调强放疗对中晚期食管癌患者短期生活质量的影响及其影响因素分析

Effect and influence factor analysis of intensity modulated radiation therapy on short-term life quality of patients with middle and advanced esophageal cancer

目的探讨调强放疗对中晚期食管癌患者短期生活质量的影响并分析其影响因素。方法选择我院肿瘤科2012年6月-2015年5月食管癌患者60例,按照随机数字表法将其分为研究组与对照组,两组各30例。研究组采用调强适形放疗,对照组采用常规放疗。记录并比较两组患者放疗前、放疗结束后1 d与放疗结束后3个月的临床症状及生活质量等问卷调查评分。结果两组患者放疗前与放疗后1 d的躯体功能、角色功能、情绪功能、认知功能、社会功能、总体健康比较,差异均无统计学意义（P〉0.05）;放疗后3个月,研究组患者的情绪功能评分明显高于对照组,差异有统计学意义（P〈0.05）,而两组患者的躯体功能、角色功能、认知功能、社会功能、总体健康等比较,差异无统计学意义（P〉0.05）。放疗1 d后两组患者的憋喘、恶心呕吐、疼痛、失眠、便秘、腹泻、疲劳评分比较,差异均无统计学意义（P〉0.05）,而研究组患者的经济困难、食欲丧失评分明显低于对照组,差异有统计学意义（P〈0.05）;放疗后3个月各项症状评分比较,差异均无统计学意义（P〉0.05）。结论常规放疗和调强适形放疗均能在放疗3个月后有所恢复,但调强适形放疗能显著改善患者的情绪功能,食欲丧失能力低,更适于治疗食管癌患者,值得在临床上大力推广应用。

Objective To discuss the effect and analyze the influence factors of intensity modulated radiation therapy on short-term life quality of patients with middle and advanced esophageal cancer. Methods 60 patients with esophageal cancer treated in our department from June 2012 to May 2015 were selected and randomly divided into study group and control group,each with 30 cases.Patients in the study group were given intensity modulated radiation therapy,and patients in the control group were given conventional radiotherapy.Clinical symptoms and QOL scores of patients were recorded and compared before treatment,at 1 day and 3 months after therapy. Results There were no significant differences in somatic function,role function,emotional function,cognitive function,social function,and general health between two groups at 1 day before and 1 day after treatment （P〉0.05）.At three months after radiotherapy,emotional function was significantly higher in the study group than that in the control group （P〈0.05）,but there were no significant differences in somatic function,role function,cognitive function,social function,and general health between two groups （P〉0.05）.There were no significant differences in scores of asthma, nausea, vomiting, pain, insomnia, constipation, diarrhea,and fatigue （P〉0.05）,while the scores of financial difficulty and appetite loss were significantly lower in the study group than those in the control group （P〈0.05）.There were no significant differences in those symptoms between two groups at 3 months after radiotherapy （P〉0.05）. Conclusion Intensity modulated radiation therapy has comparable efficacy with conventional radiation therapy,which can relieve symptoms of patients after 3 months,and it can significantly improve the emotional function of patients,with lower appetite loss,indicating that this method is more suitable for pa- tients with esophageal cancer and is worthy to be promoted.