化疗对老年肿瘤患者生活质量的影响

Influences of chemotherapy on the quality of life among elderly patients

目的研究化疗对65岁以上的老年肿瘤患者生活质量的影响。方法采用欧洲癌症研究和治疗组织的生命质量测定量表QLQ-C30(V3.0)中文版对我院94例≥65岁的老年肿瘤患者进行问卷调查,同时进行卡氏行为状态评分。其中辅助组38例,姑息组56例。在化疗前、化疗第3个周期后分别进行测定并进行比较。结果全体患者化疗3个周期后生活质量评分显示:恶心呕吐、便秘的症状较治疗前有显著性加重评分增高,但疼痛减轻评分下降(P<0.05);5项功能(躯体功能、角色功能、认知功能、情绪功能、社会功能)、其他症状(疲乏、睡眠、食欲下降、呼吸困难、腹泻、经济困难)和整体生活质量在治疗前后均无显著变化。与化疗前相比,辅助组患者化疗后恶心呕吐、食欲减退、便秘的症状加重(P<0.05)。姑息组患者化疗后恶心呕吐的症状明显加重、但疼痛减轻(P<0.05)。在化疗前后卡氏行为状态评分均未显示出明显的差别。化疗后辅助化疗组与姑息化疗组相比,姑息组在疼痛、便秘症状和经济困难的评分明显高于辅助组,姑息组的总体生活质量评分明显低于辅助组,均有统计学意义(P<0.05)。结论老年肿瘤患者的躯体、角色、认知、情绪、社会功能受化疗的影响较小,化疗后会出现消化道症状加重,疼痛减轻,总体生活质量下降不明显。卡氏行为状态评分不能全面反映患者化疗时的生活质量,QLQ-C30(V3.0)中文版评估量表对中国老年肿瘤患者测评生活质量优于卡氏行为状态评分。

Objective To investigate the influences of chemotherapy on the quality of life （QOL） in elderly patients. Methods A total of 94 elderly patients （38 cases in the adjunctive group and 56 cases in the palliative group） were enrolled in this study. QOL was assessed by the Quality of Life Questionnaire-C30 （QLQ-C30） v3.0 and Karnofsky Performance Status Score before chemotherapy and after 3 cycles of chemotherapy, respectively. Results After 3 cycles of chemotherapy, the scores of the QOL in all patients showed： the scores of nausea, vomiting, and constipation signifi- cantly increased, while the pain score significantly decreased （all P 〈 0. 05）. Compared with the scores before chemo- therapy, there were not obvious changes in the scores of physical function, role function, emotional function, cognitive function, and social function. Other symptoms （fatigue, sleep, loss of appetite, difficulty in breathing, diarrhea, and financial difficulties） and the global QOF did not significantly change. The Karnofsky performance status score did not sig- nificantly change before and after chemotherapy. Compared with the scores before chemotherapy, nausea and vomiting, appetite loss, and constipation significantly increased in adjuvant group （P 〈 0. 05）. Nausea and vomiting after chemotherapy significantly increased, but the pain was significantly relieved in palliative group （ P 〈 0. 05 ）. The scores of pain, constipation, and financial difficulties were much higher in palliative group than in adjunctive group. The global QOF was worse in palliative chemotherapy group （P 〈0. 05）. Conclusion The physical status, role functioning, emo- tion, cognition, and social functioning are less affected by chemotherapy in elderly patients. The gastrointestinal symp- toms increase after chemotherapy, while the pain relief and global QOF are not obviously changed. Karnofsky performance status score can not fully reflect the QOF of chemotherapy. The Quality of Life Questionnaire-C30 （V3.0） is better than Karnofsky Performance Status Score in assessing the QOF in Chinese elderly patients.