Cancer-related symptoms as mediators between treatment and functional capacity in adolescents and young adults (AYAs) with cancer
Refereed conference paper presented and published in conference proceedings
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摘要Background: The functional capacity of AYA patients is often disrupted by the intersection between the cancer experience and important early-life transitions. This study aimed to identify clinical/treatment risk factors of functional capacity in Chinese AYA cancer patients, and examine the mediatory effects of cancer-related symptoms.
Methods: We recruited AYAs (15 to 39 years old) diagnosed with cancer from a tertiary hospital in Hong Kong. They completed the Life Functioning Questionnaire to report their functional capacity in performing work/school and home activities. The predictive characteristics are symptom burden (Rotterdam Symptom Checklist), cognitive symptoms (CCSS-Neurocognitive Function Questionnaire) and psychological symptoms (Brief Symptom Inventory-18). General linear models were used to identify predictive characteristics of functional capacity, adjusted for age and sex. Mediation analysis was performed to examine indirect effects of symptoms on functional outcomes.
Results: This analysis included 120 AYA cancer patients (45.8% male; mean [SD] age 32.0 [5.9] years). Patients with breast cancer (16.7%) reported more functional disruption at work (Est=5.28, SE=1.18, P<0.001) than patients with hematological malignancies, sarcomas, and other solid tumors. Patients treated with surgery (Est= -1.11, SE=0.44, P =0.014) and chemotherapy (Est =1.05, SE=0.47, P =0.027) reported poor home functioning. Physical symptoms (Est= 0.09, SE=0.03, P <0.001), psychological symptoms (Est=0.10, SE=0.03, P =0.001) and cognitive symptoms (Est= 0.36, SE=0.09, P <0.001) were significantly associated with poorer work functioning. Mediation analyses showed that physical symptoms (ß= 1.01, SE= 0.39, P <0.001) and cognitive symptoms (ß= 0.87, SE= 0.36, P <0.001) are strong mediators between chemotherapy and poor work functioning. Psychological symptoms mediated the relationship between chemotherapy and home functioning (ß= 0.87, SE= 0.29, P <0.001).
Conclusion: Cancer-related symptoms are potential mediators between treatment and poor functional capacity in AYAs with cancer. Our work supports the importance of timely and effective symptom management during the cancer care continuum. (Funder: Health and Medical Research Fund/Ref 09202846)
Methods: We recruited AYAs (15 to 39 years old) diagnosed with cancer from a tertiary hospital in Hong Kong. They completed the Life Functioning Questionnaire to report their functional capacity in performing work/school and home activities. The predictive characteristics are symptom burden (Rotterdam Symptom Checklist), cognitive symptoms (CCSS-Neurocognitive Function Questionnaire) and psychological symptoms (Brief Symptom Inventory-18). General linear models were used to identify predictive characteristics of functional capacity, adjusted for age and sex. Mediation analysis was performed to examine indirect effects of symptoms on functional outcomes.
Results: This analysis included 120 AYA cancer patients (45.8% male; mean [SD] age 32.0 [5.9] years). Patients with breast cancer (16.7%) reported more functional disruption at work (Est=5.28, SE=1.18, P<0.001) than patients with hematological malignancies, sarcomas, and other solid tumors. Patients treated with surgery (Est= -1.11, SE=0.44, P =0.014) and chemotherapy (Est =1.05, SE=0.47, P =0.027) reported poor home functioning. Physical symptoms (Est= 0.09, SE=0.03, P <0.001), psychological symptoms (Est=0.10, SE=0.03, P =0.001) and cognitive symptoms (Est= 0.36, SE=0.09, P <0.001) were significantly associated with poorer work functioning. Mediation analyses showed that physical symptoms (ß= 1.01, SE= 0.39, P <0.001) and cognitive symptoms (ß= 0.87, SE= 0.36, P <0.001) are strong mediators between chemotherapy and poor work functioning. Psychological symptoms mediated the relationship between chemotherapy and home functioning (ß= 0.87, SE= 0.29, P <0.001).
Conclusion: Cancer-related symptoms are potential mediators between treatment and poor functional capacity in AYAs with cancer. Our work supports the importance of timely and effective symptom management during the cancer care continuum. (Funder: Health and Medical Research Fund/Ref 09202846)
出版社接受日期23.09.2022
著者Chung Tin Justin Ma, Herbert Ho Fung Loong, Wing Tung Ip, Junfeng Zhang, Alex Wing Kwan Leung, Chun Kit Ngan, Chi Kong Li, Yin Ting Cheung
會議名稱European Society for Medical Oncology (ESMO) Asia Congress 2022
會議開始日02.12.2022
會議完結日04.12.2022
會議地點Singapore
會議國家/地區新加坡
會議論文集題名Annals of Oncology
系列標題Supportive care
出版年份2022
月份11
卷號33
期次Suppl. 9
出版社Elsevier
出版地Switzerland
頁次1542 - 1542
語言美式英語
關鍵詞Adolescents and Young Adults, Functional capacity, Symptom burden, Cognitive symptoms, Psychological symptoms