Symptom disturbance and quality of life for patients with pituitary tumor after stereotactic radiosurgery
Date Issued
2012
Date
2012
Author(s)
Yang, Ching-Ju
Abstract
Background: Approximately 10-15% of intracranial tumors are pituitary tumors. Stereotactic radiosurgery (SRS) is a common treatment for recurrent or residual pituitary adenomas. The most frequent complications from SRS are impairments of visual function and hypopituitarism. The persistence of theses symptom disturbances and treatment related complications may impair the patient’s quality of life.
Purpose: The purpose of this study was to explore the correlation between the level of pituitary tumor post stereotactic radiosurgery-related symptom disturbances and the quality of life in the patients.
Methods: This study used a cross-sectional design and purposive sampling. We enrolled patients who were diagnosed with a pituitary tumor and also underwent stereotactic radiosurgery at the Cyberknife Unit of the Medical Center in Northern Taiwan. All participants had SRS between February 2008 and December 2011. Our data consisted of three parts, including the Pituitary Tumor Symptom Disturbance Scale, World Health Organization Quality of Life Instrument Short-Form (WHOQOL-BREF) and a demographic questionnaire.
Results: Sixty patients enrolled in our study. The mean age of participants was 51.17 years. Functional and non-functional pituitary tumors accounted for about 49% and 51%, respectively. The total number of symptom disturbances were 5.95±5.05 post stereotactic radiosurgery. Five of the most common symptom disturbances were poor memory, fatigue, blurred vision, amenorrhea and headache. The mean scores of symptom disturbance was 7.62±9.96. These symptom disturbances were negatively associated with age (Spearman ρ=-0.36, p=0.00) and positively associated with the
total number of medication (Spearman ρ=0.32, p=0.01). Patients with a functional pituitary tumors reported more symptoms disturbance as compared to the
non-functional tumor group (Z=-2.74, p=0.01). The lowest score of WHOQOL was in the psychological domain and the highest score was in the environmental domain. Patients with pituitary tumors had a lower physical health QOL as compared with the normative population (t=-2.81, p=0.01). Age was positively associated with general health (Spearman ρ=0.51, p=0.00) and psychological domain (Spearman ρ=0.33, p=0.01). Symptom disturbances were negatively associated with general QOL (Spearman ρ=-0.57, p=0.00) , general health (Spearman ρ=-0.69, p=0.00), physical health (Spearman ρ=-0.55, p=0.00), psychological (Spearman ρ=-0.54, p=0.00) and social relationship domains (Spearman ρ=-0.43, p=0.00). Compared with females, males had higher scores in the psychological (Z=-2.33, p=0.02) and environmental (Z=-2.08, p=0.04) domains. Compared to patients with 6 or more symptom disturbances, patients with≦6 symptom disturbances experienced better general QOL(Z=-4.06, p=0.00), general health(Z=-4.69, p=0.00), physical health(Z=-5.33, p=0.00), psychological(Z=-4.69, p=0.00) and social relationship QOL(Z=-3.11, p=0.00).
Conclusion: Patients with pituitary tumors can have persistent or new symptom disturbances after stereotactic radiosurgery. These disturbances can affect different aspects of the patient''s quality of life. These findings can be used to design educational and interventional programs for symptom management, thereby improving the patients’ quality of life.
Subjects
pituitary tumor
symptom disturbance
quality of life
stereotactic radiosurgery
Type
thesis
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