摘要
目的探讨术前短程放疗与长程放化疗对局部进展期直肠癌(LARC)患者长期生活质量的影响。方法纳入经术前新辅助放疗或放化疗且术后随访3年以上处于无病生存状态的LARC患者55例,根据术前新辅助治疗的方式,分为短程放疗组(n=20)和长程放化疗组(n=35)。短程放疗组术前采用短程快速大分割放疗,总放射剂量25. 0Gy,剂量分割5. 0 Gy×5次;长程放化疗组术前采用常规分割放疗,总放射剂量45. 0~50. 4 Gy,剂量分割1. 8~2. 0 Gy×23~28次,同步化疗采用5-Fu或希罗达为基础的方案。采用生活质量核心评定量表(QLQ-C30)评估术后长期生活质量状态。结果短程放疗组和长程放化疗组在QLQ-C30量表总体健康评分(74. 8±15. 2 vs 76. 5±17. 6),躯体(82. 6±16. 7 vs 83. 9±14. 0)、角色(75. 3±16. 5 vs 77. 8±15. 9)、情绪(78. 6±18. 5 vs 80. 2±19. 1)、认知(80. 6±17. 5 vs 83. 4±16. 9)和社会功能(76. 8±16. 4 vs 78. 1±16. 6) 5个领域评分,疲劳(23. 5±7. 4 vs 25. 6±8. 0)、恶心呕吐(2. 8±1. 8 vs4. 2±2. 9)、疼痛(12. 8±10. 2 vs 11. 7±9. 5)、气促(15. 6±11. 3 vs 16. 3±10. 9)、失眠(20. 5±12. 6 vs 21. 7±12. 5)、食欲减退(6. 8±4. 9 vs 8. 5±5. 8)、便秘(10. 5±5. 9 vs 8. 2±4. 3)、腹泻(13. 2±6. 1 vs 10. 7±7. 2)和经济困难(10. 6±6. 9 vs13. 8±7. 5) 9个症状评分方面,差异均无统计学意义(P均> 0. 05)。结论术前短程放疗和长程放化疗对LARC患者长期生活质量的影响可能并无明显差别。
Objective To investigate the effect of preoperative short-course radiotherapy(SC-RT) and long-course radiochemotherapy(LC-RCHT) on the long-term quality of life in locally advanced rectal cancer(LARC) patients. Methods 55 patients with LARC treated with neoadjuvant radiotherapy or radiochemotherapy,who had disease-free survival in the follow-up for more than 3 years,were enrolled in this study.According to the form of neoadjuvant radiotherapy,the patients were divided into SC-RT group( n =20) and LC-RCHT group( n =35).SC-RT group were treated with neoadjuvant radiotherapy with a total radiation dose 25.0 Gy(5.0 Gy×5).LC-RCHT group were given neoadjuvant radiochemotherapy with a total radiation dose of 45~50.4 Gy(1.8~2.0 Gy×23~28) concomitant with 5-FU or capecitabine based chemotherapy.The QLQ-C30 was used to assess the long-term quality of life in both groups. Results No differences were observed in QLQ-C30 scale score between SC-RT and LC-RCHT group( P〉0.05),including the global health status(74.8±15.2 vs 76.5±17.6),the 5 functional scales of physical functioning(82.6±16.7 vs 83.9±14.0),role functioning(75.3±16.5 vs 77.8±15.9),emotional functioning(78.6±18.5 vs 80.2±19.1),cognitive functioning(80.6±17.5 vs 83.4±16.9),and social functioning(76.8±16.4 vs 78.1±16.6),and the 9 symptom items of fatigue(23.5±7.4 vs 25.6±8.0),nausea and vomiting(2.8±1.8 vs 4.2±2.9),pain symptoms(12.8±10.2 vs 11.7±9.5),dyspnoea(15.6±11.3 vs 16.3±10.9),insomnia(20.5±12.6 vs 21.7±12.5),appetite loss(6.8±4.9 vs 8.5±5.8),constipation(10.5±5.9 vs 8.2±4.3),diarrhea(13.2±6.1 vs 10.7±7.2),and financial difficulties(10.6±6.9 vs 13.8±7.5). Conclusion There is no significant difference in the effect of preoperative short-course radiotherapy and preoperative long-course radiochemotherapy on long-term quality of life in patients with LARC.
作者
栗国
刘建仁
傅志超
冯静
曾国沐
程惠华
LI Guo;LIU Jianren;FU Zhichao(Fuzhou General Hospital of PLA,Fuzhou,35002)
出处
《实用癌症杂志》
2018年第10期1600-1603,1613,共5页
The Practical Journal of Cancer
基金
福建省自然科学基金项目(编号:2017J01222)
关键词
局部进展期直肠癌
新辅助治疗
短程放疗
长程放化疗
Locally advanced rectal cancer
Neoadjuvant
Short-course radiotherapy
Long-course radiochemotherapy