机构：[1]Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.外科中心胸外科中心四川省人民医院四川省肿瘤医院胸外科[2]Department of Thoracic and Cardiovascular Surgery, Jiangyou People's Hospital, Jiangyou, Sichuan, China.[3]Department of Cardiothoracic Surgery, Zigong First People's Hospital, Zigong, Sichuan, China.[4]Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX.[5]Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.[6]Section of Patient-Centred Outcomes Research, Leeds Institute for Medical Research at St James's, University of Leeds, Leeds, United Kingdom.[7]Department of Thoracic Surgery, Leeds Teaching Hospital Trust, Leeds, United Kingdom.[8]School of Public Health and Management, Chongqing Medical University, Chongqing, China.[9]Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.四川省人民医院四川省肿瘤医院[10]Department of Radiation Oncology, Sichuan Cancer Hospital & Institution, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.四川省人民医院四川省肿瘤医院[11]Traditional Chinese Medicine Department of Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.四川省人民医院四川省肿瘤医院[12]Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, China.四川大学华西医院[13]Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China.四川大学华西医院[14]Center for Cancer Prevention Research, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.四川省人民医院四川省肿瘤医院[15]State Key Laboratory of Ultrasound in Medicine and Engineering, School of Public Health and Management, Chongqing Medical University, Chongqing, China.
We aimed to evaluate the efficacy and feasibility of patient-reported outcome (PRO)-based symptom management in the early period after lung cancer surgery.Before surgery, patients with clinically diagnosed lung cancer were randomly assigned 1:1 to receive postoperative PRO-based symptom management or usual care. All patients reported symptoms on MD Anderson Symptom Inventory-Lung Cancer presurgery, daily postsurgery, and twice a week after discharge for up to 4 weeks via an electronic PRO system. In the intervention group, treating surgeons responded to overthreshold electronic alerts driven by any of the five target symptom scores (score ≥ 4 on a 0-10 scale for pain, fatigue, disturbed sleep, shortness of breath, and coughing). The control group patients received usual care and no alerts were generated. The primary outcome was the number of symptom threshold events (any target symptom with a score of ≥ 4) at discharge. Per-protocol analyses were conducted.Of the 166 participants, 83 were randomly allocated to each group. At discharge, the intervention group reported fewer symptom threshold events than the control group (median [interquartile range], 0 [0-2] v 2 [0-3]; P = .007). At 4 weeks postdischarge, this difference was maintained between the intervention and control groups (median [interquartile range], 0 [0-0] v 0 [0-1]; P = .018). The intervention group had a lower complication rate than the control group (21.5% v 40.6%; P = .019). Surgeons spent a median of 3 minutes managing an alert.PRO-based symptom management after lung cancer surgery showed lower symptom burden and fewer complications than usual care for up to 4 weeks postdischarge.
基金：
Supported by the Bethune Charitable Foundation (HZB-20181119-5),
Sichuan Science and Technology Program (2019YFH0070), and
National Natural Science Foundation of China (81872506).
第一作者机构：[1]Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
通讯作者：
通讯机构：[14]Center for Cancer Prevention Research, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.[15]State Key Laboratory of Ultrasound in Medicine and Engineering, School of Public Health and Management, Chongqing Medical University, Chongqing, China.[*1]Center for Cancer Prevention Research, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, No. 55, Section 4, South Renmin Rd, Chengdu 610041, China
推荐引用方式(GB/T 7714)：
Dai Wei,Feng Wenhong,Zhang Yuanqiang,et al.Patient-Reported Outcome-Based Symptom Management Versus Usual Care After Lung Cancer Surgery: A Multicenter Randomized Controlled Trial.[J].JOURNAL OF CLINICAL ONCOLOGY.2022,40(9):988-996.doi:10.1200/JCO.21.01344.
APA：
Dai Wei,Feng Wenhong,Zhang Yuanqiang,Wang Xin Shelley,Liu Yangjun...&Shi Qiuling.(2022).Patient-Reported Outcome-Based Symptom Management Versus Usual Care After Lung Cancer Surgery: A Multicenter Randomized Controlled Trial..JOURNAL OF CLINICAL ONCOLOGY,40,(9)
MLA：
Dai Wei,et al."Patient-Reported Outcome-Based Symptom Management Versus Usual Care After Lung Cancer Surgery: A Multicenter Randomized Controlled Trial.".JOURNAL OF CLINICAL ONCOLOGY 40..9(2022):988-996
医学