同步放化疗联合维持治疗对EGFR突变阴性的寡转移期肺腺癌患者生活质量的影响

Effect of concurrent chemoradiotherapy combined with maintenance therapy on quality of life of patients with EGFR mutation-negative oligometastatic lung adenocarcinoma

目的探讨培美曲塞联合顺铂同步放化疗+培美曲塞维持化疗对EGFR突变阴性的寡转移期肺腺癌患者的生活质量的影响。方法选取2018年5月至2019年6月浙江省绍兴市人民医院肿瘤内科41例表皮生长因子受体(EGFR)基因突变阴性的寡转移期肺腺癌患者为研究对象,根据患者状态行胸部原发病灶局部放疗或寡转移灶局部放疗,放疗期间予培美曲塞联合顺铂化疗,放化疗结束后予培美曲塞维持治疗,在同步放化疗治疗前1 d、同步放化疗结束后3 d内、同步放化疗结束后2个月采用生活质量量表(EORTC QLQ-C30、QLQ-LC13)对患者进行评估,并进行比较分析。结果在功能领域方面,除认知功能外,同步放化疗结束时的躯体功能、角色功能、情绪功能、社会功能及总健康状况得分较治疗前降低(P<0.05),而在同步放化疗结束后2个月均有所改善,其中躯体功能差异有统计学意义(P<0.05);在症状领域方面,同步放化疗结束时的乏力、恶心呕吐、疼痛、食欲减退得分较治疗前上升(P<0.05),但在同步放化疗后2个月可恢复至治疗前水平(P>0.05),同步放化疗结束后2个月的咳嗽、吞咽困难得分较放化疗结束时明显下降(P<0.05),而咯血、胸痛得分较治疗前明显下降(P<0.05),其他症状领域的指标均未见明显加重或减轻(P>0.05)。结论培美曲塞联合顺铂同步放化疗+培美曲塞维持化疗在一定程度上改善了EGFR突变阴性的寡转移期肺腺癌患者的近期生活质量。

Objective To investigate the effect of pemetrexed concurrent chemoradiotherapy combined with pemetrexed maintenance chemotherapy on the quality of life of patients with EGFR mutation-negative oligometastatic lung adenocarcinoma.Methods Forty-one patients with oligometastatic lung adenocarcinoma with negative epidermal growth factor receptor(EGFR)gene mutations who were treated in Shaoxing People′s Hospital in Zhejiang province from May 2018 to June 2019 were selected.Patients were given local radiotherapy for chest primary lesions or local radiotherapy for oligometastatic lesions based on status of patients.Pemetrexed combined with cisplatin chemotherapy was used during radiotherapy,and pemetrexed maintenance therapy was used after the end of chemoradiotherapy.The quality of life scales(EORTC QLQ-C30,QLQ-LC13)were used to evaluate patients at one day before concurrent chemoradiotherapy,within three days after the end of concurrent chemoradiotherapy and two months after the end of concurrent chemoradiotherapy.The results were compared and analyzed.Results In terms of function area,the scores of expect for cognitive function,the physical function,role function,emotional function,social function and general health at the end of concurrent chemoradiotherapy were lower than those before treatment(P<0.05),and were improved at two month after the end of concurrent chemoradiotherapy,among which the difference of improvements of the physical function was statistically significant(P<0.05).In terms of symptom area,the scores of fatigue,nausea,vomiting,pain,and loss of appetite at the end of concurrent chemoradiotherapy were higher than those before treatment(P<0.05)but were restored to the pre-treatment level at two months after the end of concurrent chemoradiotherapy(P>0.05).The scores of cough,dysphagia at two months after the end of concurrent chemoradiotherapy were lower than those at the end of concurrent chemoradiotherapy,and the socores of hemoptysis,chest pain were lower than those before treatment(P<0.05).No significant aggravation or alleviation of other indicators in the symptom area were observed(P>0.05).Conclusion Pemetrexed concurrent chemoradiotherapy combined with pemetrexed maintenance chemotherapy improves the recent quality of life of patients with EGFR mutation-negative oligometastatic lung adenocarcinoma to some extent.