晚期胃癌患者癌症相关性乏力的临床研究

Clinical study of cancer-related fatigue in patients with advanced gastric cancer

目的 研究晚期胃癌患者癌症相关性乏力（CRF）的发生情况与临床病理特征、生命质量之间的相互关系.方法 收集182例晚期胃癌患者的临床病理资料,用简明乏力量表（BFI）、欧洲癌症治疗研究组织（EORTC）生命质量测定量表QLQ-C30（V3.0）评估患者的CRF程度及生命质量,分析CRF与临床病理特征及生命质量的相关性.结果182例晚期胃癌患者均伴有不同程度CRF.CRF BFI评分与临床病理特征中年龄（F=6.637,P=0.001）、体能状态（PS）评分（F=15.559、P=0.000）、世界卫生组织（WHO）病理分型（F=7.352、P=0.000）有关,其中50-59岁年龄组CRF指数较其他年龄组高;PS评分1、2分组CRF BFI评分高于0分组;胃印戒细胞癌CRF BFI评分显著高于胃鳞状细胞癌.Pearson相关性分析显示,CRF BFI评分与情绪呈正相关（r=0.423,P=0.008）.功能领域5项中,轻、中、重度CRF患者比较,躯体功能和情绪2项差异均有统计学意义（F值分别为-16.254、-13.256,均P〈0.05）;症状领域9项中,疲劳、疼痛和食欲不振3项差异均有统计学意义（F值分别为12.075、14.361、13.837,均P〈0.05）.化疗结束后疾病稳定（SD）组、部分缓解（PR）组、疾病进展（PD）组患者平均CRF BFI评分与化疗前比较,差异均有统计学意义（t值分别为6.981、6.903、7.437,均P〈0.05）;随访3个月时三组患者平均CRF BFI评分与化疗前比较,SD组和PR组有所下降,PD组较前升高,差异均有统计学意义（t值分别为2.371、6.912、18.237,均P〈0.05）.结论 CRF在晚期胃癌患者中发生率非常高,其程度与年龄、PS评分、病理分型有关;缓解患者疲劳、疼痛和食欲不振等症状以及控制化疗不良反应对降低CRF程度有所帮助.

Objective To study the relationship between cancer-related fatigue （CRF） and clinicopathological features and quality of life in patients with advanced gastric cancer. Methods The clinical and pathological data of 182 patients with advanced gastric cancer were collected, The CRF level and quality of life were assessed by the brief fatigue inventory （BFI）, European Organization for Research on Treatment of Cancer （EORTC） life quality scale QLQ-C30 （V3.0）. The correlations between CRF and clinicopathological features and quality of life were analyzed. Results One hundred twenty-two patients with advanced gastric cancer were associated with different degrees of fatigue. The CEF BFI score had correlation with the age（F=6.637,P=0.001）,PS score（F=15.559,P=0.000）,the World Health Organization（WHO） pathologic type （F=7.352, P=0.000）. The CRF index of the 50-59 age group was higher than that of other age groups; the CRF BFI scores of PS score 1 and 2 were higher than that of 0 group; CRF BFI score of gastric signet ring cell carcinoma was significantly higher than that of gastric squamous cell carcinoma. The Pearson correlation analysis showed that the CRF BFI score was positively correlated with mood （r=0.423, P=0.008）. There were significant differences in body function and mood （F=-16.254, F=-13.256, both P〈0.05）and fatigue,pain and loss of appetite among 3 CRF groups（F=12.075,F=14.361,F=13.837, all P〈0.05）. There was a significant difference in the mean CRF BFI score between the three groups before and after chemotherapy（tSD=6.981,tPR=6.903,tPD=7.437,all P〈0.05）. Compared with pre-chemotherapy, the mean CRF BFI score of SD and PR group decreased after 3 months follow-up, score of PD group increased, the differences were statistically significant（t=2.371,t=6.912,t=18.237,all P〈0.05）.Conclusions The incidence of CRF in patients with advanced gastric cancer is very high,the degree of CRF has correlation with age, PS score and pathological type. Relieve symptoms such as fatigue, pain and loss of appetite and control adverse reactions could help to reduce the degree of CRF.