CAJ | 학술논문

目的探讨鼻咽癌患者生存质量随疗前、中、后时间迁移变化的趋势.方法采用头颈部最表FACT-H&N和9个条目形成的自制鼻咽癌调查表NPC-QOL,对中山大学肿瘤防治中心接受常规放疗的鼻咽癌患者进行调查,按治疗进程将患者分为9个组:治疗前组、放疗0～20 Gy组、放疗20～50 Gy组、放疗50 Gy至放疗结束组、放疗结束0～6个月组、放疗结束6～12个月组、放疗结束1～2年组、放疗结束2～3年组和放疗结束3～5年组.比较各组得分,了解生存质量变化趋势.结果共对450例鼻咽癌患者完成了调查.患者FACT-H&N总分治疗中较治疗前降低,治疗结束后逐步回升,放疗后0～6个月组的得分与治疗前组无明显差异.随着治疗进程推移,生理状况和功能状况表现为先降后升趋势,社会或家庭状况和情感状况没有明显改变,头颈部症状和鼻咽癌相关症状呈现愈来愈严重趋势.自治疗开始至放疗后6～12个月,患者口干程度不断加剧,最严重为放疗后6～12个月组,50%～60%长期无瘤生存患者自觉口干严重.随治疗进程推进,自觉张口困难患者比例不断上升,放疗后3～5年增至14%.结论首程接受常规放疗的鼻咽癌患者在治疗期间总体生存质量下降,但放疗结束6个月后基本恢复至疗前水平.口干和张口困难是影响长期生存鼻咽癌患者生存质量的重要因素.
목적 탐토비인암환자생존질량수료전、중、후시간천이변화적추세.방법 채용두경부최표FACT-H&N화9개조목형성적자제비인암조사표NPC-QOL,대중산대학종류방치중심접수상규방료적비인암환자진행조사,안치료진정장환자분위9개조:치료전조、방료0～20 Gy조、방료20～50 Gy조、방료50 Gy지방료결속조、방료결속0～6개월조、방료결속6～12개월조、방료결속1～2년조、방료결속2～3년조화방료결속3～5년조.비교각조득분,료해생존질량변화추세.결과 공대450례비인암환자완성료조사.환자FACT-H&N총분치료중교치료전강저,치료결속후축보회승,방료후0～6개월조적득분여치료전조무명현차이.수착치료진정추이,생리상황화공능상황표현위선강후승추세,사회혹가정상황화정감상황몰유명현개변,두경부증상화비인암상관증상정현유래유엄중추세.자치료개시지방료후6～12개월,환자구간정도불단가극,최엄중위방료후6～12개월조,50%～60%장기무류생존환자자각구간엄중.수치료진정추진,자각장구곤난환자비례불단상승,방료후3～5년증지14%.결론 수정접수상규방료적비인암환자재치료기간총체생존질량하강,단방료결속6개월후기본회복지료전수평.구간화장구곤난시영향장기생존비인암환자생존질량적중요인소.
Objective To investigate the tendency of quality of life in patients with nasopharyngeal carcinoma (NPC) treated with conventional radiotherapy. Methods Quality of life in NPC patients was assessed using FACT-H&N and NPC-QOL Patients were divided into nine groups according to the treatment period :before treatment group, 0 -20 Gy group, 20 -50 Gy group, > 50 Gy group, 0 -6 months after treatment group, 6 - 12 mouths group, 1 -2 years group, 2 -3 years group and 3 -5 years group. Scores of FACT-H&N and NPC-QOL were compared between the either two groups. Results 450 NPC patients were assessed. The total score of FACT-H&N decreased during the treatment and then increased six months after the treatment. The tendencies of physical and functional well-being were similar. The social/family and emotional well-being did not change significantly along with the treatment but the scores of head and neck well-being and NPC-QOL decreased obviously. Xerotomia was aggravated from the initiation of treatment and became the most severe at 6 - 12 months after treatment. 50% - 60% of the patients with disease-free reported severe xerotomia at 3 -5 years after radiotherapy. Incidence of severe trismus increased up to 14% at 3 -5 years after treatment. Conclusions Quality of life of NPC patients with conventional radiotherapy deteriorates during the treatment period, but recovers to the normal level six months after the treatment. Xerotomia and trismus can affect the quality of life of NPC patients.