Систематический обзор современных тенденций оценки качества жизни у пациентов со злокачественными новообразованиями (обзор литературы и клинических рекомендаций)

Abstract

The relevance of research. Quality of life research is an intensively developing area of medicine, with the greatest use in oncology practice. Quality of life is one of the most important criteria for the evaluation of cancer treatment. Given the steady growth, increasing morbidity and mortality rates with an increasing number of surgical procedures performed for malignancies, the quality of life indicator becomes not only a marker of treatment effectiveness, but also an implied factor, a tool for choosing the optimal treatment option in terms of potential impact on the "risk/benefit" profile. In order to assess the impact of different treatment options on the quality of life of patients receiving special treatment, it seems appropriate to analyse quality of life before and after treatment. In this context, a review of current knowledge about current approaches to assessing quality of life in patients receiving special cancer treatment, including various surgical treatment options, will consider accepted current approaches to assessing quality of life. Objective of the study. A systematic review and analysis of the literature on the use of quality of life assessment in the treatment of malignant neoplasms of different localities. Materials and Methods. A literature search was performed using the PubMed and RSCI databases of articles published in the previous 10 years up to July 2012, using the keywords "quality of life", "oncology and quality of life", "malignancies and quality of life", "quality of life", "oncology quality", "QoL". A comprehensive search strategy was used with no restrictions on the type of participants (age and gender characteristics), study design, or type of outcome assessment. Duplicate publications were removed. In the first stage, each title and abstract were checked for potential relevance to the review topic. In the next step, the full text of potentially relevant articles was analysed, after which a final list of articles included in the study was compiled. The inclusion criteria were articles in which quality of life assessment of cancer patients was a determinant of treatment. Exclusion criteria: description of techniques, systematic reviews, articles in which the determinant factor was not specified. All studies meeting the inclusion criteria were analysed as follows: country of study, nosological form, group composition, gender, age, evaluation method used. A brief description of the nature and results of the studies is given. Results. Twenty-eight articles were selected according to the inclusion criteria. A general analysis of the clinical data was performed. Conclusion. The findings suggest that a common paradigm in the treatment of oncology patients implies assessment of patient quality of life not only as a convenient tool for assessing treatment outcomes, but also as a subsequent tool for choosing one or another treatment option. In order to improve the effectiveness of treatment, multidisciplinary discussion of treatment tactics should be combined with assessment of the quality of life of the individual patient, taking into account his or her subjective perception of treatment effectiveness. A further body of evidence on the potential impact of different treatment options and combinations of options on quality of life indicators is needed to select the best treatment options for the future.