摘要
目的评价小靶区调强放射治疗对宫颈癌术后伴中危因素患者生存质量的影响,为该治疗模式提供理论依据。方法对符合纳入标准的宫颈癌术后伴中危因素患者采用静态调强放射治疗技术(1.8 Gy/次,总剂量45Gy),靶区范围包括髂内淋巴结、髂外淋巴结及闭孔淋巴结。采用欧洲肿瘤研究与治疗中心研发宫颈癌特异性生存质量量表(EORTC QLQ-CX24)进行长期问卷调查,随访时间分别为放疗前、放疗后、放疗结束后3个月、6个月、9个月、12个月。问卷内容主要包括3个多项维度和6个单项维度。结果 2006年10月—2015年10月,共79例宫颈癌患者纳入研究,中位随访18.2个月。宫颈癌术后伴中危因素患者生存质量主要与手术方式和ECOG评分有关(P<0.05),与年龄、婚姻状况、文化程度无关(P>0.05);症状维度得分在放疗后和放疗后3个月升高(P<0.05),在之后随访时间点明显下降(P<0.05);躯体维度得分在放疗后9个月出现明显下降(P<0.05);性功能维度、淋巴水肿维度、周围神经维度、绝经维度、恐惧维度在各个时间点差异未见统计学意义(P>0.05);性功能维度主要在放疗后9个月才出现相关生存质量的提高(P<0.05)。结论宫颈癌术后伴中危因素患者的生存质量在进行小靶区放射治疗后均存在不同程度的下降,主要在症状维度和躯体维度,但在放疗结束后6个月,生活质量可逐步升高。
Objective To evaluate the influence of intensity-modulated radiation therapy on postoperative quality of life( QOL) of cervical cancer patients with intermediate-risk factors. Methods The static IMRT( 1. 8 Gy per fraction,total45 Gy) was performed in the patients meeting the inclusion criteria of cervical cancer patients with intermediate-risk factors. The targets included internal iliac lymph nodes,external iliac lymph nodes and obturator lymph nodes. EORTC QLQCX24 survey was performed among all patients before the radiation therapy,immediately after the radiation therapy,3 months,6 months,9 months and 12 months after the radiation therapy. The questionnaires included 3 Multi-Dimensional and 6 unidimensionality items. Results Between October,2006 and October,2015,total 79 cervical cancer patients were enrolled into this study. Median follow-up time was 18. 2 months. The postoperative QOL of cervical cancer patients with intermediate-risk factors was associated with the ways of operation and ECOG score( P < 0. 05),however,not with age,marital status,educational level( P > 0. 05). The symptom dimension score rose immediately after the radiation therapy and 3 months after the radiation therapy( P < 0. 05),and then decreased significantly at 9 months after radiotherapy( P <0. 05); Sex functional dimensions,lymphedema dimension,peripheral nerve dimension,menopause dimension and fear dimension at each time points showed no significant difference( P > 0. 05); the sex dimensions in quality of life was improved at 9 months after radiotherapy( P < 0. 05). Conclusion QOL of cervical cancer patients with intermediate-risk factors with small-volume-target IMRT was decreased mainly in body dimension and symptom dimensions,and could be improved 6 months after the radiation therapy.
出处
《中华全科医学》
2017年第12期2045-2047,2144,共4页
Chinese Journal of General Practice
基金
2017年浙江省医药卫生科技计划项目(2017KY485)
关键词
宫颈癌
生存质量
中危因素
放射治疗
Cervical cancer
Quality of life
Intermediate-risk factors
Radiotherapy
