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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

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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

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Gastric Cancer in Europe

MaleFemale

FMUP/SBIM

Cumulative risk, 0-64 years

Eucan - Database

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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

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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

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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

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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

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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

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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.

____________________________________________

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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.

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Methods

Inclusion Criteria

o Articles in which QoL was evaluated in patients

with gastric cancer and were treated by chemo

and radiotherapy.

FMUP/SBIM

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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

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QoL after Chemo/Radiotherapy in Gastric Cancer

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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