扶正化瘀消癌汤和多西紫杉醇对老年宫颈癌复发患者生活质量及预后的影响

目的探讨扶正化瘀消癌汤联合多西紫杉醇对老年宫颈癌复发患者生活质量及预后的影响。方法选取2018年6月至2019年12月间沈阳红十字会医院收治的128例老年宫颈癌复发患者,采用随机数字表法分为观察组62例和对照组66例,对照组患者采用多西紫杉醇化疗治疗,观察组患者在此基础上联合扶正化瘀消癌汤治疗,比较两组患者治疗前后的生活质量、治疗安全性和生存率。结果治疗后,两组患者各项功能量表评分均升高,且观察组患者均高于对照组,差异均有统计学意义(均P<0.05)。治疗期间,两组患者肝肾功能损害发生率比较,差异无统计学意义(P>0.05),且两组均未出现严重肝肾功能损害病例。观察组患者胃肠道反应和骨髓抑制发生率均低于对照组,但差异无统计学意义(P>0.05)。观察组患者不良反应发生率为33.9%,低于对照组的56.1%,两组比较,差异有统计学意义(P<0.05)。观察组患者1年生存率和2年生存率均高于对照组,两组比较,差异有统计学意义(P<0.05)。结论扶正化瘀消癌汤联合多西紫杉醇能有效提高老年宫颈癌复发患者的生活质量,延长生存时间,提高生存率,缓解化疗不良反应,值得临床推广。     

参芪扶正注射液对恶性肿瘤患者生活质量影响

[目的]探讨参芪扶正注射液对恶性肿瘤患者生活质量的影响.[方法]将60例恶性肿瘤患者分为治疗组和对照组,治疗组采用参芪扶正注射液联合化疗,而对照组仅用化疗.[结果]治疗组症状显著改善率为76.6%、体重增加率为66.7%、体力状况变化(KPS)提高率为66.7%;而对照组症状显著改善率为40%、体重增加率为23.3%、体力状况变化(KPS)提高率为20%.治疗组治疗前后白细胞以及T4/T8比值差异无显著性;对照组治疗前后白细胞及T4/T8差异有显著性.[结论]参芪扶正注射液可显著改善患者临床症状,明显提高肿瘤患者生活质量.     

甲孕酮对晚期肿瘤患者生活质量的影响

甲孕酮对晚期肿瘤患者生活质量的影响陆震宇曹涤华执笔（上海市晚期肿瘤协作组；上海市北站医院肿瘤科等，上海２０００８５）甲孕酮（ＭＰＡ）是黄体酮的衍生物，近几年来在国内已广泛用于临床，成为重要的肿瘤内分泌治疗药物。上海市晚期肿瘤协作组组织１０家临床单位...     

针刺对肿瘤患者生活质量影响的临床研究

目的 观察针刺对肿瘤患者生活质量的临床研究.方法将62例肿瘤患者随机分为治疗组和对照组.治疗组用针刺穴位配合全身化疗进行临床治疗,与单纯化疗组进行对照.两组化疗方法相同.结果治疗组近期有效率达56.25%,与对照组36.67%相比,有显著差异(P＜0.05).同时,治疗组患者的生活质量指标:Karnofsky评分、体重变化情况、症状缓解情况等,均明显优于对照组.结论针刺对改善肿瘤患者生活质量有明显疗效.     

解毒消瘕饮和扶正抑瘤方对肝癌移植瘤小鼠外周血中VEGF的影响

目的：探讨解毒消瘕饮和扶正抑瘤方对小鼠肝癌移植瘤血管生成的抑制作用。方法：40只ICR小鼠随机分为A组、B组、C组及D组,造模给药后20d采瘤、取血,计算抑瘤率及测定外周血中VEGF表达。结果：B组瘤重明显小于A组（P〈0．05）,抑瘤率为19％;A组和B组VEGF表达量均高于C、D两组,四组比较差异具有显著性（P〈0．01）：进一步两两比较表明,B组与A、C、D组之间差异显著（P〈0．01）;A与C、D组之间差异显著（P〈0．01）。结论：解毒消瘢饮和扶正抑瘤方影响小鼠肝癌移植瘤的VEGF表达。     

解毒消癥饮和扶正抑瘤方对肝癌移植瘤小鼠外周血中VEGF的影响

目的: 探讨解毒消癥饮和扶正抑瘤方对小鼠肝癌移植瘤血管生成的抑制作用.方法: 40只ICR小鼠随机分为A组、B组、c组及D组,造模给药后20d采瘤、取血,计算抑瘤率及测定外周血中VEGF表达.结果: B组瘤重明显小于A组(P<0.05),抑瘤率为19%;A组和B组VEGF表达量均高于C、D两组,四组比较差异具有显著性(P<0.01):进一步两两比较表明,B组与A、C、D组之间差异显著(P<0.01);A与C、D组之间差异显著(P<0.01).结论: 解毒消癥饮和扶正抑瘤方影响小鼠肝癌移植瘤的VEGF表达.     

高压氧联合放疗或化疗对肿瘤患者生活质量影响的临床研究

目的探讨高压氧联合放疗或化疗对肿瘤患者生活质量的影响。方法①评价高压氧联合放疗对肿瘤患者生活质量的影响:选取我院肿瘤患者116例,采用随机数字表法随机分为放疗联合HBO组和单用化疗组各58例,放疗联合HBO组从放疗开始次日起加用HBO治疗,HBO采用多人氧舱,在舱内停留120 min,压力为0.25 MPa(2.5ATA),戴面罩吸入纯氧60 min(30 min各2次,中间休息10 min吸入舱内空气),10次为1个疗程,共3个疗程,每疗程间隔3～5 d。②评价高压氧联合化疗对肿瘤患者生活质量的影响:选取我院肿瘤患者120例,采用随机数字表法随机分为化疗联合HBO组和单用化疗组各60例。化疗至少2个疗程,化疗联合HBO组从化疗开始次日起加用HBO治疗,HBO采用多人氧舱,在舱内停留120 min,压力为0.25 MPa(2.5ATA),戴面罩吸入纯氧60 min(30 min各2次,中间休息10 min吸入舱内空气),10次为1个疗程,共3个疗程,每疗程间隔3～5 d。结果①两组患者的放疗疗效无明显影响,放疗联合HBO组患者的全身功能状态显著提高,食欲、精神状态、睡眠、疲乏和体重等生活质量均明显改善,且差异有显著性。②两组患者的化疗疗效无明显影响,化疗联合HBO组患者的全身功能状态明显提高,患者生活质量明显改善,且两组差异有显著性。结论高压氧联合放疗或化疗对肿瘤患者的生活质量有明显的改善作用。     

平消胶囊对肿瘤放疗患者生活质量和血清TSGF值的影响

目的:观察平消胶囊对肿瘤放疗患者生活质量和血清TSGF(恶性肿瘤特异性生长因子)的影响并探讨其作用机理。方法:选择2002年3月至2005年10月间收治的200例肿瘤放疗患者,随机分为A组(单纯放疗组)和B组(放疗 平消胶囊组)。应用Karnofsky评分法和放射免疫法观察两组肿瘤患者放疗前后生活质量和TSGF的变化。结果:放疗前两组Karnofsky评分和TSGF值相比无明显差异。放疗后:A组Karnofsky评分明显低于放疗前,B组Karnofsky评分与放疗前相比无明显差异;A、B组TSGF值明显低于放疗前;A组Karnofsky评分明显低于B组,A组TSGF值明显高于B组。结论:平消胶囊能显著减轻放疗过程中出现的急性毒性反应,改善患者的生活质量,并具有放疗增效作用。     

扶正液对于肺癌患者的肿瘤标志物CYFRA及免疫功能的影响

目的：探讨扶正液对于肺癌患者的免疫生物调控作用。方法：采用临床对比观察方法，对106例肺癌患者进行了临床症状、血清CYFRA21-1及免疫功能的动态观察。结果：扶正液可以通过调节肿瘤患者的细胞免疫，达到治疗肿瘤、调节机体免疫功能作用，从而改善患者的虚劳证候群，提高肿瘤患者的生存质量，延长生存期。结论：扶正液具有调节肿瘤患者免疫功能的作用。     

化疗对老年人化疗不敏感性实体瘤患者生活质量的影响

目的评价化疗是否有益于老年人化疗不敏感性实体瘤患者。方法65例患者随机分为治疗组及对照组，治疗组根据不同的病理类型，不同部位给予常用标准化疗方案进行全身化疗，每4周为一个周期，共3—6个周期；对照组除不予化疗外，其它支持对症冶疗同治疗组。各组分别在用药前、用药中、用药后进行生活质量问卷测试；采用WHO使用的实体瘤近期疗效评定标准进行疗效评定；长期随访计算中位生存期。结果两种治疗均无明显客观疗效；治疗组具有明显的消化道副反应、骨髓抑制及治疗相关性感染，差异具有显著性；治疗中与治疗前比较，EORTC QLQ—C30(V3．0)15项领域中5项功能指标、整体生活质量、乏力和经济困难指标的差别亦具有显著性，治疗组明显低于对照组；两组中位生存期分别为13．8和14．1个月。结论化疗不能提高老年人化疗不敏感性实体瘤患者的近期疗效，不能延长该类患者的生存期，反而降低其生活质量，增加治疗毒副反应。     

扶正抑瘤方联合乌苯美司胶囊治疗晚期结直肠癌的临床观察

目的：观察扶正抑瘤方联合乌苯美司胶囊治疗晚期结直肠癌的临床疗效及对患者免疫功能、生活质量的影响。方法将明确病理诊断的晚期结直肠癌患者60例分为两组,对照组30例仅采用mFOLFOX6方案进行化疗,治疗组30例在mFOLFOX6化疗的基础上给予扶正抑瘤方联合乌苯美司胶囊治疗,连续治疗8周,观察治疗前后患者临床疗效、免疫功能、KPS评分、体质量变化及化疗不良反应。结果治疗后,治疗组有效率为60.00%,对照组为33.33%,差异具有统计学意义（P﹤0.05）。对照组治疗后CD3+、CD4+均较治疗前下降,差异有统计学意义（P﹤0.05）;CD8+虽较前略有升高,但差异无统计学意义（P﹥0.05）。治疗组治疗后免疫指标CD3+、CD8+较治疗前升高,差异有统计学意义（P﹤0.05）;而CD4+治疗前后比较,差异无统计学意义（P﹥0.05）。治疗后两组KPS评分改善率比较,差异具有统计学意义（P﹤0.05）;体质量改善率比较,差异无统计学意义（P﹥0.05）;两组在胃肠道反应及血液毒性方面比较差异无统计学意义（P﹥0.05）。结论扶正抑瘤方联合乌苯美司胶囊治疗可提高晚期结肠癌患者临床疗效及免疫功能,并改善患者生活质量。     

肿瘤患者化疗期间的生活质量调查与分析

目的：探讨肺癌、乳腺癌及消化道恶性肿瘤患者化疗期间的生活质量状况及其影响因素。方法：选用生活质量问卷（QLQ—c30，QLQ—LC13，QLQ—BR21）对267名化疗患者进行调查，统计学方法采用t检验及多因素相关分析。结果：肺癌和消化道肿瘤患者生活质量在化疗前、化疗早期及后期组间未见统计学差异；乳腺癌患者化疗后较化疗前在疲乏（P=0．010）、失眠（P=0．007）、恶心呕吐（P=0．0001）及厌食（P=0．016）方面呈加重趋势，认知功能也在一定程度上受到损害（P=0．020）。生活质量影响因素之间的交互作用明显，经济因素明显影响肿瘤患者的生活质量。结论：乳腺癌患者化疗期间疲乏、失眠及消化道症状呈加重趋势，经济因素对癌症患者生活质量的影响不容忽视。     

缩金胶囊对三阴性乳腺癌治疗后患者生存质量影响的观察

为了观察中药缩金胶囊对三阴性乳腺癌治疗后患者生存质量的影响,运用缩金胶囊治疗放化疗后的三阴性乳腺癌患者30例,并与放化疗后的30例后续无治疗和给予胸腺五肽增强免疫力治疗的30例患者的症状相比较.同时记录症状评分、总体健康质量及生存质量评分.中药治疗组各症状评分和总体生存质量评分均高于空白对照组,两组比较差异有统计学意义(P＜0.05),与胸腺五肽组比较差异无统计学意义,P＞0.05.初步研究结果提示,中药缩金胶囊可有效地改善经手术及放化疗后的三阴性乳腺癌患者的症状,提高患者生存质量.     

Impact of newly diagnosed breast cancer on quality of life among Chinese women

Background Being diagnosed with breast cancer is a very stressful event that has a profound impact on multiple aspects of a patient’s daily life. Little is known about the quality of life (QOL) of Chinese women with newly diagnosed breast cancer. Methods The authors evaluated QOL in 2,236 Chinese women with newly diagnosed breast cancer who were recruited into the Shanghai Breast Cancer Survival Study between April 1, 2002 and March 31, 2004. Patients’ QOL was assessed after cancer diagnosis (median time 6.4 months; range 3.6–11.1 months) by using the General Quality of Life Inventory. Multiple linear regression models were used to analyze the associations of QOL outcomes with medical and socio-demographic factors. Results Patients showed significantly worse overall QOL and perceived health status than healthy women, reflected mainly by lower QOL scores in physical and psychological well-being domains. Completion of radiotherapy, ever use of tamoxifen, being underweight, having an increased number of chronic diseases, and low household income were significantly associated with lower overall QOL scores after adjusting for other factors. Age at diagnosis was inversely associated with physical well-being, positively associated with material well-being, and had minimal influence on overall QOL. Stage of disease, chemotherapy, and education were only associated with certain domains, but had no influence on overall QOL. Estrogen receptor/progesterone receptor status and type of surgery or immunotherapy did not appear to be associated with QOL. Conclusions The findings of the present study provide important information on QOL and their correlates among Chinese women with newly diagnosed breast cancer and are helpful in developing treatment strategies accordingly.     

Clinical relevance of single item quality of life indicators in cancer clinical trials

We investigated the hypothesis that global single-item quality-of-life indicators are less precise for specific treatment effects (discriminant validity) than multi-item scales but similarly efficient for overall treatment comparisons and changes over time (responsiveness) because they reflect the summation of the individual meaning and importance of various factors. Linear analogue self-assessment (LASA) indicators for physical well-being, mood and coping were compared with the Hospital Anxiety and Depression Scale (HAD), the Mood Adjective Check List (MACL) and the emotional behaviour and social interaction scales of the Sickness Impact Profile (SIP) in 84 patients with early breast cancer receiving adjuvant therapy. Discriminant validity was investigated by multitrait-multimethod correlation, responsiveness by standardized response mean (SRM). Discriminant validity of the indicators was present at baseline but less under treatment. Responsiveness was demonstrated by the expected pattern among treatments (P = 0.008). In patients without chemotherapy, the SRMs indicated moderate (0.5-0.8) to large (>0.8) improvements in physical well-being (0.70), coping (0.92), HAD anxiety (0.89) and depression (1.19), and MACL mental well-being (0.68). In patients with chemotherapy for the first 3 months, small but clinically significant improvements (>).2) included mood (0.38), coping (0.41), HAD axiety (0.31) and MACL mental well-being (0.35). Patients with 6 months chemotherapy showed no changes. The indicators also reflected mood disorders (HAD) and marked psychosocial dysfunction (SIP) at baseline and under treatment according to pre-defined cut-off levels. Global indicators were confirmed to be efficient for evaluating treatments overall and changes over time. The lower reliability of single as opposed to multi-item scales affects primarily their discriminant validity. This is less decisive in large sample sizes.     

Practice of traditional Chinese medicine for psycho-behavioral intervention improves quality of life in cancer patients: A systematic review and meta-analysis

Background

Cancer patients suffer from diverse symptoms, including depression, anxiety, pain, and fatigue and lower quality of life (QoL) during disease progression. This study aimed to evaluate the benefits of Traditional Chinese Medicine psycho-behavioral interventions (TCM PBIs) on improving QoL by meta-analysis.

Methods

Electronic literature databases (PubMed, CNKI, VIP, and Wanfang) were searched for randomized, controlled trials conducted in China. The primary intervention was TCM PBIs. The main outcome was health-related QoL (HR QoL) post-treatment. We applied standard meta analytic techniques to analyze data from papers that reached acceptable criteria.

Results

The six TCM PBIs analyzed were acupuncture, Chinese massage, Traditional Chinese Medicine five elements musical intervention (TCM FEMI), Traditional Chinese Medicine dietary supplement (TCM DS), Qigong and Tai Chi. Although both TCM PBIs and non-TCM PBIs reduced functional impairments in cancer patients and led to pain relief, depression remission, reduced time to flatulence following surgery and sleep improvement, TCM PBIs showed more beneficial effects as assessed by reducing both fatigue and gastrointestinal distress. In particular, acupuncture relieved fatigue, reduced diarrhea and decreased time to flatulence after surgery in cancer patients, while therapeutic Chinese massage reduced time to flatulence and time to peristaltic sound.

Conclusion

These findings demonstrate the efficacy of TCM PBIs in improving QoL in cancer patients and establish that TCM PBIs represent beneficial adjunctive therapies for cancer patients.     

生存质量在食管癌中的研究现状

随着临床肿瘤学以及人文医学的发展,肿瘤医学模式由重视癌症患者的生命数量转向提高患者的生命质量。随着对生存质量的深入研究,其在癌症的治疗方案选择、疗效评价、预后评估等方面具有重要意义。食管癌是消化道肿瘤中最常见的恶性肿瘤,我国食管癌的发病率和死亡率居世界首位,提高食管癌患者的生存质量是食管癌治疗的重要目标之一。近年来关于食管癌患者的生存质量的研究蓬勃发展,本文就生存质量在食管癌中的研究现状作一综述。     

Assessment and data analysis of health-related quality of life in clinical trials for gastric cancer treatments

This review contains a practical guide as well as a number of design and analytical methods for conducting health-related quality of life assessments in clinical trials for gastric cancer treatment. Although we address issues specific to the assessment of gastric cancer, many are applicable to clinical trials for different cancer types.     

A mixed-methods exploration of the quality of life of Chinese breast cancer survivors

ABSTRACT

Quality of life (QOL) in cancer survivorship is a multidimensional and subjective concept, which represents the personal sense of the physical, psychological, social, and spiritual consequences of cancer diagnosis and its treatment. This mixed method study aimed to explore the QOL of Chinese breast cancer survivors. Participants were recruited from a cancer self-help organization in the central area of China. QOL was assessed using the QOL–Cancer Survivor Scale and subsequently elicited by in-depth interviews. Results showed that participants had good overall QOL but with unfavorable aspects in psychological and social well-being. Interview data revealed that participants seldom attended spiritual activities. Instead, they actively reconnected with their “self” to create a positive meaning from their cancer experience. Understanding how Chinese breast cancer survivors perceive QOL is important for health professionals to address survivorship in this population.