総 説 化学療法による味覚変化が栄養と QOL に与える影響 : システマティックレビュー * Key words QOL taste alteration, chemotherapy, nutrition, QOL 緒言 方 法 QOL
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1 総 説 化学療法による味覚変化が栄養と QOL に与える影響 : システマティックレビュー * Key words QOL taste alteration, chemotherapy, nutrition, QOL 緒言 方 法 QOL QOL, QOL QOL PRISMA 9 レビュー文献の適格基準 情報源 PubMedCINAHL Ver 検索 ( 表 ) chemotherap tast 連絡先 Phone h15101mk@sfc.keio.ac.jp
2 Search Number and Terms #17 #16 #15 表 検索語 Search (((((( Neoplasms [Mesh]) AND Drug Therapy [Mesh]) AND Taste Disorders [Mesh])) OR (((cancer[title/abstract]) AND chemotherap*[title/abstract]) AND (((((disgeusia[title/abstract]) OR ageusia[title/abstract]) OR tast*[title/abstract]) OR gustat*[title/abstract]) OR chemosenso*[title/abstract])))) NOT ((head[title/abstract] AND neck[title/abstract])) Filters: Publication date from 2006/01/01 to 2016/08/04 Search (((((( Neoplasms [Mesh]) AND Drug Therapy [Mesh]) AND Taste Disorders [Mesh])) OR (((cancer[title/abstract]) AND chemotherap*[title/abstract]) AND (((((disgeusia[title/abstract]) OR ageusia[title/abstract]) OR tast*[title/abstract]) OR gustat*[title/abstract]) OR chemosenso*[title/abstract])))) NOT ((head[title/abstract] AND neck[title/abstract])) Search (((( Neoplasms [Mesh]) AND Drug Therapy [Mesh]) AND Taste Disorders [Mesh])) OR (((cancer[title/abstract]) AND chemotherap*[title/abstract]) AND (((((disgeusia[title/abstract]) OR ageusia[title/abstract]) OR tast*[title/abstract]) OR gustat*[title/abstract]) OR chemosenso*[title/abstract])) Results #14 Search (head[title/abstract] AND neck[title/abstract]) #13 Search ((cancer[title/abstract]) AND chemotherap*[title/abstract]) AND (((((disgeusia[title/abstract]) OR ageusia[title/abstract]) OR tast*[title/abstract]) OR gustat*[title/abstract]) OR chemosenso*[title/abstract]) #12 Search (( Neoplasms [Mesh]) AND Drug Therapy [Mesh]) AND Taste Disorders [Mesh] 36 #11 Search ((((disgeusia[title/abstract]) OR ageusia[title/abstract]) OR tast*[title/abstract]) OR gustat*[title/abstract]) OR chemosenso*[title/abstract] #10 Search chemotherap*[title/abstract] #9 Search cancer[title/abstract] #8 Search Taste Disorders [Mesh] 1896 #6 Search Drug Therapy [Mesh] #4 Search Neoplasms [Mesh] 研究の選択 個々の研究のバイアスリスク評価 Joanna Briggs Institute ( 表 ) 結果の統合, 結果 研究の選択 PubMed 115 CINEAL ( 図 ) 1134 研究内のバイアスリスク 研究の特性 ( 表 ) QOL QOL , アセスメント方法 ) 味覚変化 ( 表 )
3 identification データベースから抽出 184 件 (PubMed:115 件 /CINAHL:69 件 ) 重複文献除外後 149 件 ハンドサーチ 3 件 (PubMed) データベースから抽出 98 件 ( 医中誌 ) 重複文献なし 98 件 screening タイトル 抄録によるスクリーニング 19 件 13除外 7 5 件 2 件 9 件 7 件 3 件 5 件 2 件 12 件 14 件 1 件 目的の違い質的研究ケースレポートレビュー文献治験 臨床試験 18 歳以下動物実験放射線治療中頭頸部癌患者エキスパートコメント英語以外学会抄録 87 件除外 77 件 2 件 1 件 3 件 2 件 2 件 タイトル 抄録によるスクリーニング 11 件 eligibility 全文精読後 14 件参考文献 2 件 5 件除外 1 件 3 件 1 件 目的の違い化学療法中ではない患者が対象化学療法中の患者が 80% 以下査読なし 3 件除外 3 件 全文精読後 8 件 included 最終 16 件 最終 8 件 図 文献選択過程 (1) 主観的アセスメント (2) 客観的アセスメント CTCAECommon Terminology Criteria for Adverse Events ) 栄養 ( 表 ) BMI / 11 (1) 主観的アセスメント (2) 客観的アセスメント BMI / 11 (3) 主観的 + 客観的アセスメント PG SGAPatient Generated Subjective Global Assessment 1114 )( 表 ) EORTC QLQ C30European Organization for Research Treatment of Cancer Quality of Life Questionnaire Core 30QOL EORTC QLQ LC13 EuropeanOrganization for Research Treatment of
4 Turcott JG 11 QOL Okada N 12 Coa KI Boltong A Nishijima S Imai H 16 Kano T 17 Steinbach S 18 Gamper EM 19 1 / QOL Zabernigg A QOL Sanchez-Lara K 21 Steinbach S 22 Bernhardson BM / 1 3 表 対象文献の概要 QOL 40 CDDP PTX 1st Line /8 48 MEAM LEED 42 7/ /8 52 6/8 23 TC / /8 245 PTX FOLFOX FOLFIRI TC TS1 PTX CEF 6/8 12 TC 6/8 109 GEM VNR ED EC CEF TC PTX CBDCA or /8 197 GEM VP-16 FOLFOX or / /8 87 8/8 518 CEF CBDCA PTX or DTX FOLFIRI FOLFOX /
5 表 対象文献の概要 ( つづき ) QOL Rehwaldt M CBDCA CDDP 2 3 7/9 Jensen SB CEF or CMF /8 Bernhardson BM / 518 CEF CBDCA PTX or DTX FOLFIRI FOLFOX / CBDCA 5/ / FOLFOX DTX EC PTX Bev TC / PTX DTX FOLFOX FOLFIRI GEM / / mfolfox6 Bev FOLFIRI Bev GEM CEF VNR 46 5/8 33 FOLFOXFOLFIRI QOL 31 mfolfox6 Bev FOLFIRI Bev / FOLFOX FOLFIRI RPMI /8 Bev CBDCA CDDP : CEF : CMF : DTX : EC : ED FOLFOX FOLFIRI GEM : LEED MEAM PTX RPMI : TC VNR : VP-16 :
6 Turcott JG 11 Okada N 12 Coa KI 13 Boltong A Nishijima S 15 Imai H 16 Kano T 17 Steinbach S 18 Gamper EM 19 Zabernigg A 20 Sanchez-Lara K 21 Steinbach S 22 Bernhardson BM 23 Rehwaldt M 24 Jensen SB Bernhardson BM 表 味覚アセスメント方法 rinsing technique CTCAE 5 ** * *** CTCAE *** sip and spit technique CTCAE ISO ** CiTAS / taste strips rinsing technique taste strips 0.68 R-CHOP *** *** 30 / / / 0.84 *** 3 *** 5 ** *** 5 ** 5 5 ** 5FU 5 ** 50 * : 2 ** *** : CTCAE Grade
7 Turcott JG 11 Okada N 12 Coa KI 13 Boltong A Sanchez-Lara K 21 Bernhardson BM 23 Rehwaldt M 24 Bernhardson BM *** : / BMI 24 BMI BMI 表 栄養アセスメント方法 FAACT Anorexia/Cachexia Scale PG-SGA FFQ PG-SGA Bodystat QuadScan 4000 ultifrequency device TPN Total Parenteral Nutrition PG-SGA FFQ 1 PG-SGA *** *** *** *** *** *** 0.84 *** *** QOL *** Cancer Quality of Life Questionnaire Lung Cancer QOL 11 SF 8Short Form 8 QOL 8 17 QOL ACDQOL Questionnaire for Cancer Patients Treated with Anticancer Drugs QOL 化学療法による味覚変化の特徴 ) 化学療法中の味覚変化
8 Turcott JG 11 Kano T 17 Gamper EM 19 Zabernigg A 20 Bernhardson BM 23 Rehwaldt M 24 Bernhardson BM *** : QOL 表 アセスメント方法 EORTC-QLQ-C30 1 EORTC-QLQ-LC QOL SF QOL EORTC QLQ-C QOL EORTC QLQ-C QOL QOL *** 0.84 QOL QOL ACD QOL *** ) レジメンによる味覚変化の性質 FEC R CHOP 17 / ) 味覚変化出現と回復目安 ) 味覚変化の予測因子 味覚変化が栄養状態に与える影響. ) 食欲 ) 摂取カロリー 栄養素摂取量 ) 体重 味覚変化が に与える影響 QOL 8 QOL
9 11 QOL QOL , 考察 QOL QOL 味覚変化のアセスメント方法 real world 5 4 CiTAS Chemotherapy-induced Taste Alteration Scale 17 味覚変化の性質 栄養面との関連 22 FEC + R-CHOP との関連 QOL QOL, 限界 結論 QOL
10 QOL 利益相反. 文献 1Gamper EM, Zabernigg A, Wintner LM, et al. Coming to your senses: detecting taste and smell alterations in chemotherapy patients. A systematic review. Journal of Pain and Symptom Management Williams AR, Mowlazadeh B, Sisler L, et al. Selfreported assessment of symptoms and self-care within a cohort of U.S. veterans during outpatient care for cancer. Clinical Journal of Oncology Nursing Bolukbas F, Kutluturkan S. Symptoms and symptom clusters in non Hodgkin's lymphoma patients in Turkey. Asian Pacific Journal of Cancer Prevention Brisbois TD, Hutton JL, Baracos VE, et al. Taste and smell abnormalities as an independent cause of failure of food intake in patients with advanced canceran argument for the application of sensory science. Journal of Palliative Care Boltong A, Keast R. The influence of chemotherapy on taste perception and food hedonics: a systematic review. Cancer Treatment Reviews Epstein JB, Phillips N, Parry J, et al. Quality of life, taste, olfactory and oral function following highdose chemotherapy and allogeneic hematopoietic cell transplantation. Bone Marrow Transplantation Gabrielson DK, Scaffidi D, Leung E, et al. Use of an abridged scored PatientGenerated Subjective Global Assessment abpg SGAas a nutritional screening tool for cancer patients in an outpatient setting. Nutrition and Cancer Ravasco P. Aspects of taste and compliance in patients with cancer. European Journal of Oncology Nursing. 9 Suppl 2, S EBM PRISMA Joanna Briggs Institute Evidence-Based Practice. org/research/critical-appraisal-tools.html Turcott JG, Juarez-Hernandez E, De la Torre-Vallejo M, et al. Value: Changes in the Detection and Recognition Thresholds of Three Basic Tastes in Lung Cancer Patients Receiving Cisplatin and Paclitaxel and Its Association with Nutritional and Quality of Life Parameters. Nutrition and Cancer Okada N, Hanafusa T, Abe S, et al. Evaluation of the risk factors associated with high-dose chemotherapyinduced dysgeusia in patients undergoing autologous hematopoietic stem cell transplantation: possible usefulness of cryotherapy in dysgeusia prevention. Supportive Care in Cancer Coa KI, Epstein JB, Ettinger D, et al. The impact of cancer treatment on the diets and food preferences of patients receiving outpatient treatment. Nutrition and Cancer Boltong A, Aranda S, Keast R, et al. A prospective cohort study of the effects of adjuvant breast cancer chemotherapy on taste function, food liking, appetite and associated nutritional outcomes. PLoS One. 97e Nishijima S, Yanase T, Tsuneki I, et al. Examination of the taste disorder associated with gynecological cancer chemotherapy. Gynecologic Oncology Imai H, Soeda H, Komine K, et al. Preliminary estimation of the prevalence of chemotherapy-induced dysgeusia in Japanese patients with cancer. BMC Palliative Care Kano T, Kanda K. Development and validation of a chemotherapyinduced taste alteration scale. Oncology Nursing Forum. 402 E Steinbach S, Hundt W, Schmalfeldt B, et al. Effect of platinumcontaining chemotherapy on olfactory, gustatory, and hearing function in ovarian cancer patients. Archives of Gynecology and Obstetrics Gamper EM, Giesinger JM, Oberguggenberger A, et al. Taste alterations in breast and gynaecological cancer patients receiving chemotherapy:prevalence, course of severity, and quality of life correlates. Acta Oncologica Zabernigg A, Gamper E, Giesinger JM, et al. Taste Alterations in Cancer Patients Receiving Chemotherapy: A Neglected Side Effect? Oncologist Sanchez-Lara K, Sosa-Sanchez R, Green-Renner D, et al. Influence of taste disorders on dietary behaviors in cancer patients under chemotherapy. Nutrition Journal. 9, 15 22Steinbach S, Hummel T, Bohner C, et al. Qualitative and quantitative assessment of taste and smell changes in patients undergoing chemotherapy for breast cancer or gynecologic malignancies. Journal of Clinical Oncology Bernhardson BM, Tishelman C, Rutqvist LE. Taste and smell changes in patients receiving cancer chemotherapy: distress, impact on daily life, and self-care strategies. Cancer Nursing Rehwaldt M, Wickham R, Purl S, et al. Self-care strategies to cope with taste changes after chemotherapy. Oncology Nursing Forum. 362 E Jensen SB, Mouridsen HT, Bergmann OJ, et al. Oral mucosal lesions, microbial changes, and taste disturbances induced by adjuvant chemotherapy in breast cancer patients. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology Bernhardson BM, Tishelman C, Rutqvist LE. Self-reported taste and smell changes during cancer chemotherapy. Supportive Care in Cancer
11 , FOLFOXFOLFIRI QOL Hovan AJ, Williams PM, Stevenson-Moore P, et al. A systematic review of dysgeusia induced by cancer therapies. Supportive Care in Cancer Liem DG, Miremadi F, Keast RS. Reducing sodium in foods: the effect on flavor. Nutrients Boltong A, Keast R, Aranda S. Experiences and consequences of altered taste, flavour and food hedonics during chemotherapy treatment. Supportive Care in Cancer Tomita H, Yoshikawa T. Drug-related taste disturbances. Acta Oto-Laryngologica. Suppl Mazzeo MA, Linares JA, Lopez MM, et al., Analysis of saliva samples from oncological patients treated with 5-fluorouracil and leucovorin calcium by scanning electron microscopy with energy dispersive system. Journal of Oral Pathology and Medicine Aps JK, Martens LC. Review: The physiology of saliva and transfer of drugs into saliva. Forensic Science International Comeau TB, Epstein JB, Migas C. Taste and smell dysfunction in patients receiving chemotherapy: a review of current knowledge. Supportive Care in Cancer Heckmann JG, Heckmann SM, Lang CJ. Neurological aspects of taste disorders. Archives Of Neurology Speck RM, DeMichele A, Farrar JT, et al. Taste alteration in breast cancer patients treated with taxane chemotherapy: experience, effect, and coping strategies. Supportive Care in Cancer Influence of Chemotherapy Induced Taste Alteration on Nutritional Status and Quality of Life:Systematic Review * Kaizu Mikiko, Komatsu Hiroko Address reprint requests to : Kaizu Mikiko. Graduate school of Health management Doctoral Program, Keio University 4411, Endo, Fujisawa city, Kanagawa , JAPAN Phone h15101mk@sfc.keio.ac.jp
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