外科治疗对晚期乳腺癌骨转移患者生活质量的影响

Estimation of surgical treatment on the quality of life in late-stage breast cancer patients with bone metastasis

目的探讨乳腺癌晚期骨转移的外科治疗对患者生活质量的影响。方法1988-04/2001-03,56例有随访结果的乳腺癌骨转移患者行Guy's疼痛分级和Karnofsky评分,测量X线平片中长骨骨皮质破坏厚度(或椎体骨折塌陷的程度)作为定量计算指标。依据全身状况和骨转移灶特征将患者分为手术组与非手术组。对比两组临床缓解率、Karnofsky及生活质量评分结果并作统计学分析。结果平均随访19.5个月。56例患者中42例接受手术治疗,总有效率83%,明显高于非手术组57%。17例有病理骨折或骨折危险性的患者接受大段异体骨关节移植,依据Mankin's异体骨移植评价标准,术后总评优良率为88%。接受手术治疗与未行手术治疗的患者相比,疼痛减轻,Karnofsky评分增加,生活质量明显提高。结论根据骨转移癌分组标准进行有选择性的手术治疗可以提高患者终末期的生活质量和生命活力。

Aim To study the effect of surgical treatment on the quality of life for late stage breast cancer patients with bone metastasis.Methods 56 inpatients were divided into two groups:operation group with 42 patients and non operartion group with 14 patients according to their general condition and bone metastasis stigmata.42 patients in operation group were treated with surgical treatment while the others not.Clinical remission rate, Karnofsky and quality of life were tested in two groups.Results All patients were assessed and followed up for a mean course of 19.5 months in average. The efficiency in operation group(83%)was higher than that in non operation(57%).The eximious rate of 17 patients treated with allografts was 88%according to Mankin. Karnofsky score was increased and quality of life was enhanced in operation group after surgical treatment, compared with non operation group.Conclusion Positive and moderate treatments including operation may enhance patients' quality of life and play an important role in medical practice.