甲地孕酮对晚期直肠癌患者化疗期间及化疗后生活质量的影响研究

The Effect of Megestrol Acetate on Life Quality of Patients with Advanced Rectal Cancer during Chemotherapy

目的探讨甲地孕酮(MPA)在肿瘤化疗期间及化疗后对改善晚期直肠癌患者生活质量的作用。方法搜集新疆医科大学第一附属医院2007年6月—2010年2月收治的143例晚期直肠癌患者,将其随机分为单纯化疗(对照组)及化疗联合MPA(试验组),观察治疗期间及化疗后食欲、食量、体质量变化,化疗毒副作用及全身情况变化。结果试验组47例(64.4%)进食量增加,42例(57.5%)体质量增加;对照组10例(14.3%)进食量增加,6例(8.6%)体质量增加,两组比较差异均有统计学意义(P=0.0001)。试验组53例(72.6%)体力状况(KPS)评分改善,对照组13例(18.6%)KPS评分改善,两组比较差异有统计学意义(P=0.0001)。两组腹泻发生率比较差异无统计学意义(P=0.304),而试验组恶心、呕吐的发生率尤其是Ⅲ～Ⅳ度恶心、呕吐的发生率较对照组均明显减轻,差异有统计学意义(P<0.05)。两组血红蛋白下降,发生Ⅲ～Ⅳ度贫血及平均恢复时间,白细胞计数下降,发生Ⅲ～Ⅳ度白细胞计数下降及平均恢复时间比较差异均有统计学意义(P<0.05)。两组血小板计数下降,发生Ⅲ～Ⅳ度血小板计数下降及平均恢复时间比较差异无统计学意义(P>0.05)。试验组31例(42.5%)出现脱发反应,对照组39例(55.7%)出现脱发反应,两组比较差异有统计学意义(P<0.05)。结论 MPA可明显降低晚期直肠癌患者化疗时消化道毒副作用,提高食欲,改善患者的化疗期间及化疗后生活质量。

Objective To observe the assisting effect of megestrol acetate on improving life quality of the patients suffering from advanced rectal cancer during Chemotherapy. Methods 143 cases sufferring from advanced rectal cancer admitted to the first affiliated hospital of Xin Jiang Medical University from June 2007 to December 2010 were cellected, and they were divid- ed int9 control group treated only by chemotherapy and experiment group treated by chemotherapy combined with MPA. Appetite, weight, toxicum reaction and the whole body change of two groups were observed. Results 47 cases （64. 4% ） had an increase on appetite and 42 cases （57. 5% ） had an increase on weight in experiment group, while the numbers in control group were 10 cases （ 14. 3% ） and 6 cases （ 8. 6% ） respectively. The differences between the two groups were statistically significant （ P = 0. 0001 ） . 53 cases （72.6%） improved on KPS in experiment group and 13 cases （18.6%） improved in control group, the difference between the two groups was statistically significant （ P = 0. 0001 ） . The difference of diarrhea incidence between the two groups was not statistically significant （P = 0. 304） . The incidences of nausea and vomit, especially the nausea and vomit from stage m to Iv in experiment group were significantly lower than that in control group （ P 〈 0. 05 ） . The differences in the decrease of haematoglobin, anemia from stage III to IV, recovery time, decrease of leukocyte count, decrease of leukocyte count from stage III to IV and recovery time between the two groups were statistically significant （ P 〈 0. 05 ） . The differences of platelet count, platelet count from stage III to IV and recovery time between the two groups were not statistically significant （ P 〉 0. 05 ）. 31 cases （42. 5% ） in experiment group had phalacresis while 39 cases （55. 7% ） in control group had phalacrosis, the difference between the two groups was statistically significant （ P 〈 0. 05 ） . Conclusion Megestrol acetate can reduce gastrointestinal side effects, increase appetite, and improve life quality during chemotherapy in patients with advanced stage rectal cancer.