老年子宫内膜癌术后化疗患者生活质量及其影响因素  

Quality of life and its influencing factors in elderly patients with endometrial cancer after chemotherapy

作　　者：韩芸芸 刘晓红 陈玥 Han Yunyun;Liu Xiaohong;Chen Yue(Department of Gynecology,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属北京世纪坛医院妇科,北京100038

出　　处：《中华老年多器官疾病杂志》2024年第8期603-606,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：首都医科大学附属北京世纪坛医院科研课题(2019-q25)。

摘　　要：目的调查老年子宫内膜癌术后化疗患者生活质量,并分析其影响因素。方法选择2018年6月至2023年6月首都医科大学附属北京世纪坛医院收治的158例老年子宫内膜癌术后化疗患者进行问卷调查,使用癌症治疗功能评价系统共性模块(FACT-G)第4版的子宫内膜癌模块评估生活质量,根据FACT-G评分将158例患者分为生活质量良好组(FACT-G评分≥平均分,82例)与生活质量不良组(FACT-G评分<平均分,76例),收集病理分期、病理类型、分化程度、化疗方案等资料。采用SPSS 24.0统计软件进行数据分析。根据数据类型,分别采用χ^(2)检验或t检验进行组间比较。采用logistic回归分析老年子宫内膜癌术后化疗患者生活质量不良的影响因素。结果158例患者FACT-G评分的平均分为(79.68±10.85)分。生活质量不良组癌灶p53突变率、3~4级不良反应发生率及抑郁、焦虑、癌症复发恐惧发生率均高于生活质量良好组,差异有统计学意义(P<0.05)。logistic回归分析显示,癌灶p53突变(OR=2.670,95%CI 1.343~5.309)、3~4级不良反应(OR=4.646,95%CI 2.734~7.896)、抑郁(OR=2.612,95%CI 1.315~5.186)、焦虑(OR=3.284,95%CI 1.787~6.036)及癌症复发恐惧(OR=3.442,95%CI 1.892~6.262)均为老年子宫内膜癌术后化疗患者生活质量不良的危险因素。结论癌灶分子分型、重度不良反应及抑郁、焦虑、癌症复发恐惧的负性情绪是造成老年子宫内膜癌术后化疗患者生活质量下降的重要原因,临床可以此制定针对性生理及心理干预措施,提升患者生活质量。Objective To investigate the quality of life(QOL)in elderly patients with endometrial cancer after chemotherapy and analyze its influencing factors.Methods A questionnaire survey was conducted on 158 elderly patients with postoperative chemotherapy for endometrial cancer from June 2018 to June 2023.Their QOL level was assessed by endometrial cancer module of the fourth edition of functional assessment of cancer therapy-general(FACT-G).According to their score of FACT-G,they were divided into good QOL group(≥average level,82 cases)and poor QOL group(<average level,76 cases).Pathological stage and type,differentiation grade,chemotherapy regimen and other data were collected.SPSS statistics 24.0 was used for data analysis.Depending on data type,Chi-square test or student′s t test was applied for intergroup comparison,and logistic regression analysis was adopted to identify the influencing factors for poor QOL in elderly patients with postoperative chemotherapy for endometrial cancer.Results The average score of FACT-G was(79.68±10.85)points in the 158 patients.The poor QOL group had significantly higher mutation rate of p53 in tumor foci,incidence of adverse reaction grades 3-4 and rates of depression,anxiety and fear of cancer recurrence than the good QOL group(P<0.05).Logistic regression analysis showed that p53 mutation(OR=2.670,95%CI 1.343-5.309),adverse reaction grades 3-4(OR=4.646,95%CI 2.734-7.896),depression(OR=2.612,95%CI 1.315-5.186),anxiety(OR=3.284,95%CI 1.787-6.036)and fear of cancer recurrence(OR=3.442,95%CI 1.892-6.262)were risk factors for poor QOL in elderly patients with postoperative chemotherapy for endometrial cancer.Conclusion Molecular type in tumor foci,severe adverse reactions and negative emotions such as depression,anxiety and fear of cancer recurrence are important reasons for the decline of QOL in elderly patients with endometrial cancer after chemotherapy.It is necessary to formulate targeted physiological and psychological intervention measures so as to enhance their QOL in clinic

关 键 词：老年人 子宫内膜癌 化疗 手术切除 生活质量 P53突变 

分 类 号：R592[医药卫生—老年医学] R737.33[医药卫生—内科学]