Publication: Meme kanseri ile ilişkili kol lenfödeminde mevcut son durum ölçütü skalalarının yanıt verilebilirliklerinin (responsiveness) araştırılması
Abstract
Amaç: Bu çalışmanın amacı meme kanseri ile ilişkili lenfödemde mevcut son durumölçütü skalalarının yanıt verilebilirliklerinin karşılaştırılmasıdır.Gereç ve Yöntem: Çalışmaya mastektomi sonrası lenfödem gelişen 40 hasta dahiledildi ve kompleks dekonjestif tedavi faz 1 dört hafta boyunca uygulandı. Hastalaratedavi öncesi ve sonrası Lenfödem Yaşam Etki Ölçeği (LLIS), LenfödemFonksiyonellik, Yetersizlik ve Sağlık Sorgulaması (Lymph-ICF), Yaşam KalitesiÖlçeği-Kol (LYMQOL), Hasta Fayda İndeksi (PBI), Avrupa Kanser Araştırma veTedavi Teşkilatı Yaşam Kalitesi Ölçeği (EORTC-QLQ-30), Meme Kanserine ÖzgüYaşam Kalitesi Ölçeği (EORTC-QLQ-BR-23) ve Kısa Form 36 (SF-36) uygulandı.Bulgular: LLIS, Lymph-ICF, LYMPQOL ve EORTC-QLQ-BR 23 (cinsel işlev vecinsel haz dışında) tedavi sonrası skorun tedavi öncesi skora kıyasla çok yüksekdüzeyde anlamlı olduğu belirlendi (p<0,0001). SF-36 tedavi sonrası skorlarda tedaviöncesine kıyasla (sağlığın genel algısı dışında) anlamlı fark belirlendi. Total skoruhesaplanabilen ölçeklerden iki sonuç ölçütü en büyük etki büyüklüğünü gösterdi:LYMQOL (d=-0,88; SRM=-0,38; GI=-0,36), VAS gerginlik (d=0,88; SRM=0,41;GI=0,7). Total skoru hesaplanamayan ölçeklerde üç sonuç ölçütü en büyük etkibüyüklüğünü gösterdi: EORTC-QLQ-BR23 kola bağlı sorunlar, saç dökülme kaygısıve sistemik tedavi yan etkileri (d=1,35; SRM= 0,46; GI=0,41), (d=1,15; SRM=0,47;GI=0,44), (d=1,10; SRM=0,47; GI=0,43).Sonuç: Total skoru hesaplanabilen ölçeklerden LYMQOL ve VAS gerginlik; totalskoru hesaplanamayan ölçeklerden EORTC-QLQ-BR23 kola bağlı sorunlar, saçdökülme kaygısı ve sistemik tedavi yan etkileri alt ölçekleri meme kanseri ile ilişkililenfödemde yanıt verilebilirliği en yüksek son durum ölçütleridir
Objective: The aim of this study is to compare the responsiveness of the scales of theend state criteria in breast cancer-associated lymphedema.Materials and Methods: Forty patients who developed post-mastectomylymphedema were included in the study and complex decongestive therapy wasadministered for four weeks in phase 1. Lymphedema Life Impact Scale (LLIS),Lymphedema Functioning, Disability and Health Questionnaire (Lymph-ICF), Qualityof Life Scale-Arm (LYMQOL), Patient Benefit Index (PBI), European Organizationfor Cancer Research and Treatment Life before and after treatment Quality of LifeScale (EORTC-QLQ-30), Breast Cancer Specific Quality of Life Scale (EORTCQLQ-BR-23) and Short Form 36 (SF-36) were applied.Results: The post-treatment score of LLIS, Lymph-ICF, LYMPQOL and EORTCQLQ-BR23 (excluding sexual function and pleasure) was found to be significantlyhigher than before (p<0.0001). Significant difference was determined in SF-36 posttreatment scores compared to before (except healthchange). For those whose totalscore could be calculated, two outcome measures showed the largest effect size:LYMQOL (d=-0.88; SRM=-0.38; GI=-0.36), VAS tension (d=0.88; SRM=0.4;GI=0.7). For those whose total score could not be calculated, three outcome measuresshowed the greatest effect size: EORTC-QLQ-BR23 arm-related problems, hair lossanxiety, and systemic treatment side effects (d=1.35; SRM=0.46; GI=0.41), (d=1.15;SRM=0.47; GI=0.44), (d=1.10; SRM= 0.47; GI=0.43).Conclusion: LYMQOL and VAS strain; The EORTC-QLQ-BR23 arm-relatedproblems, hair loss anxiety and systemic treatment side effects subscales, among thescales whose total score cannot be calculated, are the most responsive end-state criteriain breast cancer-related lymphedema.
Objective: The aim of this study is to compare the responsiveness of the scales of theend state criteria in breast cancer-associated lymphedema.Materials and Methods: Forty patients who developed post-mastectomylymphedema were included in the study and complex decongestive therapy wasadministered for four weeks in phase 1. Lymphedema Life Impact Scale (LLIS),Lymphedema Functioning, Disability and Health Questionnaire (Lymph-ICF), Qualityof Life Scale-Arm (LYMQOL), Patient Benefit Index (PBI), European Organizationfor Cancer Research and Treatment Life before and after treatment Quality of LifeScale (EORTC-QLQ-30), Breast Cancer Specific Quality of Life Scale (EORTCQLQ-BR-23) and Short Form 36 (SF-36) were applied.Results: The post-treatment score of LLIS, Lymph-ICF, LYMPQOL and EORTCQLQ-BR23 (excluding sexual function and pleasure) was found to be significantlyhigher than before (p<0.0001). Significant difference was determined in SF-36 posttreatment scores compared to before (except healthchange). For those whose totalscore could be calculated, two outcome measures showed the largest effect size:LYMQOL (d=-0.88; SRM=-0.38; GI=-0.36), VAS tension (d=0.88; SRM=0.4;GI=0.7). For those whose total score could not be calculated, three outcome measuresshowed the greatest effect size: EORTC-QLQ-BR23 arm-related problems, hair lossanxiety, and systemic treatment side effects (d=1.35; SRM=0.46; GI=0.41), (d=1.15;SRM=0.47; GI=0.44), (d=1.10; SRM= 0.47; GI=0.43).Conclusion: LYMQOL and VAS strain; The EORTC-QLQ-BR23 arm-relatedproblems, hair loss anxiety and systemic treatment side effects subscales, among thescales whose total score cannot be calculated, are the most responsive end-state criteriain breast cancer-related lymphedema.