骨肉瘤患者生活质量的影响因素及生存分析

The factors influencing the quality of life in patients with osteosarcoma and survival analysis

目的探讨骨肉瘤患者生活质量的影响因素及生存情况。方法采用癌症患者生命质量测定量表(QLQ-C30)对52例骨肉瘤患者的生活质量进行评价,并对骨肉瘤患者生活质量的影响因素及生存情况进行分析。结果单因素分析结果显示:营养水平良好、Enneking分期为Ⅱ期、无病理性骨折、手术方式为保肢手术、睡眠质量良好、有中药干预、术后辅助化疗次数≥6次、无远处转移、应对方式积极的骨肉瘤患者的生活质量总评分高于营养水平不良、Enneking分期为Ⅲ期、有病理性骨折、手术方式为截肢手术、睡眠质量差、无中药干预、术后辅助化疗次数<6次、有远处转移、应对方式消极的患者(P﹤0.05)。多因素分析结果显示:有远处转移、手术方式为截肢手术是骨肉瘤患者生活质量的独立危险因素(P﹤0.05);术后辅助化疗次数≥6次、有中药干预、营养水平良好、应对方式积极是骨肉瘤患者生活质量的独立保护因素(P﹤0.05)。52例骨肉瘤患者的3年累积生存率为82.1%,5年累积生存率为58.2%。结论骨肉瘤患者生活质量的影响因素较多,应针对相关影响因素给予患者更多的干预措施,以提高骨肉瘤患者的生活质量。

Objective To explore the factors influencing the quality of life (QOL) of patients with osteosarcoma and survival analysis. Method The medical records of 52 patients with osteosarcoma were retrospectively analyzed. The QOL of patients with osteosarcoma was evaluated by the quality of life questionnaire-core 30 (QLQ-C30), and the factors influencing QOL, and survival of patients with osteosarcoma were analyzed. Result Univariate analysis showed that, good nutritional level, Enneking stage II, no pathological fracture, surgical procedure of limb salvage surgery, good sleep quality, administration of traditional Chinese medicine, postoperative adjuvant chemotherapy ≥6 times, no distant metastasis, and positive coping style were associated with better QOL score compared with poor nutritional level, Enneking stage III, presence of pathological fracture,surgical procedure of limb amputation surgery, poor sleep quality, no traditional Chinese medicine, postoperative adjuvant chemotherapy <6 times, with distant metastasis and negative coping style (P< 0.05). Multivariate analysis indicated that, with distant metastasis and surgical approach of limb salvage surgery were independent risk factors for QOL in patients with osteosarcoma (P<0.05);the number of postoperative adjuvant chemotherapy ≥6 times, with traditional Chinese medicine intervention, good nutritional level, and positive coping style were independent protective factors for the QOL of patients with osteosarcoma (P<0.05). The 3-year survival rate and the 5-year survival rate of 52 patients with osteosarcoma were 82.1%, 58.2%. Conclusion There are a number of factors influencing the quality of life of osteosarcoma patients, thus more interventions should be administered to improve the quality of life of osteosarcoma patients.