鼻咽癌放疗后无进展生存者的生存质量分析

目的探讨鼻咽癌放疗后无进展生存者的生存质量与相关影响因素及调强放疗技术在改善鼻咽癌放疗后患者生存质量的意义。方法参考FACT-H&N量表,制定"鼻咽癌患者生存质量调查问卷"。选择2004年1月—2008年12月新疆医科大学附属肿瘤医院放疗一科收治的有完整资料并经复查无进展的鼻咽癌患者96例,进行放疗后的生存质量问卷调查。应用多元线性回归分析生存质量影响因素,将患者分为调强放疗组(55例)及常规放疗组(41例),比较两组附加关注及特殊症状和治疗不良反应领域评分。结果鼻咽癌放疗后无进展生存者生存质量总得分为(66.6±9.7)分,得分最低为功能状况。附加关注及特殊症状和治疗不良反应主要体现在不能进食固体食物、吞咽困难、口干、声音嘶哑方面。性别、年龄、婚姻、文化程度、家庭月人均收入、临床分期及放疗技术为生存质量独立影响因素。调强放疗组及常规放疗组在进食情况、口干、声音嘶哑、交流情况、头晕头痛、耳鸣、听力下降、龋齿、颈部活动受限、张口困难、记忆力下降、味觉减退方面的差异有统计学意义(P<0.05)。结论性别、年龄、婚姻、文化程度、家庭月人均收入、临床分期、放疗技术在多个维度上影响鼻咽癌放疗后无进展生存者的生存质量。调强放疗技术在改善生存质量方面优于常规放疗技术。

Analysis of the quality of life in progressive-free survivals with nasopharyngeal carcinoma after radiotherapy

Objective To assess and discuss the status of post radiotherapy quality of life(QOL) in progressive-free survivals with nasopharyngeal carcinoma(NPC),and explore the significance of intensity modulated radiation therapy(IMRT) in improving QOL.Methods Ninty-six cases were designed in the questionnaire according to FACT-H&N and combining the related symptoms and side effects of NPC from January 2004 to December 2008,progressive-free survivals with NPC were surveyed for the evaluation of QOL in our hospital.The factors of the QOL were analyzed with multiple linear regression analysis.The patients were divided into IMRT group(n=55)and conventional radiotherapy(CRT) group(n=41).Rank sum test was used to compare the marks of QOL between the two groups.Results The QOL score was(66.6±9.7) in all patients.The score of "functional well-being domain" was the lowest among the score of QOL.The worse items of the related symptoms and side effects of NPC were can’t eat solid diet,dysphagia,xerostomia,hoarse voice.Multiple factors analysis suggested that sex,age,marriage,educational background,family income per capita,clinical stage and techniques of radiation were significant independent factors for QOL.In IMRT group and CRT group,the marks were significant difference in eating solid diet,xerostomia,hoarse voice,communication,dizziness and angina capitis,auditory harm and bombus,radiation caries,restriction of neck movement,difficult in opening mouth,degression of remembrance,gustatory hypoesthesia(P<0.05).Conclusion Sex,age,marriage,educational background,family income per capita,clinical stage and the irradiation techniques may affect QOL of NPC.IMRT could improve QOL of the patients with NPC.