肺癌相关疲劳：研究议程：美国呼吸学会官方研究声明

Cancer-related Fatigue in Lung Cancer: A Research Agenda: An Official American Thoracic Society Research Statement

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE

影响因子:19.4

分区:医学1区 Top / 危重病医学1区呼吸系统1区

发表日期:2023 Mar 01

作者: Brett C Bade, Saadia A Faiz, Duc M Ha, Miranda Tan, Margaret Barton-Burke, Andrea L Cheville, Carmen P Escalante, David Gozal, Catherine L Granger, Carolyn J Presley, Sheree M Smith, Dawn M Chamberlaine, Jason M Long, Daniel J Malone, William F Pirl, Halley L Robinson, Kazuhiro Yasufuku, M Patricia Rivera

DOI: 10.1164/rccm.202210-1963ST

摘要

背景：疲劳是癌症幸存者中最常见的症状。癌症相关疲劳（CRF）可能在癌症护理的任何阶段发生。多种因素影响CRF的发生和严重程度，包括癌症类型、治疗方式、其他症状的存在、合并症和药物副作用。临床上，增加身体活动、改善睡眠质量以及识别睡眠障碍是管理CRF的重要措施。不幸的是，尽管肺癌患者的症状比其他癌症更频繁和严重，但CRF在肺癌幸存者中很少被识别、评估或治疗。因此，增加对CRF的认识和理解对于改善肺癌幸存者的生活质量至关重要。目标：1）识别并优先考虑知识和研究空白；2）制定和优先排序研究问题，以评估肺癌幸存者CRF的机制、诊断和治疗方法。方法：我们召集了一个多学科专家组，回顾关于CRF的现有文献，重点关注身体活动、康复和睡眠障碍对肺癌的影响。采用三轮修订的Delphi方法对研究问题进行优先排序。结果：本声明识别了以下方面的知识空白：1）肺癌幸存者CRF的检测和诊断评估；2）身体活动和康复的时机、目标及实施；3）睡眠障碍及其治疗以减轻CRF。最后，提出了最初的32个研究问题和7个最终优先问题。结论：本声明提供了一个优先研究议程，以推动临床与科研工作，并提高对肺癌幸存者CRF的认识。

Abstract

Background: Fatigue is the most common symptom among cancer survivors. Cancer-related fatigue (CRF) may occur at any point in the cancer care continuum. Multiple factors contribute to CRF development and severity, including cancer type, treatments, presence of other symptoms, comorbidities, and medication side effects. Clinically, increasing physical activity, enhancing sleep quality, and recognizing sleep disorders are integral to managing CRF. Unfortunately, CRF is infrequently recognized, evaluated, or treated in lung cancer survivors despite more frequent and severe symptoms than in other cancers. Therefore, increased awareness and understanding of CRF are needed to improve health-related quality of life in lung cancer survivors. Objectives: 1) To identify and prioritize knowledge and research gaps and 2) to develop and prioritize research questions to evaluate mechanistic, diagnostic, and therapeutic approaches to CRF among lung cancer survivors. Methods: We convened a multidisciplinary panel to review the available literature on CRF, focusing on the impacts of physical activity, rehabilitation, and sleep disturbances in lung cancer. We used a three-round modified Delphi process to prioritize research questions. Results: This statement identifies knowledge gaps in the 1) detection and diagnostic evaluation of CRF in lung cancer survivors; 2) timing, goals, and implementation of physical activity and rehabilitation; and 3) evaluation and treatment of sleep disturbances and disorders to reduce CRF. Finally, we present the panel's initial 32 research questions and seven final prioritized questions. Conclusions: This statement offers a prioritized research agenda to 1) advance clinical and research efforts and 2) increase awareness of CRF in lung cancer survivors.