WBRT对肺癌脑转移者认知功能及生活质量影响前瞻性研究  

A prospective study of effects of whole brain radiotherapy on cognitive function and quality of life in patients with brain metastases from lung cancer

作　　者：连一新[1] 周梦耘 邹莉[2] 陈清清[2] 田野[2] 

机构地区：[1]苏州大学附属第二医院呼吸科,215004 [2]苏州大学附属第二医院放疗科苏州大学放射肿瘤治疗学研究所苏州市肿瘤放射治疗学重点实验室

出　　处：《中华放射肿瘤学杂志》2016年第12期1290-1294,共5页Chinese Journal of Radiation Oncology

基　　金：国家自然科学基金（81372411）;江苏省临床医学科技专项资助项目（BL2014040）;苏州市科技发展计划项目（SZS201509）;苏州市肿瘤放射治疗医学中心（Szzxj201503）

摘　　要：目的 评估WBRT对肺癌脑转移患者认知功能及生活质量的影响.方法 以2015年收治的41例行WBRT的肺癌脑转移患者为研究对象,以蒙特利尔认知评估量表（MoCA）、简易精神状态量表（MMSE）为认知评估工具,以阿尔茨海默病协作研究日常能力量表（ADCS-ADL）为生活质量评估工具.独立样本t检验WBRT前后认知功能和生活质量水平.结果 WBRT前与后经MoCA、MMSE评估认知功能障碍比例分别为96.55%、48.28%和94.29%、31.43%.WBRT前与后相比MoCA、MMSE各量表总分分别为18.24±0.95与19.37±0.70（P=0.341）,23.51±0.88与24.54±0.71（P=0.375）.WBRT前与后ADCS-ADL得分分别为57.44±2.59、59.37±2.27（P=0.583）.结论 WBRT对肺癌脑转移患者总体认知功能及日常生活质量水平无明显影响.MoCA对脑转移癌患者认知功能障碍筛查时较MMSE具有更高敏感性.Objective To evaluate the effects of whole brain radiotherapy （ WBRT ） on cognitive function and quality of life （ QOL） in patients with brain metastases from lung cancer. Methods A total of 41 patients with brain metastases from lung cancer who were admitted to our hospital and treated with WBRT in 2015 were enrolled as subjects. Montreal Cognitive Assessment （ MoCA ） and Mini-Mental State Examination （ MMSE ） were used for cognitive evaluation. The Alzheimer′s Disease Cooperative Study Activity of Daily Living （ ADCS-ADL ） scale was used for evaluation of QOL. Comparison of cognitive function and QOL before and after WBRT was made by the independent sample t-test. Results The incidence rates of cognitive dysfunction based on MoCA and MMSE were 96. 55% and 48. 28% before WBRT, and 94. 29% and 31. 43% after WBRT, respectively. There were no significant changes in MoCA score, MMSE score, or ADCS-ADL score after WBRT （ 18.24± 0. 95 vs. 19.37± 0. 70, P=0. 341;23.51± 0. 88 vs. 24.54±0. 71,P=0. 375;57.44±2. 59 vs. 59.37±2. 27,P=0. 583）. Conclusions WBRT has no significant impacts on cognitive function and QOL in patients with brain metastases from lung cancer. MoCA is more sensitive than MMSE in detection of cognitive dysfunction in patients with brain metastases.

关 键 词：脑转移 肺肿瘤/全脑放射疗法 认知功能 生活质量 量表 

分 类 号：R734.2[医药卫生—肿瘤]