鼻咽癌立体定位适形放疗疗效及影响因素分析  

Quality of life and radiotherapy complications of nasopharyngeal carcinoma patients at different 3DCRT stages

作　　者：陈永朝[1] 熊如涛[1] 李清波[1] 

机构地区：[1]浙江省湖州市中心医院介入放疗科,浙江湖州313000

出　　处：《中国现代医生》2013年第12期6-8,11,共4页China Modern Doctor

基　　金：浙江省卫生厅科技项目(2012KYB198)

摘　　要：目的研究中国鼻咽癌患者立体定位适形放疗各阶段生存质量和放疗并发症,以分析其疗效。方法 511例立体定位适形放疗各阶段中国鼻咽癌患者纳入研究,通过进行SF-36问卷、并发症和社会人口统计变量问卷以及肿瘤治疗变量问卷的随访调查,并据此进行协变量分析。结果躯体状态得分的影响因素包括立体定位适形放疗所处阶段和年龄因素,心智状态得分的影响因素为立体定位适形放疗所处阶段和收入状况。排除各种干扰因素后,立体定位适形放疗所处阶段对鼻咽癌患者生存质量得分影响最为显著,正在接受立体定位适形放疗的患者得分最低,放疗结束后得分升高。立体定位适形放疗后生存5年以上的患者身体状态得分优于立体定位适形放疗前得分。鼻咽癌患者立体定位适形放疗不同状态下的主要并发症包括口腔干燥症、咽痛、味觉减退、龋齿、听力下降及鼻塞等。结论临床医生应多关注老年和低收入鼻咽癌患者。当患者接受立体定位适形放疗时,应采取必要手段减少放疗并发症,提高患者生存质量。Objective To compare the quality of life （QOL） and radiotherapy complications among Chinese nasopharyn- geal carcinoma （NPC） patients at different 3-dimensional conformal radiotherapy （3DCRT） stages adjusting for other variables. Methods A total of 511 NPC patients at different 3DCRT stages were enrolled. They were interviewed re- garding SF-36, complications and socio-demographic variables and cancer- or treatment- related variables. Analysis of covariance （ANCOVA） based on SF-36, complications scores as dependent variables, 3DCRT stages as independent variables, and other variables as covariate were established. Results The influencing factors of PCS included 3DCRT stages and age group. The influencing factors of MCS included 3DCRT stages and income. Most QOL scores of NPC pa- tients were significantly associated with 3DCRT stage, after accounting for other variables. QOL scores of the patients receiving 3DCRT were the lowest, QOL scores of people after 3DCRT gradually increased. PCS scores of people greater than 5 years after 3DCRT was improved to or even better than the level before 3DCRT. The complications with signif- icantly different scores of patients at different 3DCRT status included xerostomia, throat ache, hypogeusia, caries, hear- ing loss, snuffles. Conclusion Clinicians should pay more attention to older NPC patients and patients with lower income. When patients receive 3DCRT, measures should be taken to reduce radiation injury to improve the patients＇ QOL.

关 键 词：鼻咽癌 SF-36 立体定位适形放疗 并发症 

分 类 号：R739.63[医药卫生—肿瘤]