接受不同治疗方式的宫颈癌患者治疗后生活质量评价

Evaluation of Life Quality of Patients with Cervical Cancer after Different Treatments

目的:评估宫颈癌患者在接受不同治疗方式后的生活质量,分析治疗方式对患者治疗后生活质量的影响。方法:选取2019年1月至2019年12月因宫颈癌就诊于我院妇瘤科的102例患者。患者分期为ⅠB~ⅡA期。根据接受的治疗方法不同,将患者分为3组:同步放化疗组(接受同步放化疗治疗)、单纯手术组(接受广泛性子宫切除+盆腔淋巴结切除术)、术后追加治疗组(在接受广泛性子宫切除+盆腔淋巴结切除术后补充放疗或放化疗治疗)。统计患者一般资料,采用癌症治疗功能评价系统共性模块(Functional Assessment of Cancer Therapy-General, FACT-G)(V4.0)宫颈癌量表在全程治疗结束后2个月首次复诊时评估患者的生活质量。使用t检验、ANOVA方差分析和LSD法进行各治疗组间的比较,并通过协方差分析除外协变量产生的影响来探讨不同治疗方式对宫颈癌治疗后生活质量的影响。结果:单因素分析中,单纯手术组除社会/家庭维度(social/family well-being, SWB)和情感维度(emotional well-being, EWB)外,问卷中涉及到的其余版块得分均最高(P<0.05);SWB、EWB得分各组之间无差别(P≥0.05)。不同文化程度患者之间生活质量差异无统计学意义(P≥0.05)。不同年龄组患者癌症治疗功能评价系统宫颈癌特异模块(Functional Assessment of Cancer Therapy with Cervical Cancer Subscale, FACT-CX)、FACT-G、功能维度(functional well-being, FWB)、宫颈癌特异模块(Cervix Cancer-Specific Scale, CCS)的得分差异有统计学意义(P<0.05),小于40岁组患者的得分最高。协方差分析中,除外年龄因素影响,同步放化疗组的患者生理维度(physical well-being, PWB)、FACT-G总分高于单纯手术组的患者,术后追加治疗组的患者得分最低;单纯手术组的患者CCS的得分最高(P<0.05)。结论:无论是否有年龄的影响,治疗方式的选择影响着宫颈癌患者治疗后的生活质量,提示在临床中为改善宫颈癌患者的生存质量,应充分评估后选择合适的治疗方法,尽量避免不必要的叠加治疗,并辅以适当的心理辅导。

Objective: To evaluate the life quality of cervical cancer patients after receiving different treatment methods, and analyze the effects of treatment methods on the quality of life of patients. Methods: 102 patients admitted to our hospital from January 2019 to December 2019 were selected. According to the different treatment methods, the patients were assigned to the concurrent chemoradiotherapy group, the surgery group(extensive hysterectomy + pelvic lymphadenectomy), and the additional treatment group(radiotherapy/chemoradiotherapy after extensive hysterectomy + pelvic lymphadenectomy), respectively. General data of the patients were collected. The Functional Assessment of Cancer Therapy-General(FACT-G)(Version 4) was used to assess the quality of life of the patients at the first 2 months after the end of the whole course of treatment. Comparison among groups was made using t-test, analysis of variance and Fisher’s least significant difference. Impacts of different treatment methods on the quality of life after cervical cancer treatment were evaluated by analysis of covariance. Results: In the univariate analysis, ratings of PWB(the physical well-being domain of FACT-G), FWB(the functional well-being domain of FACT-G), FACT-G, CCS(Cervix Cancer-Specific Scale) and FACT-CX(FACT-G + CCS) in the surgery group were higher than those in other two groups(P<0.05), and there were no differences among three groups in ratings of SWB(the social/family well-being domain of FACT-G) and EWB(the emotional well-being domain of FACT-G);there was no significant difference in the quality of life among patients with different education levels(P≥0.05);there were statistically significant difference in FACT-CX, FACT-G, FWB and CCS scores among different age groups(P<0.05), and the <40 group showed the highest scores in the above four scales. In the analysis of covariance excluding the influence of age, scores of PWB and FACT-G in the concurrent chemoradiotherapy group were higher than those in the surgery group(the highest score) and the additional group(the lowest score);the surgery group had the highest CCS score(P<0.05). Conclusion: Regardless of age, the choice of treatment methods affects the quality of life of cervical cancer patients after treatment. It is suggested that appropriate treatment methods should be selected after full evaluation supplemented by appropriate psychological counseling, so as to avoid unnecessary treatments, thus improving the quality of life of cervical cancer patients.