探讨同期放化疗对儿童青少年鼻咽癌患者生活质量的影响

目的 探讨同期放化疗对儿童青少年鼻咽癌患者生活质量(QOL)的影响及其不良反应。 方法 通过儿童生存质量普适性核心量表(Peds QL^TM4.0)和儿童生存质量癌症模块量表(Peds QL^TM3.0)对放化疗治疗的21例儿童青少年鼻咽癌患者进行调查与评估,并对患儿治疗期间的不良反应进行统计分析。 结果 一定周期的放化疗后,患儿的QOL较治疗前均呈下降趋势,Peds QL^TM4.0中,患儿的生理功能、情感功能、学校功能3个维度总分均下降(P<0.01),以学校功能影响较为显著,而Peds QL^TM3.0中,疼痛、恶心、操作焦虑、认知、交流5 个方面总分均下降,差异均有统计学意义(P<0.01)。放化疗的不良反应主要集中在皮肤损害、口腔黏膜损害、口干、恶心呕吐、白细胞下降等方面。 结论 儿童自我报告的生活质量应受到更多关注,儿童青少年鼻咽癌患者因放化疗而导致的不良反应,可显著影响其生活质量,对不良反应可采取相应措施积极预防。

Effects of concurrent chemotherapy and radiotherapy on the quality of life in children and adolescents with nasopharyngeal carcinoma

Objective To investigate the effects of concurrent chemotherapy and radiotherapy on the quality of life and adverse reactions in children and adolescents with nasopharyngeal carcinoma.Methods A total of 21 children and adolescents with nasopharyngeal carcinoma treated with concurrent chemotherapy and radiotherapy were surveyed with Pediatric Quality of Life Inventory 4.0 Generic Core Scales (Peds QLTM4.0) and Pediatric Quality of Life Inventory 3.0 Cancer Module (Peds QLTM3.0) questionnaires.The quality of life scores were calculated and toxic reactions were observed.Results After proper periods of concurrent chemoradiotherapy,patients' quality of life dropped.In Peds QLTM4.0,the scores of physical,emotional and school functioning dimensions were markedly reduced (P ＜ 0.01),especially the school functioning item.In Peds QLTM3.0,such dimensions as pain,nausea,procedure anxiety,cognitive and communication were markedly lowered (P ＜ 0.01).Adverse reactions mainly included skin damage,mouth mucitis,dry mouth,nausea,vomiting and neutropenia.Conclusion More attention should be attached to children's self-reported quality of life.The adverse reactions of concurrent chemoradiotherapy can significantly affect the quality of life.Targeted interventions are supposed to be taken to improve patients' quality of life.