CAJ | 학술논문

目的分析鼻咽癌患者放疗后的生存质量情况及影响因素,探讨调强放疗技术对减轻患者治疗后副反应,提高生存质量方面的意义.方法参考EORTC QLQ-C30并结合鼻咽癌的相关症状及副反应,制定了包括35项内容的"鼻咽癌患者生存质量调查问卷".面访问卷调查了142例鼻咽癌无瘤生存患者的生存质量情况,同时收集患者的社会人口学信息和临床资料,随访中位时间为25个月,按不同的放疗技术将患者分为调强放疗组(IMRT组)75例和常规放疗组(CRT组)67例.用SAS 8.1软件包处理数据,比较两组无瘤生存患者的生存质量评分,分析患者治疗后生存质量的影响因素.结果 IMRT组、CRT组在情感认知功能领域评分分别为82.8±14.7、77.5±16.0(t=2.07,P=0.040);在疾病与治疗相关症状、反应领域评分分别为78.9±10.3、69.8±13.3(t=4.59,P=0.000).两组在口干、张口困难、吞咽呛咳、声嘶、颈部活动受限、进食吞咽困难的评分差异均有统计学意义(P值均<0.05).影响生存质量的因素中,身体功能评分的因素为性别,回归系数为-4.692;总体生存质量自我评分的因素为随访时间和学历,回归系数分别为-0.618和12.316;经济状况评分的因素为家庭人均月收入,回归系数-11.133;疾病与治疗相关症状反应评分的因素为组别(即放疗技术)和年龄,回归系数分别为-9.384和-5.853.结论 IMRT技术可减轻鼻咽癌患者治疗后口干、张口困难、颈部活动受限、进食吞咽困难等副反应,提高了患者的生存质量;不同放疗技术、性别、年龄、家庭月人均收入、学历、随访时间等从多个维度上影响着鼻咽癌患者治疗后的生存质量.
목적 분석비인암환자방료후적생존질량정황급영향인소,탐토조강방료기술대감경환자치료후부반응,제고생존질량방면적의의.방법 삼고EORTC QLQ-C30병결합비인암적상관증상급부반응,제정료포괄35항내용적"비인암환자생존질량조사문권".면방문권조사료142례비인암무류생존환자적생존질량정황,동시수집환자적사회인구학신식화림상자료,수방중위시간위25개월,안불동적방료기술장환자분위조강방료조(IMRT조)75례화상규방료조(CRT조)67례.용SAS 8.1연건포처리수거,비교량조무류생존환자적생존질량평분,분석환자치료후생존질량적영향인소.결과 IMRT조、CRT조재정감인지공능영역평분분별위82.8±14.7、77.5±16.0(t=2.07,P=0.040);재질병여치료상관증상、반응영역평분분별위78.9±10.3、69.8±13.3(t=4.59,P=0.000).량조재구간、장구곤난、탄인창해、성시、경부활동수한、진식탄인곤난적평분차이균유통계학의의(P치균<0.05).영향생존질량적인소중,신체공능평분적인소위성별,회귀계수위-4.692;총체생존질량자아평분적인소위수방시간화학력,회귀계수분별위-0.618화12.316;경제상황평분적인소위가정인균월수입,회귀계수-11.133;질병여치료상관증상반응평분적인소위조별(즉방료기술)화년령,회귀계수분별위-9.384화-5.853.결론 IMRT기술가감경비인암환자치료후구간、장구곤난、경부활동수한、진식탄인곤난등부반응,제고료환자적생존질량;불동방료기술、성별、년령、가정월인균수입、학력、수방시간등종다개유도상영향착비인암환자치료후적생존질량.
Objective To analyze the status of quality of life (QOL) and the related factors in pa-tients with uasopharyngeal carcinoma (NPC) after radiotherapy, and to explore the significance of intensity modulated radiotherapy (IMRT) in decreasing side effects and improving QOL. Methods A questionnaire including 35 items was designed according to EORTC QLQ-30 and the related symptoms and side effects of NPC. 142 NPC patients surviving with disease-free after radiotherapy were surveyed for the evaluation of QOL. The median follow-up was 25 months. The information of social demography and clinical details were collected. The patients were divided into IMRT group (75 patients) and conventional radiotherapy (CRT) group (67 patients). A statistical software package SAS 8.1 was used to compare the marks of QOL between the groups and analyze the influencing factors. Results In IMRT group and CRT group, the marks of affec-tire cognitive domain were 82.8±14.7 and 77.5±16.0(t=2.07, P=0.040);and the marks of disease and treatment-related symptoms, and reactive domain were 78.9±10.3 and 69.8±13.3 (t=4.59, P=0.000). The marks were significantly different in xerostomia, trismus, deglutitory choke, hoarseness, re-striction of neck movement and dysphagia (P < 0.05). Of the influencing factors of QOL, the domain of body function was sex (regression coefficient was -4.692), the self-evaluation of total QOL were follow-up time and educational background (regression coefficients were -0.618 and 12.316, respectively), the fi-nancial status was family monthly income per capita (regression coefficient was -11.133), and the disease and treatment-related symptoms and reactive domain were group (techniques of radiation) and age (regression coefficients were -9.384 and -5.853, respectively). Conclusions IMRT could improve the QOL through decreasing the side effects of patients with NPC including xerostomia, trismus, restriction of neck movement and dysphagia. Sex, age, family monthly income per capita, educational background, fol-low-up time and the irradiation techniques may affect QOL.