甲孕酮对乳腺癌患者化疗期间生活质量的影响

目的评价甲孕酮对乳腺癌患者化疗期间生活质量的影响.方法对62例住院化疗的乳腺癌患者随机分为甲孕酮(MPA)组和对照组(服淀粉片),根据KPS评分进行双盲回顾性分析.结果MPA组综合指数KPS评分(86.7%)较对照组(33.3%)明显提高(p＜0.01);伴有骨转移的晚期患者癌痛缓解率,治疗组为83.3%,对照组为50%.结论甲孕酮可显著改善乳腺癌患者化疗期间的生活质量.     

甲孕酮对改善癌症患者化疗期间生活质量的临床观察

目的为了改善癌症患者化疗期间生活质量。方法1991年12月至1994年12月期间,对30例癌症患者进行了甲孕酮（MPA）治疗的临床观察,设对照组30例。结果口服MPA的癌症患者普遍反映精神、食欲好转,体重有所增加,生活质量综合指数NPS评分较治疗前明显提高（80％,对照组为36．7％,P＜0．01）,伴有痛疼的患者（计18例）的癌痛改善率治疗组为83．3％,显著高于对照组的41％。结论甲孕酮（MPA）可以广泛用于各种肿瘤的化疗期间,来改善患者生活质量。     

甲孕酮对改善癌症患者化疗期间生活质量的临床观察

目的 为了改善癌症患者化疗期间生活质量,方法 １９９１年１２月至１９９４年１２月期间,对３０例癌症患者进行了甲孕酮（ＭＰＡ）治疗的临床观察,设对照组３０例,结果 口服ＭＰＡ的癌症患者普遍反映精神,食欲好转,体重有所增加,生活质量综合指数ＫＰＳ评分较好治疗明显提高（８０％对照组为３６．７％,Ｐ〈０．０１）,伴有痛疼的患者（计１８例）的癌痛改善治疗组８３．３％显著高于对照组的４１％,结论 甲孕酮（ＭＰ     

醋酸甲孕酮改善癌症患者化疗期间生活质量的临床研究

目的 观察患者口服250mg醋酸甲孕酮改善化疗期间生活质量。方法 108例各种肿瘤患者,随机分成两组,治疗组化疗期间采用甲孕酮250mg,每日3次口服,8周为一观察周期,对照组采用单独化疗。结果 治疗组中,转移灶控制率（11.1%),疼痛缓解率（29.6%),食欲增加（38.9%),体重增加（46.3%),骨髓保护较理想,与单独化疗组相比较,取得了满意的疗效。结论 250mg甲孕酮能有效改善癌症患者化疗期间的食欲,增加体重,缓解疼痛。     

甲孕酮合并化疗改善晚期胃癌病人的生活质量

目的：通过甲孕酮与化疗并用的方法，探讨晚期胃癌化疗中改善生活质量的有效措施。方法：采用甲孕酮与EDF化疗方案联合应用，并以单纯EDF方案化疗作为对照组进行临床研究，通过观察分析治疗组和对照组之间的生活质量差异评价治疗效果。结果：化疗甲孕酮组的化疗后的进食量增加77.1％（37/48），无变化占22.9％（11/48），无一例食欲减退；而单纯化疗组化疗后食欲减退为58.3％（28/48），无变化41.7％（20/48），无食欲增加病例。化疗加甲孕酮组化疗后体重增加、无变化、减少分别为35.4％（17/48），54.2％（26/48）和10.4％（5/48）；单纯化疗组则分别为4.2％（9.2/48）、35.4％（17/48）和60.4％（29/48）。上述结果均有显著性差异。结论：甲孕酮与化疗并用，能够显著改善晚期胃癌病人化疗后的生活质量，对树立病人的信心，提高病人对化疗的承受能力和提高化疗效果具有重要应用价值。     

甲孕酮合并化疗改善晚期胃癌病人的生活质量

目的　通过甲孕酮与化疗并用的方法 ,探讨晚期胃癌化疗中改善生活质量的有效措施。方法　采用甲孕酮与EDF化疗方案联合应用 ,并以单纯EDF方案化疗作为对照组进行临床研究 ,通过观察分析治疗组和对照组之间的生活质量差异评价治疗效果。结果　化疗甲孕酮组的化疗后的进食量增加占 77 1% ( 3 7/ 4 8) ,无变化占 2 2 9% ( 11/ 4 8) ,无一例食欲减退 ;而单纯化疗组化疗后食欲减退为 5 8 3 % ( 2 8/ 4 8) ,无变化 41 7% ( 2 0 / 4 8) ,无食欲增加病例。化疗加甲孕酮组化疗后体重增加、无变化、减少分别为 3 5 4%( 17/ 4 8) ,5 4 2 % ( 2 6/ 4 8)和 10 4% ( 5 / 4 8) ;单纯化疗组则分别为 4 2 % 92 / 4 8)、3 5 4% ( 17/ 4 8)和 60 4% ( 2 9/ 4 8)。上述结果均有显著性差异。结论　甲孕酮与化疗并用 ,能够显著改善晚期胃癌病人化疗后的生活质量 ,对树立病人的信心 ,提高病人对化疗的承受能力和提高化疗效果具有重要应用价值     

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...     

甲孕酮改善晚期肿瘤病人化疗期生活质量

目的　观察病人服用甲孕酮后改善化疗引起的厌食、体重下降、Kps评分下降、骨髓抑制及胃肠道反应的作用。方法　 117例接受化疗的晚期肿瘤患者 ,采用单盲随机分成化疗 +甲孕酮组共 5 8例 ,单用化疗组 5 9例作为对照。结果　在化疗 +甲孕酮治疗的 15 6个周期中有 5 5 .1%食量增加 ;42 .3 %体重增加 ;平均每周期体重增加 1.46± 0 .82kg ;血浆白蛋白升高 2 .1± 3 .3 0 g/L ;2 6.9%Kps评分改善。按WHO抗癌药物急性毒性分级标准 ,3 1.4%出现Ⅱ度以上的白细胞下降、血红蛋白下降 2 3 .7%、胃肠道反应 17.9% ,平均恢复时间分别为 5 .8± 5 .5天、5 .9± 3 .8天及 1.8± 1.4天。上述各项指标与对照组比较均有显著性差异。结论　甲孕酮如能正确合理地应用于晚期肿瘤病人的辅助治疗 ,可以全面改善化疗期癌症患者的生活质量。     

甲孕酮合并化疗改善晚期肺癌患者的生活质量

目的 :观察患者服用甲孕酮后改善化疗所致的厌食、体重下降、ECOG下降、骨髓抑制及胃肠道反应的作用 ,同时观察甲孕酮对晚期癌症的止痛作用及促进蛋白同化作用。方法 :130例接受化疗的晚期肺癌患者 ,采用单盲随机分成单用化疗组及化疗 甲孕酮组。结果 :在化疗 甲孕酮组治疗的160个周期中有43 1 %食量增加 ;45%体重增长 ;平均每周期体重增加0 74±1 56kg;血浆白蛋白升高1 2±2 9g/L ;88 1 %疼痛减轻及28 1 ?OG改善。化疗的毒副作用按WHO抗癌药物急性毒性分级标准 ,出现Ⅱ度以上的白细胞下降33 8%、血红蛋白下降15 6 %及胃肠道反应18 1 % ,平均恢复时间分别为6 4±4 6天、5 3±4 1天及1 89±1 2天。以上各项指标与单用化疗组相比均有显著性差异。结论 :甲孕酮如能正确合理地用于晚期癌症的治疗 ,可以全面改善化疗期癌症患者的生活质量     

甲孕酮对多发性骨髓瘤化疗患者生活质量影响34例分析

运用化疗加甲孕酮治疗34例多发性骨髓瘤，比较甲孕酮对多发性骨髓瘤患者生活质量及化疗耐受性的影响。     

醋酸甲地孕酮联合化疗改善晚期肺癌患者的生活质量

目的 观察醋酸甲地孕酮合并化疗对晚期肺癌患者的生活质量影响.方法 甲地孕酮联合化疗作为治疗组,单纯化疗作为对照组进行临床研究,观察两组治疗前后进食、体重、Karnofsky评分变化.结果 治疗组中食欲改善占93.8%,体重增加率72.9%,Karnofsky分值提高66.7%,明显优于对照组(P＜0.01).结论 醋酸甲地孕酮联合化疗能显著改善晚期肺癌患者生活质量,且毒副反应较轻.     

乳腺癌患者化疗后抗抑郁治疗对患者生活质量及其免疫功能的影响

目的观察乳腺癌患者化疗后抗抑郁治疗对患者生活质量及其免疫功能的影响。方法选择80例乳腺癌化疗后伴抑郁的患者作为研究对象,随机分为试验组和对照组,每组40例。对照组术后不给予抗抑郁药物治疗,试验组给予帕罗西汀。比较2组患者汉密尔顿抑郁量表(HAMD)评分情况,比较2组患者生活质量评分情况,检测2组患者免疫功能。结果2组患者HAMD评分治疗前比较,无明显差异(P>0.05)。试验组治疗后HAMD评分较治疗前降低,差异有统计学意义(P<0.05)。治疗后,试验组HAMD评分较对照组降低,差异有统计学意义(P<0.05)。生活质量调查表结果表明,试验组治疗后躯体功能、角色功能、情绪功能评分、疲乏、疼痛、失眠、食欲减退方面评分大于对照组,差异有统计学差异(P<0.05);试验组整体生活质量评分(63.22±1.78)高于对照组(43.22±1.73),差异有统计学意义(P<0.05)。治疗后,试验组患者CD_3^+T细胞、CD_4^+T细胞、IgG、IgA、IgM均明显高于对照组,差异有统计学意义(P<0.05);治疗后,2组患者CD_8^+T细胞水平差异无统计学意义(P>0.05)。结论乳腺癌化疗后伴抑郁的患者采取帕罗西汀抗抑郁治疗的疗效显著,同时还可改善患者生活质量和免疫功能,值得临床推广。     

Effect of a Pedometer-based Exercise Program on Cancer Related Fatigue and Quality of Life amongst Patients with Breast Cancer Receiving Chemotherapy

Background: Breast cancer is the most common cancer amongst Indian women. Cancer treatments leads to various side effects out of which Cancer-Related fatigue (CRF) is one of the most under-addressed side-effects. It is experienced the most in patients receiving chemotherapy. Exercise has been proven to be a beneficial intervention to manage CRF but the benefits of pedometer-based exercise programs is under-studied in patients with breast cancer. Hence, we set out to investigate the effects of a pedometer-based exercise program for patients with breast receiving chemotherapy. Methods: The current study was a non-randomized controlled trial with 22 patients each in exercise and control group. The exercise group received a pedometer-based walking program, whereas the control group received standard physical activity advice. Fatigue, quality of life, functional capacity and body composition were assessed at baseline, 3rd week and 7th week. Results: At the end of 7 weeks intervention, functional capacity, quality of life and skeletal mass were found to have improved with statistical significance, while the fatigue and changes in total fat did improve but were not statistically significant. Conclusion: A 7-week pedometer-based exercise program improved functional capacity, quality of life and percentage of skeletal mass and also shows to have prevented deterioration in fatigue levels in patients with breast cancer receiving chemotherapy.     

The Impact of Chemotherapy on the Quality of Life of Breast Cancer Patients

One hundred and thirty-seven breast cancer patients, 102 receiving adjuvant chemotherapy and 35 receiving palliative chemotherapy for metastatic disease underwent a 37-item quality-of-life questionnaire to evaluate the impact of disease and treatment on physical, psychological and social well being. Patient groups were designated as follows — Adj CT: patients undergoing the questionnaire during their adjuvant chemotherapy program; Post Adj CT: patients evaluated 3 to 8 months after termination of adjuvant chemotherapy; Mts CT: patients assessed during palliative chemotherapy for metastatic disease, and Post Mts CT: patients 3 to 8 months after termination of palliative chemotherapy. Physical and social activities were reported as unaltered or normal by 64 to 70% and 52 to 67% of patients, respectively. Psychological status was judged normal by 39 to 45% of patients. No significant differences were observed between the patient groups. In 83 to 90% of cases the patient normally took care of herself. In 62 to 87% of cases time dedicated to recreational activities was reported as unaltered. The majority of patients (84%) judged that their relationship with partner and/or family were good. Severe anxiety was reported in 19 to 28% of patients and severe depression was infrequent (3.9%). Information regarding disease and treatment given by health professionals was considered satisfactory by 80 to 100% of patients. This pilot experience indicates that the majority of breast cancer patients respond normally to the stresses of both adjuvant and palliative chemotherapy; quality of life does not appear to improve 3-8 months after termination of chemotherapy; family support is good in the majority of cases and that a subset of patients with severe anxiety who could benefit from pharmacological and/or psychological intervention can be identified.     

Energy Balance in Early Breast Cancer Patients Receiving Adjuvant Chemotherapy

Weight gain is a common problem amongst women receiving adjuvant chemotherapy for early breast cancer. We undertook a study to determine the causes of this weight gain. Prospective measurements of body mass and composition (skinfolds, bioelectrical impedance, total body potassium), energy balance (resting energy expenditure dietary intake, and physical activity), were determined in 17 women during and in the 6 months after commencing adjuvant chemotherapy. Women gained significant amounts of weight (5.0 +/- 3.8; p < 0.01) and body fat (7.1 kg +/- 4.5; p < 0.01) over the year. Waist circumference (5.1 +/- 4.5 cm; p < 0.01) and abdominal skinfold (16.2 +/- 10 mm; p < 0.01) were also increased but there was a decline in fat free mass (FFM); 1.7 +/- 2.5 kg. Women due to receive adjuvant chemotherapy had a greater resting energy expenditure (REE) compared with healthy subjects (n = 21); 100.5 +/- 8.0% Harris Benedict compared to 94.5 +/- 8.4% Harris Benedict (p = 0.05). REE declined by 3% during adjuvant chemotherapy (p < 0.05), and remained depressed until at least 3 months posttreatment. There were no significant changes in dietary intake or physical activity over the year. Failure of women to reduce their energy intake to compensate for the decreased energy requirement may account for some of the weight gain. Treatment of adjuvant chemotherapy causes gain of body fat because of reduced energy expenditure, and the failure of women to reduce their energy intake to compensate for the decline in energy requirement during and in the 6 months posttreatment. Since weight gain impacts on survival, patients should be counselled to reduce energy intake and exercise during and after adjuvant treatment.     

肿瘤化疗与生命质量研究

癌症是严重威胁人类健康的疾病之一,近年来国内外对癌症病人生命质量的研究日趋重视.文章从生命质量的概念及定义,生命质量在肿瘤化疗中的应用,肿瘤化疗生命质量量表的制作及使用三方面对国内外研究现状作一综述.     

Changes in Hematologic Parameters during Treatment with Medroxyprogesterone Acetate for Breast Cancer

To elucidate the etiology of the thrombogenic effects of high-dose medroxyprogesterone acetate (MPA) in the treatment of breast cancer, hematologic parameters were sequentially assessed in 12 patients receiving MPA 800 mg p.o. daily for 6 months as adjuvant hormone therapy after mastectomy. The results were as follows. (1) Coagulation system: levels of factor VII and fibrinogen decreased significantly, whereas factors II and IX increased significantly, with a shortened activated partial thromboplastin time. (2) Fibrinolytic system: plasminogen and α₂-lasmin inhibitor-plasmin complex increased, whereas fibrinogen degradation products remained low. (3) Anticoagulation system: antithrombin III increased significantly. (4) These changes were most marked after 2 or 4 weeks of MPA treatment, and returned to the pretreatment level one month after discontinuation of treatment. (5) No patients in this study developed thromboembolic disease during or after MPA administration. These results indicate that MPA may induce a hypercoagulable state, but this state does not directly lead to the development of thrombosis.