CAJ | 학술논문

背景与目的:食管癌在临床确诊时大多病变较广泛,难以达到根治目的,因此改善其生存质量尤为重要.同期放化疗对食管癌有较好疗效,但其对食管癌生存质量的影响国内报道较少,笔者旨在评价同期放化疗对食管癌患者近期生存质量的影响.方法:应用欧洲痛症研究治疗组织的癌症患者生存质量自评核心量表(EORTC QLQ-C30)汉化中文版进行生存质量评价.食管鳞癌随机分为同期放化疗组(CRT)26例和后程加速超分割组(LAHF)26例,所有患者在治疗前、放疗第4周、放疗完成时、放疗后1个月、放疗后3个月共5次进行生存质量的测定.结果:CRT组和LAHF组在放疗过程中至放疗结束后1个月短时间降低了总体健康状况、躯体功能、角色功能、社会功能,但与放疗前相比均未有显著性差异(P>0.05);而CRT组在放疗后3个月显著改善了总体健康状况、躯体功能和角色功能,评分均值分别提高了12.0±3.7(P=0.012)、8.1±2.9(P=-0.023)和14.8±5.2(P=-0.015).虽然CRT组在治疗过程中加重了恶心呕吐、疼痛和食欲丧失症状,但治疗后恢复较快.结论:同期放化疗显著改善了食管癌患者近期生存质量的总体健康状况领域、躯体功能领域和角色功能领域,以生存质量的观点出发,同期放化疗是一种可行的治疗手段.
배경여목적:식관암재림상학진시대다병변교엄범,난이체도근치목적,인차개선기생존질량우위중요.동기방화료대식관암유교호료효,단기대식관암생존질량적영향국내보도교소,필자지재평개동기방화료대식관암환자근기생존질량적영향.방법:응용구주통증연구치료조직적암증환자생존질량자평핵심량표(EORTC QLQ-C30)한화중문판진행생존질량평개.식관린암수궤분위동기방화료조(CRT)26례화후정가속초분할조(LAHF)26례,소유환자재치료전、방료제4주、방료완성시、방료후1개월、방료후3개월공5차진행생존질량적측정.결과:CRT조화LAHF조재방료과정중지방료결속후1개월단시간강저료총체건강상황、구체공능、각색공능、사회공능,단여방료전상비균미유현저성차이(P>0.05);이CRT조재방료후3개월현저개선료총체건강상황、구체공능화각색공능,평분균치분별제고료12.0±3.7(P=0.012)、8.1±2.9(P=-0.023)화14.8±5.2(P=-0.015).수연CRT조재치료과정중가중료악심구토、동통화식욕상실증상,단치료후회복교쾌.결론:동기방화료현저개선료식관암환자근기생존질량적총체건강상황영역、구체공능영역화각색공능영역,이생존질량적관점출발,동기방화료시일충가행적치료수단.
Background and purpose: Most of the patients with esophageal cancers were late stage cases when diagnosed clinically. Since the prognosis is very poor, it is extremely important to improve the quality of life (QOL) of these patients. Concurrent chemoradiotherapy is an effective modality for esophageal cancer. However, effects on quality of life of chemoradiotherapy are rarely reported domestically. Our purpose was to assess the immediate effect on the quality of life in patients with primary esophageal carcinoma. Methods: QOL was assessed by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) Chinese edition. Fifty-two patients were randomized to receive either concurrent chemoradiotherapy (CRT) or late course accelerated hyperfractionated radiotherapy (LAHF). QOL questionnaires were given before therapy and at the 4th week during radiotherapy, the completion of radiotherapy, and then after 1 and 3 months after the completion of radiotherapy, respectively. Results: It has been observed that the scores of global health status, physical functioning,role functioning and social functioning during the radiotherapy and from completion of radiotherapy to 1 month post radiotherapy in CRT and LAHF groups, deteriorated temporarily, but it were not significant when compared with those before radiotherapy (P>0.05). However, global health status scores, physical functioning scores, role functioning scores were significantly improved in patients who received CRT at 3 months post radiotherapy. Mean scores were improved by 12.0±3.7 (P=0.012),8.1±2.9 (P=0.023) and 14.8±5.2 (P=0.015), respectively. Nausea and vomiting, pain and appetite loss scales scores rapidly recovered to the baseline level after therapy, although they were worsened during therapy.Conclusion: Global health status scores, physical functioning scores and role functioning scores were significantly improved at 3 months after radiotherapy in patients treated by CRT. In terms of QOL, CRT is a feasible modality for esophageal cancer.