食管癌新辅助化疗患者生活质量的定量研究  

Quantitative study of quality of life of neo-adjuvant chemotherapy in patients with esophageal cancer

作　　者：钱勇[1] 潘跃银[1] 孙国平[1] 顾康生[1] 熊福星[1] 郝吉庆[1] 张从军[1] 朱学庆[1] 陈振东[1] 

机构地区：[1]安徽医科大学第一附属医院肿瘤内科,合肥230022

出　　处：《肿瘤研究与临床》2006年第4期233-236,共4页Cancer Research and Clinic

基　　金：安徽省科技厅2005年度重点资助项目(05021002)

摘　　要：目的评估食管癌新辅助化疗患者的生活质量(QOL)。方法68例无手术指征的食管癌患者接受FLP方案化疗,采用QLQ-C30、QLQ-OES18、Stooler吞咽困难分级、Karnofsky评分四种方法评价化疗前后的QOL变化。结果无论化疗有效与否,化疗后第一周QOL均有轻微下降,主要影响因素是化疗相关恶心、呕吐和腹泻,但可在化疗第四周末恢复到基线水平;化疗有效患者(36.8%)的躯体、角色等功能分和总体状况分化疗后一周即有提高,至第四周末尤其显著(P<0.05)。食欲减退、吞咽困难、进食、疼痛等症状较化疗前有明显缓解。化疗无效者的角色、认知、社会得分治疗后略有降低,情绪得分下降显著,但化疗后吞咽困难等主观症状仍有30%左右得到改善。结论食管癌FLP方案新辅助化疗安全可行,多数患者能从治疗中获益,QOL改善与化疗效果不完全相关。Karnofsky评分不能反映化疗前后的QOL变化,QLQ-C30配合QLQ-OES18或Stooler吞咽困难分级,能准确方便地评估食管癌新辅助化疗患者QOL。Objective To evaluate the quality of life （QOL） of neo-adjuvant chemotherapy in patients with esophageal cancer. Methods Sixty-eight eligible patients receiving FLP protocol were included in the study. Their QOL was assessed using EORTC QLQ-C30, QLQ-OES18, Stooler＇s dysphagia score and KPS respectively. Results Given the effectiveness of chemotherapy, the patients＇ QOL all declirled slightly after the first week, that was affected prominently by chemotherapy-related nausea, vomiting and the diarrhea, but returned to the baseline level at the end of the fourth week. The score of physical function, role function and global health status in patients who was effectiveness to chemotherapy （36.8%） began to improve after the first week, and especially remarkable to the end of the fourth week （P 〈0.05）. There score of symptoms like appetite loss, dysphagia, eating and pain also obviously alleviated after chemotherapy. Although the score of role function, cognitive function, and social function declined slightly and emotional function dropped remarkably, main symptom of esophageal cancer like dysphagia improved in 30 % about in the chemotherapy non-responder. Conclusions Neo-adjuvant chemotherapy with FIX＇ protocol for esophageal cancer is safe and convenient, and effective to most of the patients. The improvement of QOL is not totally correlated to chemotherapy responds. KPS could not reflect the patients＇s QOL change after chemotherapy. QLQ-C30 together with QLQ-OES18 or Stooler＇s dysphagia score may evaluate accurately the changes of QOL in esophageal cancer patients with neo-adjuvant chemotherapy.

关 键 词：食管癌 新辅助化疗 生活质量 

分 类 号：R735.1[医药卫生—肿瘤]