辅助放疗对乳腺癌患者生活质量和癌因性疲乏的影响分析

The Impact of Postoperative Adjuvant Radiotherapy on Quality of Life and Cancer-Related Fatigue in Patients with Breast Cancer

目的探讨术后辅助放疗对乳腺癌患者的癌因性疲劳(cancer-relatedfatigue,CRF)和生活质量的影响。方法选取2018年3月—2019年8月盘锦市中心医院乳腺外科收治的行保乳术或改良根治术的乳腺癌患者45例作为研究对象,分别于放疗前(TP_(1))、放疗结束时(TP_(2))及中位随访时间为10个月(7~12个月)(TP3)时,利用慢性疾病治疗功能评估-疲劳量表(functional assessment of chronic illness therapy-fatigue,FACIT-F)和乳腺癌患者生存质量测定表(functional assessment of cancer therapy-breast,FACT-B)对患者的CRF和生活质量进行评价。结果对于未接受化疗的患者,TP_(2)期的疲劳程度高于TP_(1)期(P<0.05),并且在TP3期也未恢复至TP_(1)期的水平(P>0.05)。而对于既往接受过化疗的患者,疲劳程度从TP_(1)到TP3逐渐减轻。对于未接受化疗者,随着治疗时间的推进,生理状况(physical wellbeing,PWB)评分从TP_(1)的23.5分下降到TP_(2)的21.4分(P<0.05),但在TP3时,PWB则恢复到TP_(1)的水平。而从TP_(1)到TP3,社会功能(social wellbeing,SWB)评分则逐步下降(P<0.05)。而对于既往接受过化疗的患者,这些评分随着时间的推进始终保持在一个较为恒定的水平。结论术后接受辅助放疗的乳腺癌患者是一个异质性群体,受既往治疗方式的影响,发生CRF的几率也不同。这一发现有助于有针对性地对患有CRF的患者进行早期干预,未来的研究需要集中于为这类患者群体制定科学的治疗和干预策略。

Objective To investigate the impact of postoperative adjuvant radiotherapy(RT)on quality of life(QoL)and cancer-related fatigue(CRF)in patients with breast cancer.Methods A total of 45 patients was evaluated for CRF and QoL using the Functional Assessment of Chronic Illness Therapy-Fatigue(FACIT-F)and Functional Assessment of Cancer Therapy-Breast(FACT-B),respectively.Patients were required to finish the FACIT-F and FACT-B questionnaire before(TP_(1))and at the end of radiotherapy(TP_(2))as well as at median follow-up time of 10months(TP3).Results In patients who did not receive chemotherapy,the severity of fatigue at TP_(2) was significantly higher than that at TP_(1)(P<0.05)and did not return to baseline scores at TP3(P>0.05).In contrast,the severity of fatigue has been reduced gradually from TP_(1)~TP3 in patients who had previously received chemotherapy.For patients who did not receive chemotherapy,a significant decrease of physical wellbeing(PWB)from TP_(1) to TP_(2) was observed(P<0.05),and returned to baseline score at TP3.Social wellbeing(SWB)score decreased gradually from TP_(1) to TP3(P<0.05).For patients who had previously received chemotherapy,these scores remained relatively constant over time.Conclusion Breast cancer patients undergoing postoperative RT constitute a heterogeneous group,and the incidence of CRF is various due to different prior treatment.This finding is help for early target intervention in patients with CRF,and future research needs to focus on developing scientific treatment and intervention strategies for this patient population.