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1
Assessment of Quality Of Life in
patients treated with Chemo and
Radiotherapy for Gastric Cancer: A
Systematic Review Authors: Turma 14
Supervisors: Mário Dinis Ribeiro
Cláudia Camila Dias
Professor Doutor Altamiro da Costa Pereira
FMUP/SBIM
2
Gastric Cancer in the World
31
14
109 8
4 4 3
1 0 0 0 0
108
68
4
0
3 3 21 1
13
8
4
16
0
5
10
15
20
25
30
35
Lung
Stom
ach
Live
rCCR
Oesop
hagu
s
Pros
tate
Panc
reas
Leuk
emia
NHLSk
in
Thyr
oid
Breas
t
Uteru
s
Ovary
Men Women
FMUP/SBIM
850 000 deaths worlwide each year cause due to 850 000 deaths worlwide each year cause due to
gastric cancergastric cancer
World, age-standardized rates (per 100.000 persons.year)
Eucan - Database
3
Gastric Cancer in Europe
MaleFemale
FMUP/SBIM
Cumulative risk, 0-64 years
Eucan - Database
4
Introduction
Stomach
adenocarcinoma is the
most common form of
gastric cancer (95% of
the cases).11
Stomach cancer is a
multifactorial disease:
diet, hereditary factors,
Helicobacter pylori
infection are possible
causes. 2-32-3
1- http://www. vidasaudavel.pt
2- http://cancer.healthcentersonline.com/gastrointestinalsystemcancer/stomachcancer.cfm
3- http://hcd2.bupa.co.uk/fact_sheets/html/stomach_cancer.html
FMUP/SBIM
QoL after Chemo/Radiotherapy in Gastric Cancer
5
Introduction
Treatment for gastric
cancer often involves
surgery, usually a
partial or a total
gastrectomy (removal
of stomach tissue).22
Chemotherapy and
radiotherapy are
standard for some
stages of stomach
cancer.22 2- http://cancer.healthcentersonline.com/gastrointestinalsystemcancer/stomachcancer.cfm
FMUP/SBIM
QoL after Chemo/Radiotherapy in Gastric Cancer
6
Introduction Chemotherapy is the use
of chemical agents to
stop cancer cells from
growing.
Chemotherapy is considered a systemic treatment.22
More than half of all people diagnosed with cancer receive chemotherapy.22
2- http://cancer.healthcentersonline.com/gastrointestinalsystemcancer/stomachcancer.cfmFMUP/SBIM
QoL after Chemo/Radiotherapy in Gastric Cancer
7
Radiotherapy uses high
energy x-rays to
destroy cancer cells.44
A small dose of
radiotherapy may be
very helpful to relieve
pain.44
4- http://info.cancerresearchuk.org/cancerstats/types/stomach/?a=5441FMUP/SBIM
QoL after Chemo/Radiotherapy in Gastric Cancer
8
QoL cannot be yet universally defined5, however there are many attempts to do so.
These multiple treatments
have different
consequences in de Quality
of Life (QoL) in patients.
Schipper et al. proposed:
“the functional effect of illness and its consequent
therapy upon a patient, as perceived by the patient”.6
FMUP/SBIM
QoL after Chemo/Radiotherapy in Gastric Cancer
5- Spilker B, ed. Quality of Life and pharmacoeconomics in clinical trials. Philadelphia:Lippincott-Raven, 1996
6- Schipper H, Clinch J, Olweny LM. Definitions and conceptual issues. In: Spilker B, ed. Quality of Life and pharmacoeconomics
in clinical trials, Philadephia : Lippincott- Raven, 1996: 11-24
9
Aim
FMUP/SBIM
QoL after Chemo/Radiotherapy in Gastric Cancer
____________________________________________
• To review which instruments were used to measure
the QoL in patients with gastric cancer submitted to
chemo and radiotherapy.
• To summarize QoL measures across studies.
____________________________________________
10
Methods:
The MesH terms that we use were:
◊ ″Quality of Life And stomach Neoplasms
Not surgery. “
FMUP/SBIM
QoL after Chemo/Radiotherapy in Gastric Cancer
Literature searches were
conducted
in Medline.
11
Limits:
Publication Date till September 2005.
Only items with an abstract.
Humans.
12
Methods
Inclusion Criteria
o Articles in which QoL was evaluated in patients
with gastric cancer and were treated by chemo
and radiotherapy.
FMUP/SBIM
13
Methods
• After searching in
Medline 45 articles
were found. Due to the
applying of the
inclusion and exclusion
criteria the number of
articles was reduced to
13.
Exclusion critérium
Number of articles
Patients with more than one type of cancer
7
Patients with another type of cancer (not gastric cancer)
4
Patients weren’t treated with chemo and radiotheraphy
5
QoL was not measured 6
Other reasons 10
Total of articles excluded: 32
FMUP/SBIM
QoL after Chemo/Radiotherapy in Gastric Cancer
14
FluxogramBeginning
Read title and abstract
Excluded by 2 reviewers
Exclude article
Included by 2 reviewers
End
Opinion of a third reviewer
no
Include article
yes
Read complete
article
Introduce data in the SPSS
Yes No
Discuss until reviewers agreement
Exclude article
Include article
QoL after Chemo/Radiotherapy in Gastric Cancer