Ispitivanje prediktora kvaliteta života dece sa novootkrivenim solidnim tumorima

Abstract

Poslednjih decenija došlo je do porasta stope preživljavanja dece obolele od malignih bolesti, najviše kao posledica standardizacije i intenziviranja protokola lečenja što je dovelo i do porasta broja i težine neželjenih efekata u vidu različitih fizičkih i psihičkih simptoma sa kojima se deca suočavaju tokom lečenja a i kasnije tokom života. Cilj ovog rada bio je procena kvaliteta života dece sa novootkrivenim solidnim tumorima kao i određivanje prediktora kvaliteta života na početku lečenja. Metod: Istraživanje je obuhvatilo grupu dece sa novootkrivenim solidnim tumorima koja su započela onkološko lečenje na Institutu za onkologiju i radiologiju Srbije u periodu od decembra 2016. do januara 2018. godine. Rezultati: Ukupan broj dece bio je 51. Dečaka je bilo 24 (47,1%), a devojčica 27 (52,9%). Većina dece imala je tumore CNS-a (21/51; 41,2%), dok su na drugom mestu bili koštani tumori (19/51; 39,2%). Diseminovanu formu bolesti imalo je 14/51 dete (27%) a najčešće je diseminacija bila prisutna kod koštanih tumora (8/20; 40%). Prosečan uzrast dece sa tumorima CNS bio je 7,3 ± 3,9 godina a najčešći tip tumora je bio meduloblastom (38%). Prosečan uzrast dece sa koštanim tumorima je bio 13,6±5,7 godina a više dece je imalo Ewing sarkom (12/20; 60%). Najčešća lokalizacija koštanih tumora bili su ekstremiteti (60%). Nije uočena razlika u kvalitetu života u odnosu na pol. U domenu za mučninu značajna razlika u odnosu na uzrast postojala je između namlađe i najstarije dece (p=0,06), dok je u odnosu na tip tumora razlika postojala između dece sa tumorima CNS u odnosu na decu sa tumorima kostiju (p=0,019). U domenu kognitivnih smetnji značajna razlika je postojala između dece uzrasta 5-7 i 8-12 godina (p=0,040) kao i između dece uzrasta 8-12 i 13-18 godina (p=0,020). U domenu za uznemirenost zbog lečenja značajna razlika je postojala između dece sa tumorima CNS i dece sa tumorima kostiju (p=0,042). Značajna razlika uočena je u odnosu na tip tumora za domen fizičkog funkcionisanja između dece sa tumorima CNS i dece sa tumorima kostiju (p=0,021) kao i za domen emocionalnog funkcionisanja između dece sa tumorima kostiju i dece sa tumorima mekih tkiva (p=0,042)...

In the last decades, an increase in the survival rate of children diagnosed with malignant diseases has been observed, predominantly as a consequence of standardization and intensification of treatment protocols, which also led to the increase of number and severity of treatment adverse effects represented by various physical and mental symptoms children encounter during the treatment and later in life. The aim of this research was the assessment of the quality of life of children with newly diagnosed solid tumors as well as the assessment of predictors of quality of life at the beginning of treatment. Methods: This research included a group of children with newly diagnosed solid tumors who began their oncological treatment at the Institute for Oncology and Radiology of Serbia from December 2016 until January 2018. Results: The total number of children enrolled was 51, out of which 24 (47.1%) were boys and 27 (52.9%) girls. Majority of children had tumors of the central nervous system (21/51; 41.2%), followed by bone tumors (19/51; 39.2%). Disseminated form of the disease was present in 14/51 children (27%), predominantly seen in bone tumors (8/20; 40%). The average age of children with CNS tumors was 7.3±3.9 years and the most frequent type of tumor was medulloblastoma (38 %). The average age of children with bone tumors was 13.6 ± 5.7 years with Ewing sarcoma as the most frequently diagnosed bone tumor (12/20; 60%). The most frequent localization of bone tumors were extremities (60%). No difference in the quality of life related to gender was observed. In the nausea domain, a significant difference was found between the youngest and oldest children (p=0.06), while in relation to the type of tumor, the difference was found between children with CNS tumors and children with bone tumors (p=0.019). In the cognitive disorder domain, a significant difference was found between children in 5-7 years age group and children in 8-12 years age group, as well as between children of 8-12 years and 13-18 years (p=0.020). In the treatment anxiety domain, a significant difference was found between children with CNS tumors and children with bone tumors (p=0.042)...