鼻咽癌患者经调强放疗后放射性口干的减少对生活质量的影响  

The effect on life quality of nasopharyngeal cancer patients through xerostomia decrease after intensity-modulated radiotherapy

作　　者：谢聪颖[1] 苏华芳[1] 李文峰[1] 张薛榜[1] 张萍[1] 温红蕾[2] 吴式琇[1] 

机构地区：[1]温州医学院附属第一医院放化疗科,325000 [2]温州大学数学与信息学院

出　　处：《中华医学杂志》2010年第19期1313-1316,共4页National Medical Journal of China

基　　金：浙江省科技厅重大科技专项（2007C13054）;温州市重大科技计划（S20070026）

摘　　要：目的 探索鼻咽癌患者调强放疗（IMRT）后口干的减少对生活质量的影响.方法 2002年8月至2008年12月,温州医学院附属第一医院收治鼻咽癌调强放射治疗患者共235例,其中存活2年以上、无复发转移患者91例,在放疗前、放疗结束时、放疗后3、6、9、12、18和24个月分别完成1份8个项目的 口干调查表（XQ）及头面部专用的生活质量调查表（QOL）,然后对数据进行统计分析.结果 XQ评分在放疗结束时明显上升,以后随时间推移逐渐下降,在放疗后9个月开始XQ评分改善差异有统计学意义（P=0.024）,至18个月时XQ评分几乎恢复至基线水平.QOL总评分放疗结束时比放疗前明显上升（P=0.012）,以后随时间推移逐渐下降,至18个月时评分跟结束时相比差异有统计学意义（P=0.020）,基本恢复基线水平.子项目沟通能力、进食能力及疼痛总评分在放疗结束时亦明显升高（P＜0.05）,而放疗对情绪评分相对影响较小.XQ总评分和QOL总评分在各时间点存在密切相关（r=0.976）,XQ评分跟一些子领域的QOL也显著相关,包括沟通能力和进食能力,并患者自我评价总的治疗影响.结论 放射性口干减少能影响总的生活质量评价而改善生活质量.Objective To evaluate the gain on the life quality of NPC from efforts to reduce the radiotherapy-induced xerostomia after IMRT. Methods From August 2002 to December 2008, 235 patients with nasopharyngeal carcinoma were treated with IMRT in the First Affiliated Hospital of Wenzhou Medical College. Ninety-one patients with minimum 2 years of survival and no replaces and metastasis were enlisted.XQ and QOL questionnaires were completed at baseline, then 0, 3, 6, 9, 12, 18 and 24 months after IMRT. Results The XQ scores were substantially higher at the end of IMRT compared with baseline and descended over time. At 9 months post-RT, the XQ scores improved significantly（ P = 0. 024）and recovered nearly to baseline at 18 months post-RT. Likewise, the QOL scores were siguifieanfly higher at the end of IMRT compared with baseline（ P = 0. 012） and had a sequential trend towards improvement over the study period. At 18 months post-RT, the QOL scores almost recover to baseline （P = 0. 020 ）.Multiple comparisons testing revealed that communication, eating and pain sub-scale scores were significantly higher at the end of IMRT compared with baseline（ P 〈0. 05 ）with the exception of emotion domain. There was a significant correlation between XQ scores and QOL scores in general in all the study time（ r =0. 976, P 〈0. 001 ） ,also a significant position correlation was found between XQ scores and communication, eating subscale scores and overall bother scores. Conclusions IMRT technique can reduce the incidence of postradiation xerostomia significantly and can improve the quality of life in many domains.

关 键 词：鼻咽肿瘤 口腔干燥 调强放疗 生活质量 

分 类 号：R739.63[医药卫生—肿瘤]