调强放疗与常规放疗鼻咽癌患者生活质量的比较

Quality of life after intensity-modulated radiotherapy versus conventional radiotherapy for nasopharyngeal carcinoma

目的通过与常规放疗比较，了解调强放疗对鼻咽癌患者生活质量的影响，并分析鼻咽癌患者总体生活质量和口干的影响因素。方法以2005年5月至2008年5月武汉大学中南医院放化疗科行常规放疗或词强放疗且同意配合调查的初治鼻咽癌患者为研究对象，采用问卷方式调查接受调强放疗和常规放疗鼻咽癌患者的生活质量。调查表包括生活质量核心问卷（QLQ-30）中文版及头颈部特殊问卷（QLQ-H＆N35）。结果120例鼻咽癌患者，其中调强组61例，常规组59例。与常规放疗比较，调强放疗改善了总体生活质量、角色功能、口干、口黏等，两者比较差异有统计学意义（P〈0．05）。接受调强放疗的患者总体生活质量较高（OR=2．685；95％CI：1．212～5．948），接受化疗的患者总体生活质量较低（OR=0．374；95％CI：0．150～0．933），接受调强放疗的患者口干症状较轻（OR=0．347；95％CI：0．124～0．968）。结论与常规放疗比较，调强放疗改善了患者口干、口黏、疼痛、乏力及总体生活质量等评分。治疗方式和化疗是患者总体生活质量的影响因素。

Objective To directly compare the treatment outcomes of intensity-modulated radiotherapy（1MRT） with that of conventional radiotherapy（CRT） and explore the risk factors involved in dry mouth and quality of life. Methods We studied the quality of life （QoL） of patients who either received intensity-modulated radiotherapy （IMRT） or conventional radiotherapy （CRT） by the Chinese version of the EORTC QLQ-30 and QLQ-H＆N35 questionnaires. All these patients had received intensity-modulated radiotherapy or conventional radiotherapy in the oncology department of Zhongnan hospital of the Wuhan University from May 2005 to May 2008. Results Among 120 patients with nasopharyngeal carcinoma（NPC）, 61 cases received IMRT, while 59 cases received CRT. Patients treated with IMRT had a statistically significant improvement in global QoL, role function, dry mouth, sticky saliva and so on（P 〈 0. 05 ）. There was a positive correlation between IMRT and global QoL（ OR, 2. 685; 95% CI：1. 212 -5. 948）. In contrast, a negative correlation（OR, 0. 374; 95% CI： 0. 150 -0. 933） presented in chemotherapy and global QoL. There was a negative correlation be- tween IMRT and dry mouth symptoms （ OR, 0. 347; 95% CI：0. 124 -0. 968）. Conclusion Compared with CRT, IMRT improved the index of dry mouth, sticky saliva, pain, fatigue and global QoL. The major factors influencing global quality of life were radiotherapy technique and chemotherapy.