同期放化疗对晚期非小细胞肺癌患者生活质量的影响评价

Life-quality assessment of the effect of concurrent chemotherapy on advanced non-small cell lung cancer patients

背景与目的:晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者生活质量的提高日益受到重视。同期放化疗是目前晚期非小细胞肺癌的主要治疗方式。本研究探讨同期放化疗对晚期NSCLC患者生活质量的影响。方法:对70例例经病理确诊为晚期NSCLC的患者应用胸部适形放疗联合化疗;采用欧洲癌症研究与治疗组织(European Organization For Research Treatment of Cancer,EORTC)生活质量核心问卷(QLQ-C30)对同期放化疗治疗前及治疗结束后第1天、1个月的具体情况进行评估并比较分析;并分析不同治疗阶段影响生活质量的因素对EORTC QLQ-C30各领域得分的影响;同时对1年生存率进行统计。结果:同期放化疗治疗结束后第1天与治疗前相比,患者的躯体功能、角色功能、情绪功能、社会功能及总体健康状况下降;而治疗结束后1个月,功能领域显著改善,与治疗前相比仅躯体功能改善明显,差异具有统计学意义(F=3.70～17.53,P<0.05)。治疗结束后第1天患者疲劳、恶心呕吐、食欲减退及便秘症状加重,疼痛症状改善;而治疗结束后1个月患者上述症状均进一步改善,与治疗前相比,患者疼痛、呼吸困难症状改善,差异具有统计学意义(F=9.64～63.64,P<0.05)。<70岁组、男性、文化程度高、汉族以及治疗有效组患者生活质量相对较好。1年生存率为54.6%。结论:同期放化疗能够改善晚期NSCLC患者的近期生活质量,提高生存率。年龄、文化程度、治疗效果是影响生活质量的主要因素。

Background and purpose： Patients with advanced non-small cell lung cancer （NSCLC） pay more attention to improving the quality of life. Concurrent chemoradlotherapy is the primary form of treatment for advanced NSCLC. In this study, quality of life and clinical significance of concurrent chemoradio therapy for advanced NSCLC patients＇ were discussed. Methods： Seventy patients with pathologically confirmed advanced NSCLC patients were treated with chest radiotherapy combined with chemotherapy. We adopted the EORTC QLQ-C30 questionnaire to assess the conditions before treatment and 1 day, 1 month after treatment; and to analyze the factors that affected the quality of life on the EORTC QLQ-C30 scores in all areas of impact during different stages of treatment. Meanwhile, 1 year survival rate was calculated. Results： The patient＇s physical function, role function, emotional function, social function, and general health status declined on the first day after concurrent chemotherapy. After the treatment for 1 month, some functional areas were improved significantly, but increased treatment only improved physical function in comparison with previous physical ability （F=3.70-17.53, P〈0.05）. One day after treatment, symptoms such as fatigue, nausea, vomiting, anorexia and constipation worsened whereas pain eased. One month after the treatment, the symptoms mentioned above improved, the symptoms of pain and dyspnea eased compared with before treatment. The improvement was statistical meaningful （F=9.64-63.64, P〈0.05）. Patients were un-elderly, male, education level, Han race and received effective treatment, their quality of life was relatively good. The 1 year survival rate was 54.6%. Conclusion： Concurrent chemoradiotherapy could improve the patients＇ quality of life and increase the survival rate.Age, education and treatment are main factors affecting the quality of life.