鼻咽癌放疗后长期存活者的生存质量分析

Quality of Life of the Long-term Survivors with Nasopharyn- geal Carcinoma After Radiotherapy

[目的]评价鼻咽癌放疗后长期存活者的生存质量及其影响因素。[方法]采用横断面研究,应用EORTCQLQ-C30中文版和EORTCQLQ-H&N35台湾中文版量表评价根治性放疗后存活5年以上患者的生存质量情况。采用多元线性回归分析方法对总体生存质量领域评分的影响因素进行分析;采用t检验和卡方检验分析放射性后组颅神经损伤(RILCN)与各领域的关系。[结果]入组患者169例,其中伴有RILCN者19例,中位随访时间为10年(5～13年)。总体生存质量领域得分为65.97±25.38。影响总体生存质量领域得分的症状因素为性趣减少、感觉到不舒服和疲倦,其回归系数分别为-0.132、-0.208和-0.330;临床指标因素为年龄,其回归系数为-0.755。RILCN与言语问题、社会交往障碍、性趣减少、用胃管灌食和体重增加有关。[结论]鼻咽癌常规放疗后长期存活患者的总体生存质量尚好,对患者进行心理干预可能有利于提高生存质量。

[Purpose] To evaluate the quality of life （QOL） of the long-term survivors with nasopharyngeal carcinoma （NPC） after radiotherapy and to explore the factors correlated with their QOL. [Methods] Cross-sectional study was carried out using the Chinese version of the European Organization for Research and Treatment of Cancer core questionnaire and the Taiwan Chinese version of head and neck module to measure the QOL of the NPC patients who had survived five years or more longer after radical radiotherapy. The influencing factors of the global QOL score were analyzed with multiple linear regression analysis. The relationships between radiation-induced lower cranial neuropathy （RILCN） and the QOL score of every scale were analyzed with t test or Chi-square test. [Results ] One hundred and sixty-nine NPC survivors were enrolled in the study. Median follow-up was ten years （range 5-15 years）. There are 19 patients with RILCN. Global QOL score was calculated as 65.97±25.38. The chosen symptomatic factors in the regression formula were less sexuality, felt ill and fatigue, whose coefficients were -0.132, -0.208 and -0.33, respectively. The clinical physiology factor was age whose coefficient was -0.755. There were significant correlations between speech problems, trouble with social contact, less sexuality, feeding tube, weight gain and RILCN. [Conclusions] The long-term survivors with NPC after radiotherapy have a not bad global QOL score. Psychological intervention may improve the QOL.