meet our threshold of being statistically different from an ICC of 0.70. The EQ-5D index score means were equivalent between paper and IVR, however the EQ VAS score differences were not wholly contained in the equivalence interval. The ICCs were above 0.890 for the index and the EQ VAS. In the test-retest analysis, the ICCs for the nine multi-item scales for the QLQ-C30 were all above 0.69, ranging from 0.698 to 0.891. Ten of the fifteen mean differences analyzed were within the equivalence interval set a priori. For the EQ-5D, the mean differences were wholly contained within the equivalence intervals for both the index and the EQ VAS and the ICCs were significantly different from 0.70. Overall, the IVR version of the questionnaires provided psychometrically equivalent results to those obtained on the original paper version and showed good stability over time.

O câncer de colo do útero é o segundo tumor mais frequente entre as mulheres brasileiras, os tratamentos disponíveis trazem complicações de curto a longo prazo e estudos que avaliam a qualidade de vida destas mulheres ainda são escassos no Brasil. Isto é justificado pela falta de instrumentos específicos e validados para esta finalidade em língua portuguesa (Brasil). Neste estudo objetivou-se testar as propriedades psicométricas dos questionários EORTC QLQ-CX24 e FACT-CX em uma amostra de mulheres brasileiras com câncer do colo do útero. O estudo é metodológico e foi realizado com 100 mulheres tratadas no Hospital de Câncer de Barretos, por meio de três avaliações (no início do estudo, 15 dias e 18 a 24 meses após o início). Foi testada a consistência interna (alfa de Cronbach), reprodutibilidade (coeficiente de correlação intraclasse), validade convergente (correlação com o questionário SF-36 e com o questionário EORTC QLQ-C30), a validade discriminante pelo estadiamento, tipo de tratamento e autoclassificação de saúde e a responsividade pelo método de distribuição dos dados, além da análise da facilidade de compreensão das questões e dos questionários. Confirmou-se a confiabilidade do questionário EORTC QLQ-CX24, a reprodutibilidade foi baixa nas escalas de preocupação sexual, atividade sexual e prazer sexual, bons resultados observou-se ao avaliar a validade convergente e discriminante. A análise da responsividade não confirmou todas as hipóteses. Ao avaliar o questionário FACT-CX, por meio da consistência interna, exceto pela escala de bem-estar emocional, as demais apresentaram valores de Alpha de Cronbach superiores a 0,70. A reprodutibilidade foi satisfatória nas cinco escalas que compõem o FACT- CX. Na análise da validade convergente, somente as escalas de bem-estar físico e bem-estar emocional mostrou boa correlação com as escalas do SF-36. Em geral, o questionário revelou boa validade discriminante, principalmente em relação a autoclassificação da saúde. Resultado satisfatório encontrou-se na análise da responsividade. Em geral observou-se um bom grau de entendimento das questões e dos questionário. Concluindo os questionários desenvolvidos para medir a QVRS em mulheres com câncer de colo do útero EORTC QLQ-CX24 e FACT-CX obtiveram resultados aceitáveis recomendando-se que outros estudos testem a responsividade por outros métodos / Cervical cancer is the second most common tumor among Brazilian women. Available treatments bring short and long-term complications, and studies assessing the quality of life of these women are still rare in Brazil. Such situation is warranted by the lack of specific and validated tools in (Brazilian) Portuguese for such a purpose. The goal of this study was to test the psychometric properties of EORTC QLQ-CX24 and FACT-CX questionnaires in a sample of Brazilian women affected by cervical cancer. This is a methodological study and it was conducted on 100 women treated at the Barretos Cancer Hospital by way of three assessments (at baseline, 15 days and 18 to 24 months after the onset). We tested the internal consistency (Cronbach\'s alpha), reproducibility (intraclass correlation coefficient), convergent validity (correlation with the SF-36 questionnaire and the EORTC QLQ-C30 questionnaire), the discriminant validity by way of staging, type of treatment and health self-classification and responsiveness by the method of data distribution, as well as the analysis of how easy it was their understanding of questions and questionnaires. The reliability of the EORTC QLQ-CX24 questionnaire was confirmed, reproducibility was low in the scales of sexual worry, sexual activity and sexual enjoyment, and good results were observed when evaluating the convergent and discriminant validity. The analysis of responsiveness did not confirm all hypotheses. Upon evaluation of the FACT-CX questionnaire through internal consistency, except for the scale of emotional well-being, the others showed Cronbach\'s alpha values above 0.70. Reproducibility was satisfactory in the five scales comprising FACT-CX. In convergent validity analysis, only the scales of physical well-being and emotional well-being showed good correlation with the scales of the SF-36. In general, the questionnaire demonstrated good discriminant validity, especially in relation to the self-ratings of health. Satisfactory result was found in the analysis of responsiveness. In general there was a good degree of understanding of questions and questionnaires. In conclusion, questionnaires developed to measure HRQOL in women with cervical cancer such as EORTC QLQ-CX24 and FACT-CX achieved acceptable results, and we do recommended that further studies are performed to assess responsiveness by other methods

O câncer de colo do útero é o segundo tumor mais frequente entre as mulheres brasileiras, os tratamentos disponíveis trazem complicações de curto a longo prazo e estudos que avaliam a qualidade de vida destas mulheres ainda são escassos no Brasil. Isto é justificado pela falta de instrumentos específicos e validados para esta finalidade em língua portuguesa (Brasil). Neste estudo objetivou-se testar as propriedades psicométricas dos questionários EORTC QLQ-CX24 e FACT-CX em uma amostra de mulheres brasileiras com câncer do colo do útero. O estudo é metodológico e foi realizado com 100 mulheres tratadas no Hospital de Câncer de Barretos, por meio de três avaliações (no início do estudo, 15 dias e 18 a 24 meses após o início). Foi testada a consistência interna (alfa de Cronbach), reprodutibilidade (coeficiente de correlação intraclasse), validade convergente (correlação com o questionário SF-36 e com o questionário EORTC QLQ-C30), a validade discriminante pelo estadiamento, tipo de tratamento e autoclassificação de saúde e a responsividade pelo método de distribuição dos dados, além da análise da facilidade de compreensão das questões e dos questionários. Confirmou-se a confiabilidade do questionário EORTC QLQ-CX24, a reprodutibilidade foi baixa nas escalas de preocupação sexual, atividade sexual e prazer sexual, bons resultados observou-se ao avaliar a validade convergente e discriminante. A análise da responsividade não confirmou todas as hipóteses. Ao avaliar o questionário FACT-CX, por meio da consistência interna, exceto pela escala de bem-estar emocional, as demais apresentaram valores de Alpha de Cronbach superiores a 0,70. A reprodutibilidade foi satisfatória nas cinco escalas que compõem o FACT- CX. Na análise da validade convergente, somente as escalas de bem-estar físico e bem-estar emocional mostrou boa correlação com as escalas do SF-36. Em geral, o questionário revelou boa validade discriminante, principalmente em relação a autoclassificação da saúde. Resultado satisfatório encontrou-se na análise da responsividade. Em geral observou-se um bom grau de entendimento das questões e dos questionário. Concluindo os questionários desenvolvidos para medir a QVRS em mulheres com câncer de colo do útero EORTC QLQ-CX24 e FACT-CX obtiveram resultados aceitáveis recomendando-se que outros estudos testem a responsividade por outros métodos / Cervical cancer is the second most common tumor among Brazilian women. Available treatments bring short and long-term complications, and studies assessing the quality of life of these women are still rare in Brazil. Such situation is warranted by the lack of specific and validated tools in (Brazilian) Portuguese for such a purpose. The goal of this study was to test the psychometric properties of EORTC QLQ-CX24 and FACT-CX questionnaires in a sample of Brazilian women affected by cervical cancer. This is a methodological study and it was conducted on 100 women treated at the Barretos Cancer Hospital by way of three assessments (at baseline, 15 days and 18 to 24 months after the onset). We tested the internal consistency (Cronbach\'s alpha), reproducibility (intraclass correlation coefficient), convergent validity (correlation with the SF-36 questionnaire and the EORTC QLQ-C30 questionnaire), the discriminant validity by way of staging, type of treatment and health self-classification and responsiveness by the method of data distribution, as well as the analysis of how easy it was their understanding of questions and questionnaires. The reliability of the EORTC QLQ-CX24 questionnaire was confirmed, reproducibility was low in the scales of sexual worry, sexual activity and sexual enjoyment, and good results were observed when evaluating the convergent and discriminant validity. The analysis of responsiveness did not confirm all hypotheses. Upon evaluation of the FACT-CX questionnaire through internal consistency, except for the scale of emotional well-being, the others showed Cronbach\'s alpha values above 0.70. Reproducibility was satisfactory in the five scales comprising FACT-CX. In convergent validity analysis, only the scales of physical well-being and emotional well-being showed good correlation with the scales of the SF-36. In general, the questionnaire demonstrated good discriminant validity, especially in relation to the self-ratings of health. Satisfactory result was found in the analysis of responsiveness. In general there was a good degree of understanding of questions and questionnaires. In conclusion, questionnaires developed to measure HRQOL in women with cervical cancer such as EORTC QLQ-CX24 and FACT-CX achieved acceptable results, and we do recommended that further studies are performed to assess responsiveness by other methods

Bakgrund: Cancer är en sjukdom som omfattar tumörsjukdomar med onaturlig och okontrollerad cellväxt. Sjukdomen drabbar tiotusentals personer i Sverige varje år. Hälsorelaterad livskvalitet är ett begrepp som använts för att beskriva individers uppfattning av sitt välmående i relation till sin hälsa. Livskvaliteten kan användas som ett verktyg för att förstå patientgruppen och de förändringar de genomgår i samband med sjukdomsprogression och behandling. Onkologisk rehabilitering erbjuds vissa patientgrupper. Syftet med rehabiliteringen är främst att genom patientundervisning och träning återge patienten kontroll över sitt liv. Syfte: Att undersöka hälsorelaterad livskvalitet över tid hos patienter som genomgått onkologisk rehabilitering. Metod: Studien har en prospektiv design. Samtliga patienter som remitterades till en onkologisk rehabiliteringsverksamhet i Sverige under ett år tillfrågades. För att utvärdera livskvaliteten användes enkäten EORTC QLQ-C30. Enkäten lämnades ut till patienterna vid baseline, efter tre och sex månader. Deskriptiv statistik. Resultat: Studiens resultat visar att livskvaliteten var låg och oförändrad vid de tre mätningarna. Deltagarnas uppvisar goda funktioner i samtliga mätningar, högst vid tre månader. Symtomen minskar överlag vid varje mätning. Kraftigast minskar sömnsvårigheterna. Slutsats: Sammanfattningsvis visar studien att livskvaliteten var opåverkad de sex första månaderna efter rehabiliteringen. Dock förbättrades deltagarnas sömn, vilket kan ses som en positiv effekt av rehabiliteringen. Viss skillnad mellan kön, cancerdiagnoser samt svenskfödda och utlandsfödda finns; men dessa kan även bero på skillnader inom normalpopulationen. Funktionsskalornas maxvärde efter tre månader kan visa på behov av uppföljande rehabilitering. Klinisk betydelse: Studiens resultat ska användas i ett kvalitetsgranskningsarbete. / Background: Cancer is a diagnosis which encompasses diseases with abnormal and uncontrolled cellular growth. Tens of thousands of people are affected by cancer every year in Sweden. Health-related quality of life (HRQoL) is a concept used to describe people’s perception of well-being in relation to their health. HRQoL can also be used as a tool to understand the patients and the changes they go through during progression of disease and treatment. Oncological rehabilitation is offered to some patient groups. The goal with the rehabilitation is to give the patients control back over their lives through education and training. Aim: To study the oncological rehabilitations effect on HRQoL over time. Method: All patients remitted to a certain rehabilitation facility in Sweden during one year were asked to participate. To evaluate the HRQoL the EORTC QLQ-C30 questionnaire was used. The questionnaire was sent out to the respondents at baseline and after three and six months. Descriptive statistics. Result: The results of the study showed that quality of life was low and unaffected at the three measurements. The functions reached their highest value after three months. The symptoms overall decreased at each measurement. The most positive change was seen with insomnia. Conclusion: In conclusion, the quality of life was unaffected during the first six months after the rehabilitation. The improvement of the participants’ insomnia might be a positive outcome of the rehabilitation. The results points to some differences between gender, cancerdiagnose and people born in Sweden or abroad; but these might as well depend on differences in the population. The functions higher value after three months might show a need for follow-up rehabilitation. Clinical implication: The result of the study is to be used in a quality audit.

Die Anlage eines Hautstomas nach exenterativen Beckeneingriffen stellt für Betroffene einen drastischen Einschnitt in die körperliche Integrität dar. Vielfach führen ästhetische und funktionelle Bedenken dazu, dass wasserbezogene Angebote zur Rehabilitation nicht genutzt werden. Fragestellung: Ziel war es, im Rahmen des Pilotprojekts „UROAquaFIT“ die Möglichkeit einer wasserbezogenen Rehabilitationsmaßnahme für Patienten nach Zystektomie mit inkontinenter Harnableitung zu evaluieren. Methode: Im Rahmen des Pilotkurses „UROAquaFIT“ wurde Patienten nach radikaler Zystektomie mit inkontinenter Harnableitung die Möglichkeit einer wasserbezogenen Rehabilitationsmaßnahme angeboten. Aufgeteilt in Kleingruppen erfolgte ein Wassergymnastikkurs unter Anleitung einer Physiotherapeutin und einer Stomatherapeutin unter ärztlicher Aufsicht. Daten zur Lebensqualität und der persönlichen Beurteilung des Kurses mittels Fragebögen wurden vor Beginn und 6 Monate nach Kursende erhoben und qualitativ ausgewertet. Darüber hinaus erfolgte eine Literaturrecherche (MEDLINE) zum Thema Aquagymnastik in der Onkologie. Ergebnis und Diskussion: Das Kursangebot wurde von allen Teilnehmern als durchweg positiv und bereichernd empfunden. Wohlbefinden und Selbstwertgefühl der Probanden konnten gesteigert werden. Wassergymnastik unter gezielter physio- und stomatherapeutischer Anleitung kann somit eine höchst effektive Rehabilitationsmaßnahme für Patienten nach inkontinenter Harnableitung darstellen. Darüber hinaus stärkt sie die körperliche Integrität der Betroffenen und erweitert somit die Möglichkeiten der sozialen Reintegration. Diese Form der Therapie sollte als fester Baustein in der Rehabilitation nach exenterativen Beckeneingriffen mit Stomaanlage verankert werden.

PURPOSE: To compare the characteristics of cancer patients in Taiwan who use complementary and alternative medicine (CAM) to cancer patients who do not use CAM and determine the predictors of quality of life (QoL) among cancer patients who use CAM. PATIENTS AND METHODS: Face-to-face interviews were conducted with and 3 questionnaires (the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire, the Brief Fatigue Inventory, and the Pittsburgh Sleep Quality Index) were administered to 216 cancer patients being treated at the Nuclear Medicine Department in southern Taiwan. Chi-square testing for categorical variables and t-testing for continuous variables were conducted to determine the correlation between sociodemographic and clinical data and CAM use. Analysis of variance was performed to conduct within-group comparison of QoL scales and CAM use. Linear regression models were established to predict QoL score. RESULTS: A total of 216 cancer patients were interviewed. The prevalence of CAM use was found to be 69.4% (150 of 216 subjects). Among the CAM users, 91.6% had used traditional Chinese medicine (TCM), dietary supplementation (vitamin, herbal, mineral, glucosamine, mushroom, and/or fish oil supplementation), or detoxification therapy. A greater percentage (49.5%) of CAM users had breast cancer than any other type of cancer, and a very large percentage (74.7%) did not inform their primary caregiver of their CAM use, whereas 52.7% used CAM after initiation of diagnosis and 26.7% increased the original frequency of their CAM use during the course of their treatment. Overall QoL was not found to be significantly different between CAM users and nonusers. Predictors of poor QoL were female gender, breast or liver cancer patient, younger age, lower education, chemotherapy, increased frequency of CAM use, non-vitamin/TCM use, and having received CAM information from primary caregiver. The factors of CAM use, number of CAM modalities used, frequency of CAM use, duration of cancer diagnosis, mineral/algae supplementation, and detoxification therapy were not found to be significant in this population. CONCLUSION: Cancer patients in Taiwan have a high rate of CAM use but a low rate of disclosure of CAM use to their primary caregivers. Multiple factors appear to have a significant correlation with poor QoL. Clinical physicians should emphasize the QoL of cancer survivors, providing more accurate CAM information and endeavoring to address their unmet needs.

Introduction: Each year 1200-1300 patients are diagnosed with head neck cancer. Treatment that involves radiotherapy can cause severe side effects for example trismus that affects quality of life. Purpose: To study health-related quality of life in patients who have undergone radiation treatment for head and neck cancer and participated in a intervention group who received training intended to prevent trismus or in a control group who received standard treatment. Method: This is a prospective study in which data is collected from 66 patients participating in a randomized study aiming to evaluate a training program to prevent trismus. Thirty three participated in the intervention group and thirty three in the control group. Both patient groups assessed health related quality of life (HRQOL) with EORTC QLQ C30 and QLQ-H&N35, at start and end of the radiation treatment, and at 3 and 6-months after completing radiation treatment. Results: There is no difference between the intervention and control groups regarding symptoms, functional status and global health, except for intake of nutritional supplements.  For both groups almost all scales measuring HRQOL deteriorated under the radiation treatment. However, 3 and 6 months after end of radiotherapy HRQOL had improved and had returned to the baseline values. The only exceptions were dry mouth, sticky saliva, problems with social eating, senses and physical ability. Conclusion: Radiation therapy for head and neck cancer affects patients HRQOL both in the short and long term. Medical staff needs strategies to manage patients ' functional and symptomatic deterioration throughout the treatment period and try to prevent or relieve the symptoms that may still remain several months after radiotherapy.

The aim of this study was a prospective detection of postoperative lymphedema of the lower limbs in patients after the surgery for cervical and vulvar cancer using different methods of examination and their comparison and monitoring of postoperative complications and quality of life. Totally 78 women were followed after the surgery for cervical cancer and 36 for carcinoma of the vulva. Due to the radicality of the surgery the patients were divided into the conservative and radical groups. Lower limbs lymphedema were evaluated preoperatively and 3, 6 and 12 months after the surgery by the measurement of the lower limbs circumference, multifrequency bioelectrical impedance analysis (MFBIA) and subjective feeling. Quality of life using the European Organisation for Research and Treatment of Cancer (EORTC) questionnaires was evaluated before and 6 and 12 month after the surgery. 12 months after the cervical cancer surgery 35.9 % of patients reported subjective lymphedema, 37.18 % lymphedema were objectively diagnosed by the measurement of lower limb circuits and in 52.56 % of cases the increase of amount of extracellular fluid was detected by the MFBIA Ri/R0 method. The prevalence of lymphedema after the surgery for vulvar cancer reached 19.44% by the subjective assessment, 38.89 % by the measurement of...

The aim of this study was a prospective detection of postoperative lymphedema of the lower limbs in patients after the surgery for cervical and vulvar cancer using different methods of examination and their comparison and monitoring of postoperative complications and quality of life. Totally 78 women were followed after the surgery for cervical cancer and 36 for carcinoma of the vulva. Due to the radicality of the surgery the patients were divided into the conservative and radical groups. Lower limbs lymphedema were evaluated preoperatively and 3, 6 and 12 months after the surgery by the measurement of the lower limbs circumference, multifrequency bioelectrical impedance analysis (MFBIA) and subjective feeling. Quality of life using the European Organisation for Research and Treatment of Cancer (EORTC) questionnaires was evaluated before and 6 and 12 month after the surgery. 12 months after the cervical cancer surgery 35.9 % of patients reported subjective lymphedema, 37.18 % lymphedema were objectively diagnosed by the measurement of lower limb circuits and in 52.56 % of cases the increase of amount of extracellular fluid was detected by the MFBIA Ri/R0 method. The prevalence of lymphedema after the surgery for vulvar cancer reached 19.44% by the subjective assessment, 38.89 % by the measurement of...