食管癌化疗患者生活质量评价133例

Assessment of life quality of esophageal cancer patients received chemotherapy

目的:评估食管癌化疗患者的生活质量及影响因素．方法:采用EORTC QLQ问卷表访问133例食管癌患者．影响生活质量的因素经t检验和单变量方差检验处理．结果:无论化疗有效与否,入组患者化疗后 1 wk生活质量得分多稍有降低,但4 wk后可恢复至化疗前水平．<55岁年龄组躯体、角色、认知、社会功能和总体状况得分较高(P<0．05)．症状得分随年龄增加而有所增加,在疲乏、失眠和食欲丧失有统计学意义 (P<0．05);文化程度较高者有较高的社会功能得分和较低的经济困难得分(P<0．05):缩窄型食管癌患者QLQ-C30功能得分较其它型为低,失眠、食欲丧失得分显著高于其它类型 (P<0．05)．蕈伞型有较高的躯体、角色、认知和社会功能得分(P<0．05):随着临床分期的增加,大部分QLQ-C30功能得分如躯体、角色、认知及社会和总体健康状况得分显著下降(P<0．05),而疲乏、疼痛、失眠及食欲丧失等症状得分则有所增加(P<0．05);KPS≥80分组QLQ-C30功能得分明显高于<80分组,而症状得分如疲乏、疼痛、失眠及食欲丧失显著低于<80分组(P<0．05)．结论:对食管癌化疗患者的生活质量及影响因素进行了分析,结果对建立食管癌化疗患者生活质量的评价标准及临床医生选择合适的治疗方式有一定的指导意义．

AIM： To evaluate the quality of life （QOL） in esophageal cancer patients and investigate the differences in QOL with respect to social and medical characteristics. METHODS： Structured questionnaires （EORTC QLQ-C30 and QLQ-OES18） were used for data collection in 133 consecutive esophageal cancer patients. The t-test and one-way analysis of variance （ANOVA） were used to compare the differences in QOL at a 5% significance level. RESULTS： Without regard to the effectiveness of chemotherapy, almost all the patients＇QOL declined slightly at the end of the Ist week, but returned to the baseline level at the end of the 4th wk. The scores for physical function, role function, cognitive function, social function and overall health status were remarkably higher in the patient less than 55 years old （P 〈 0.05）. The scores of symptoms were increased with the ages of patients, and fatigue, insomnia and appetite loss made sense statistically. More civilized patients had higher scores of social function and lower score of financial difficulties （P 〈 0.05）. The patients with constrictive type esophageal cancer had lower scores of QLQ-C30 function while the patients with fungoid type had higher scores of physical function, role function, cognitive function, and social function. With the increase of clinical stages, most of QLQ-C30 function scores such as physical, role, cognitive, and social function as well as the overall health status decreased tremendously （P 〈 0.05）, while the scores of symptom such as fatigue, pain, insomnia, appetite loss increased a little bit （P 〈 0.05）. The score of function in KPS≥80 group was significantly higher than that in KPS〈80 group, while the scores of symptoms such as fatigue, pain, insomnia and appetite loss were strikingly lower than those in the 〈80 group. CONCLUSION： The establishment of QOL judgment standard in chemotherapy may help to select a suitable therapeutic method for patients with esophageal cancer.