摘要
近些年评估患者生活质量（quality of life，QOL）的工具发展十分迅速，生活质量作为评价临床治疗效果的一个指标，越来越受到研究者的重视。既往过多重视由医生评估的疼痛和功能障碍，而忽视了患者的社会心理方面评估。目前，许多评价标准越来越注重将患者的主观感受纳入到评分系统中，患者进行自我评价（patient-reported outcome，PRO）所使用的评估工具通常是患者自评量表或问卷调查。骨转移瘤作为常见的晚期癌症并发症，对其治疗多为姑息性，提高或者维持患者的生活质量的观点已经得到共识。骨转移瘤患者生活质量评估的量表包括一些癌症普适性量表，如欧洲癌症研究与治疗组织（Europe Organization for Research and Treatment of Cancer，EORTC）研发的QLQ—C30、癌症治疗评估量表（functional assessment of cancer therapy-general，FACT—G）、简明健康问卷（the MOS 36-item short from health survey，SF-36）等，但它们在评估中缺乏特异性及准确性。为使评价更加完善，优化对骨转移患者的治疗，全面、系统地评估不同治疗方案的优劣，EORTC QLQ—BM22量表作为骨转移瘤特异性量表在2009年推出，其经过信度、效度、跨文化适应性的验证，配合EORTC QLQ—C30使用或单独使用，是近些年来骨转移瘤患者生活质量评估的主要量表，越来越多地应用到临床试验和实践中。它的加入完善了EORTC评估系统，对评估疗效等有重大意义。EORTC QLQ-BM22简体中文版在我国经过了效度、信度等检测，可作为评估中国群体骨转移瘤患者生存质量的一份有效量表。本文对骨转移患者生活质量的评估现状及进展进行总结，指导临床研究中选取合适的量表，更好地评估疗效，发现治疗的利弊，以指导临床治疗决策。
There is increasing recognition of the importance of the quality of life （QOL） since it became an endpoint of clinical practices, a variety of disease-specific quality of life instruments have been developed and used as a means of assessing clinical interventions. Traditional evaluation was performed by researchers who generally ignore the subjective feeling from patiens. At present, many evaluation criteria has paid more attention to the patient＇s subjective feelings into the scoring system, the assessment tool of patient-reported outcome （PRO） is usually the patient self-rating scale or questionnaire. As a common complica- tions of terminal stages of cancer, the treatment of bone metastases is usually conservative, improving or maintaining the quality of life of patients has been the consensus. Bone metastases trials have employed QLQ-C30 which raised by Europe Organization for Research and Treatment of Cancer （EORTC） or other generic health related QOL measurement, such as functional assessment of cancer therapy-general （FACT-G） and the MOS 36-item short from health survey （SF-36）. But they lack specificity and accuracy in the assessment. EORTC QLQ-BM22 scale is considered as a bone metastases specific scale which was introducted in 2009, after the reliability, validity, cross-cultural adaptability verification, with the combination of EORTC QLQ-C30 or used alone, has in- creasingly applied to clinical trials and practice for QOL assessment of bone metastatic cancer patients in recent years. It complete the EORTC evaluation system, which has significant value for assessing efficacy. EORTC QLQ-BM22 has been translated into sim- plified Chinese and evaluated its utility, could be used in China as an effective questionnaire in evaluating the QOL for patients with bone metastases. In this study, current situation and progress of QOL measuring tools for bone metastases patients is re- viewed, in order to help researchers choose appropriate scale and better assess the efficacy, find the pros and cons to guide the clinical treatment decision.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2017年第18期1177-1184,共8页
Chinese Journal of Orthopaedics
