恶性肿瘤患者自体造血干细胞移植后的生活质量

目的研究我国恶性肿瘤患者自体造血干细胞移植（ASCT）后的生活质量状况。方法应用欧洲癌症研究与治疗组织（EORTC）QLQ—C303．0生活质量问卷中文版对1991至2004年中国医学科学院肿瘤医院89例接受ASCT,并目前处于无病状态患者的生活质量进行分析。结果总体健康状况和功能评分均接近或超过80分,80％以上的患者总体健康状况和功能状况良好,出现中重度经济斟难、睡眠障碍、乏力、呼吸困难和腹泻的患者分别占72．5％（65例）、50．6％（45例）、42．7％（38例）、33．7％（30例）和32．5％（29例）;女性患者的呼吸困难症状评分显著高于男性（P=0．024）;总体健康状况、躯体功能、角色功能、社会功能评分随时间的延长明显升高（P=0．000,0．000,0．031,0．029）,乏力症状的评分则明显降低（P=0．020）;霍奇金淋巴瘤患者的恶心、呕吐和呼吸困难症状的评分显著高于非霍奇金淋巴瘤患者（P=0．002,0．006）;移植及评价时处于不同年龄阶段患者的评分比较,差异无统计学意义。结论患者在ASCT治疗后,多数具有较好的总体健康状况和功能状况,经济困难、乏力、呼吸困难、睡眠障碍和腹泻是影响他们生活质量的主要症状;女性患者的呼吸困难症状比较突出,患者的生活质茸会随着距离移植时间的延长逐步改善,霍奇金淋巴瘤患者较非霍奇金淋巴瘤患者有更多的症状主诉,没有发现移植和评价时年龄对患者的生活质量产生影响。

Quality of life of malignant patients after autologous stem cell transplantation

OBJECTIVE: To investigate the quality of life of Chinese malignant patients who treated with the high dose chemoradiotherapy combined with autologous stem cell transplantation (ASCT). METHODS: The data of 89 patients who answer the EORTC QLQ-C30 Chinese version 3.0 after finished ASCT and disease free were analyzed using SPSS 10.0. RESULTS: The score of global health status and functional assessment were near or over 80, more than 80 percent of patient had good or very good global health status or function, the patients who were experiencing moderate or severe financial dysfunction, fatigue, dyspnea, sleeping disturbance and diarrhea were in 72.5% (65/89), 50.6% (45/89), 42.7% (38/89), 33.7% (30/89) and 32.5% (29/89) respectively. The score of dyspnea in female patients was significant higher than male patients (P = 0.024). The score of global health status (P = 0.000), physical function (P = 0.000), role function (P = 0.031) and social function (P = 0.029) became higher significantly with time from transplantation and the score of fatigue became lower (P = 0.020). The Hodgkin's lymphoma patients had higher score significantly in nausea & vomiting (P = 0.002) and dyspnea (P = 0.006) than NHL. The age at transplantation and evaluation took none effect on the score. CONCLUSION: Most patient have good global health status and function after autologous stem cell transplantation, they are more suffered from financial dysfunction, fatigue, dyspnea, sleeping disturbance and diarrhea. Females have more dyspnea symptoms, the quality of life of patient will improve gradually with the time from transplantation, the Hodgkin's lymphoma patients have more symptoms than non-Hodgkin's lymphoma patients, we do not find any effect of age at transplantation and assessment on the quality of life.