新辅助化疗对局部晚期非小细胞肺癌患者术后生存质量的影响

The Effect of Neoadjuvant Chemotherapy on Quality of Life in Patients Diagnosed with Local Advanced Non-small Lung Cancer

目的：探讨新辅助化疗对局部晚期非小细胞肺癌患者术后生存质量的影响。方法：选取2011年5月至2012年5月于本院胸腔外科接受治疗的ⅢA～ⅢB期非小细胞肺癌患者240例并将其随机分成2组,即新辅助化疗组（A组）和单纯手术组（B组）,每组120例。A组患者在临床确诊后接受2个周期的新辅助化疗,化疗结束2～3周后接受手术治疗;对照组患者临床确诊后直接行手术治疗。术后,两组患者均给予4周期常规放化疗。采用QLQ-C30量表对两组患者术前与术后第1、3、6个月的生存质量进行评估,并比较两组患者生存质量评分的差异。结果：术后1、3、6个月时,两组患者的各项功能分值均较术前显著升高（P〈0.05）;术后第3、6个月,患者的总体健康状况得分较术前显著升高（P〈0.05）;术后1个月时,A组患者的呼吸困难评分较术前明显增加（P〈0.05）,术后第3个月后,该分值与术前比较无显著性差异;术后第1、3个月时,两组患者的疼痛评分均较术前明显升高（P〈0.05）,但第6个月时,该评分与术前无显著性差异;术后第6个月时,两组患者的疲乏得分较术前明显降低（P〈0.05）;术后第1、3、6个月时,两组患者的经济困难评分明显较术前升高（P〈0.05）。术后1、3、6个月时,A组患者的总体状况得分均显著高于B组（P〈0.05）,呼吸困难评分和疲乏评分明显低于B组（P〈0.05）,经济困难评分均显著高于B组（P〈0.05）。结论：新辅助化疗可以提高局部晚期非小细胞肺癌患者术后半年内的生存质量。

Objective： To explore the effect of neoadjuvant chemotherapy on quality of life in patients diagnosed with local advanced non-small lung cancer. Methods： Selected 240 patients diagnosed with non-small cell lung cancer of ⅢAand ⅢBform May 2011 to May 2012 in thoracic surgery department of our hospital. The subjects were equally divided into two groups： Group A represented patient received neoadjuvant chemotherapy and surgery treatment; Group B represented patient without neoadjuvant chemotherapy. Patients in Group A received two cycles of neoadjuvant chemotherapy, and then received surgery treatment after 2～3 weeks. Patients in Group B only received surgery treatment. Patients in both groups were given four cycles of chemotherapy and radiotherapy. The life quality was measured by QLQ-C30 scale before and after surgery. Results： In the first, third and sixth months after surgery, the functional scales of both groups were significantly higher than that of pre-operation（P〈0.05）; In the third and sixth months after operation, the global health status of both groups were much better when compared with pre-operation（P〈0.05）. For patients of Group A, the dyspnea was more serious in the first month after operation（P〈0.05）, but two months later, the difference was not significant. The pain scales of both groups were higher than pre-operation in the first and third month（P〈0.05）, but in the sixth month, the pain eased significantly. In the sixth month after surgery, the fatigue scales of both group were significantly lower than that of pre-operation（P〈0.05）. The global health status scales of Group A were much higher than that of Group B, while the fatigue and dyspnea scales were lower than that of Group B, but the financial difficulties of Group A were much heavier in all observation time points than Group B（P〈0.05）. Conclusion： The neoadjuvant chemotherapy could improve the quality of life in patients diagnosed with local advanced non-small lung cancer.