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ORIJINAL ARAŞTIRMA

Meme Kanserine Bağlı Lenfödemin Sağlıkla İlgili Yaşam Kalitesi Üzerine Etkisi
The Effect of Breast Cancer Related Lymphedema on Health Related Quality of Life
Received Date : 06 Feb 2020
Accepted Date : 12 Jul 2020
Available Online : 28 Sep 2020
Doi: 10.31609/jpmrs.2020-73720 - Makale Dili: EN
J PMR Sci. 2020;23(3):201-8
ÖZET
Amaç: Meme kanseri ile ilişkili lenfödem (BCRL) hastaları ile sağlıklı kontroller arasında sağlıkla ilgili yaşam kalitesi (HRQOL) skorları açısından bir fark var mı? BCRL hastalarının HRQOL skorlarında lenfödem şiddetine göre bir fark var mı? Gereç ve Yöntemler: 1 Ocak 2012-31 Aralık 2018 tarihleri arasında üçüncü basamak merkez olan Fiziksel Tıp ve Rehabilitasyon Eğitim ve Araştırma Hastanesi'nde toplam 50 sağlıklı gönüllü ve 78 tek taraflı BCRL hastasının tıbbi kayıtları incelendi. Yaş, cinsiyet, vücut kitle indeksi (BMI), cerrahi müdahaleler (modifiye radikal mastektomi (MRM) + aksiler lenf nodu disseksiyonu (ALND) veya lumpektomi), kemoterapi, radyoterapi, hormon tedavisi, ağrı, uyuşma, omuz eklem hareket açıklığı aralığı, ameliyat sonrası geçen süre, metastaz varlığı, metastatik lenf nodu sayısı, rezeke edilen lenf nodu sayısı, lenfödem durumu ve BCRL hastalarının SF-36 HRQOL skorları kaydedildi. Bulgular: Çalışmaya BCRL'li yetmiş sekiz kadın ve 50 sağlıklı kadın dahil edildi. SF-36 HRQOL parametreleri BCRL grubu ile kontrol grubu arasında karşılaştırıldığında; fiziksel işlevsellik (42,57±8,3’e karşı 46,84±7,4, p=0,004), fiziksel rol işlevi (38,02±12,2 vs. 44,63±10,8, p=0,001) ve fiziksel bileşen özeti (40,47±8,4’e karşılık 45,30±9,7, p=0,005) skorları BCRL grubunda anlamlı olarak düşüktü. Diğer SF-36 HRQOL parametreleri gruplar arasında benzerdi (p>0,05). SF-36 HRQOL parametreleri lenfödem ≤3 cm ve lenfödem >3 cm olan alt gruplar arasında karşılaştırıldığında; tüm parametreler benzerdi (p>0,05). Sonuç: Çalışmamızda lenfödem ve kontrol grubu SF-36 ile karşılaştırıldığında lenfödem hastalarında fiziksel fonksiyon, fiziksel rol fonksiyon ve fiziksel bileşen skorları daha düşük olup istatistiksel olarak anlamlı idi. İlginç bir şekilde, lenfödemi ≤3 cm ve >3 cm olan alt gruplar arasında SF-36 skorları karşılaştırıldığında, istatistiksel olarak anlamlı bir fark bulunmadı. Bu sonuçlar, lenfödem varlığının, yaşam kalitesinde lenfödem şiddetinden çok daha önemli olduğunu göstermektedir.
ABSTRACT
Objective: First, is there any difference in health related quality of life (HRQOL) scores between breast cancer-related lymphedema (BCRL) patients and healthy controls? Second, is there any difference in HRQOL scores of BCRL patients according to lymphedema severity? Material and Methods: The medical records of a total of 50 healthy volunteers and 78 unilateral BCRL patients were examined between 01 January 2012 and 31 December 2018 in the Physical Medicine and Rehabilitation Training and Research Hospital which is a tertiary center. Age, gender, BMI, surgical interventions (modified radical mastectomy (MRM) + axillary lymph node dissection (ALND) or lumpectomy), chemotherapy, radiotherapy, hormone therapy, pain, numbness, shoulder joint range of motion measurement, time after surgery, remove metastasis, metastatic lymph nodes, number of metastatic lymph nodes, number of resected lymph nodes, lymphedema status, and the SF-36 HRQOL scores of BCRL patients were noted from the files. Results: Seventy-eight women with BCRL and 50 healthy women were included in the study. When the parameters of the SF-36 HRQOL were compared between the BCRL group and the control group; physical functioning(42.57±8.3 vs. 46.84±7.4, p=0.004), physical role functioning (38.02±12.2 vs. 44.63±10.8, p=0.001), and physical component summary(40.47±8.4 vs. 45.30±9.7, p=0.005) scores were significantly lower in the BCRL group. Other SF-36 HRQOL parameters were similar between the groups (p>0.05). When the parameters of SF-36 HRQOL were compared between the lymphedema ≤ 3 cm and the lymphedema > 3 cm subgroups; all of the parameters were similar(p>0.05). Conclusion: In our study, compared to the lymphedema and control group SF-36, physical function, physical role function and physical component scores in lymphedema patients were lower and statistically significant. Interestingly, no statistically significant difference was found when SF-36 scores were compared between the lympedema ≤3 cm and >3 cm subgroups. These results show that the presence of lymphedema is much more important than the lymphedema severity in impairing quality of life.
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