Background: A focused anamnesis of symptoms is essential in medical practice, especially in oncology, where new or increasing symptoms often indicate disease progression or therapy side effects. However, there are only a few studies in dermato-oncology that address the question of how symptoms should ideally be recorded. There are no validated questionnaires specifically tailored to the needs of dermato-oncology. Patients and Methods: Over a one-year period, all patients at the skin cancer centre were given a standardised questionnaire to record relevant symptoms before consultation. This was followed by the attending dermato-oncologist completing an additional section regarding therapeutic measures based on the reported symptoms. Results: 809 patients with 1879 consultations were included. In most patient contacts, patients did not report an increase in symptoms (n = 840; 44.7%). Fatigue, restlessness/anxiety, pruritus, and pain were the most recorded distressing symptoms. The chi-square test revealed that increased symptoms led to significantly more frequent interventions. Overall, symptom relief was observed at follow-up. Analysis using Generalised Estimating Equations showed patients benefited significantly from interventions for sleep disorders. Subgroup analysis showed that patients in ongoing therapy benefitted significantly from interventions for pain and nausea. Those in advanced disease stages benefitted significantly from interventions for pain. In those groups, if symptoms were explicitly stated as having worsened using the questionnaire, measures taken by physicians also showed significant benefit for obstipation and nausea along with pruritus. Conclusions: Targeted symptom screening is feasible and provides valuable insights for guiding diagnostic or therapeutic interventions. However, the questionnaire is most useful at higher tumour stages, as it is only effective when distressing symptoms are present.
背景：在医疗实践中，特别是肿瘤学领域，对症状进行重点问诊至关重要，因为新发或加重的症状往往提示疾病进展或治疗副作用。然而，皮肤肿瘤学中关于症状应如何理想记录的研究较少，目前尚无针对皮肤肿瘤学需求而设计的经过验证的问卷。患者与方法：在一年的时间里，皮肤癌中心的所有患者在就诊前均需填写一份标准化问卷以记录相关症状。随后，接诊的皮肤肿瘤科医生根据报告的症状填写关于治疗措施的附加部分。结果：共纳入809名患者，涉及1879次就诊。在大多数患者接触中，患者未报告症状加重（n = 840；44.7%）。疲劳、烦躁/焦虑、瘙痒和疼痛是最常记录的痛苦症状。卡方检验显示，症状加重导致干预措施显著更频繁。总体而言，随访时观察到症状缓解。使用广义估计方程分析表明，针对睡眠障碍的干预措施使患者显著获益。亚组分析显示，正在接受治疗的患者在疼痛和恶心干预方面获益显著。晚期疾病阶段的患者在疼痛干预方面获益显著。在这些组别中，若问卷明确报告症状恶化，医生采取的措施对便秘、恶心以及瘙痒也显示出显著益处。结论：针对性症状筛查是可行的，并为指导诊断或治疗干预提供了宝贵信息。然而，该问卷在较高肿瘤分期时最为有用，因为它仅在存在痛苦症状时才有效。
肿瘤(癌症)患者之家