^(131)I治疗对早期甲状腺乳头状癌女性患者健康相关生存质量的影响  

Impact of ^(131)I treatment on health-related quality of life in female patients with early stage papillary thyroid cancer

作　　者：赵敏[1] 张露月 柏林[1] 温强[1] 赵劼[1] 高识[1] 马庆杰[1] Min Zhao;Luyue Zhang;Lin Bai;Qiang Wen;Jie Zhao;Shi Gao;Qingjie Ma(Department of Nuclear Medicine,China-Japan Union Hospital of Jilin University,Changchun 130033,China)

机构地区：[1]吉林大学中日联谊医院核医学科,长春130033

出　　处：《国际放射医学核医学杂志》2021年第1期10-17,共8页International Journal of Radiation Medicine and Nuclear Medicine

摘　　要：目的探讨早期甲状腺乳头状癌(PTC)女性患者接受^(131)I治疗与否对健康相关生存质量(HRQOL)的影响。方法回顾性分析2015年6月至2016年6月于吉林大学中日联谊医院接受双侧甲状腺全切的PTC女性患者356例(患者组),年龄21~65(41.00±9.64)岁。应用欧洲癌症研究与治疗组织(EORTC)开发的生存质量核心量表30(QLQ-C30)(简称EORTC QLQ-C30)进行HRQOL评估,分别比较400名与上述患者年龄相匹配[21~65(41.70±9.38)岁]的健康女性体检者(对照组)与患者组在EORTC QLQ-C30各领域得分[包括5个功能领域、9个症状领域以及独立的总体生活质量(GQOL)]。根据是否接受过^(131)I治疗将所有患者分为2组:^(131)I治疗组(205例)和未治疗组(151例),分别比较2组患者术前及术后(1、3、6个月)的促甲状腺激素(TSH)和甲状腺球蛋白(Tg)水平、EORTC QLQ-C30各领域得分。数据的组间比较采用Mann-Whitney U秩和检验。结果患者组术前的GQOL得分(59.11±21.12)明显低于对照组(83.08±14.62),除了身体功能以外的其他功能领域的得分均低于对照组,除了疼痛以外的其他症状领域的得分均高于对照组,且差异均有统计学意义(Z=−6.958~−4.673,均P<0.05)。术后6个月,患者组的GQOL得分(73.88±18.04)虽然仍低于对照组,但与术前相比有明显提升,除了身体功能、认知功能、社会功能以外的其他功能领域的得分均比术前升高,除了乏力、疼痛、气短以外的其他症状领域的得分均比术前降低,且差异均有统计学意义(Z=−5.790~−2.876,均P<0.05)。术前^(131)I治疗组与未治疗组的GQOL及其他所有领域的得分的差异均无统计学意义(Z=−0.876~−0.001,均P>0.05)。术后1个月,^(131)I治疗组的TSH和Tg水平明显高于未治疗组,且差异均有统计学意义(Z=−6.159、−10.061,均P<0.01);^(131)I治疗组的GQOL得分(50.57±17.72)低于未治疗组(55.74±18.82),功能领域的得分均低于未治疗组,除了疼痛、腹泻、经济困�Objective To analyze the effect of ^(131)I treatment on health-related quality of life(HRQOL)in female patients with early stage thyroid papillary carcinoma(PTC).Methods The data of 356 female PTC patients(aged 21−65(41.00±9.64)years)with pT1N1aM0 in China-Japan Union Hospital of Jilin University collected from June 2015 to June 2016 were retrospectively analyzed.A total of 400 healthy women(aged 21−65(41.70±9.38)years)were selected as healthy controls.The HRQOL scores by the European Organization for Research and Treatment of Cancer(EORTC)quality of life questionnaire-core 30(QLQ-C30)between the controls and PTC patients at preoperative period and at 6 months after the operation were compared.Patients were divided into two groups according to whether or not they received ^(131)I treatment(^(131)I treatment group:n=205,non-^(131)I treatment group:n=151).The levels of thyroid-stimulating hormone(TSH),thyroglobulin(Tg),and HRQOL scores at preoperative period and at 1,3,and 6 months after the operation were compared between the two groups.Informed consent was obtained from all subjects.Non-parametric test of Mann-Whitney U was used to compare the groups with SPSS 19.0 software.Results Before the operation,the global quality of life(GQOL)score of all patients was significantly lower than that of the controls(59.11±21.12 vs.83.08±14.62),functional domain scores in patients were lower than those in the controls except physical function,symptom domain scores were significantly higher except pain(Z=−6.958 to−4.673,all P<0.05).At 6 months after operation,the GQOL score in patients was still lower than that in the controls(73.88±18.04 vs.83.08±14.62),but it was significantly higher than the preoperative score.Similar improvements were found in eight other domains other than physical function,cognitive function,social function,fatigue,pain and dyspnoea(Z=−5.790 to−2.876,all P<0.05).No significant difference was found in the preoperative all-domain scores between the ^(131)I and non-^(131)I treatment groups

关 键 词：碘放射性同位素 近距离放射疗法 甲状腺癌 乳头状 生活质量 EORTC QLQ-C30 

分 类 号：R736.1[医药卫生—肿瘤]