老年妇科恶性肿瘤患者化疗相关性恶心呕吐与癌因性疲乏的关系及其影响因素

目的 分析老年妇科恶性肿瘤患者化疗相关性恶心呕吐(CINV)现状、影响因素及其与癌因性疲乏(CRF)的关系。方法 选取2021年3月至2022年9月运城市中心医院乳腺科收治的206例老年妇科恶性肿瘤化疗患者为研究对象。根据CINV发生情况,将患者分为CINV组92例及非CINV组114例。收集患者临床资料。采用多维疲劳量表(MFI-20)评估患者CRF情况,并分析其与CINV的关系。采用SPSS 22.0统计软件进行数据分析。根据数据类型,组间比较采用独立样本t检验、χ²检验或秩和检验。采用logistic回归模型分析影响老年妇科恶性肿瘤患者CINV的危险因素。结果 206例患者中,92例(44.66%)发生CINV。其中,52例(56.52%)为急性CINV,40例(43.48%)为延迟性CINV；34例(36.96%)为轻度CINV,35例(38.04%)为中度CINV,23例(25.00%)为重度CINV。多因素logistic回归分析显示,胃部疾病史(OR=2.438,95%CI 1.106~5.372)、晕车史(OR=3.051,95%CI 1.460~6.376)、含顺铂化疗方案(OR=3.678,95%CI 1.519~8.911)、焦虑(OR=2.542,95%CI 1.174~5.508)、抑郁(OR=2.333,95%CI 1.098~4.959)及CRF(OR=2.769,95%CI 1.232~6.221)均为CINV的独立危险因素(均P<0.05)。不同CINV程度患者的CRF程度、MFI-20评分比较,差异均有统计学意义(P<0.05)。结论 有胃部疾病史、有晕车史、含顺铂化疗方案、焦虑、抑郁及CRF均为CINV的独立危险因素,其中CRF程度与CINV程度密切相关。

Relationship of chemotherapy-induced nausea and vomiting with cancer-related fatigue and its influencing factors in elderly patients with gynecologic cancer

Objective To analyze the status quo and influencing factors of chemotherapy-induced nausea and vomiting (CINV) and its relationship with cancer-related fatigue (CRF) in elderly patients with gynecological malignant tumors. Methods A total of 206 elderly women who suffered from gynecologic cancer and had received chemotherapy in the Breast Department of Yuncheng Central Hospital from March 2021 to September 2022 were recruited as the research subjects. According to the occurrence of CINV, they were divided into a CINV group (92 cases) and a non-CINV group (114 cases). Their clinical data were collected. Multidimensional fatigue Inventory (MFI-20) was used to evaluate their CRF status, and the results were analyzed for its relationship with CINV. SPSS statistics 22.0 was employed for data analysis. Independent sample t test, Chi-square test or rank sum test was applied for intergroup comparison depending on different data type. Logistic regression model was conducted to analyze the risk factors affecting CINV in elderly patients with gynecologic cancer. Results Among the 206 patients, 92 cases (44.66%) developed CINV, including 52 cases (56.52%) of acute CINV and 40 cases (43.48%) of delayed CINV, and 34 cases (36.96%) of mild, 35 cases (38.04%) of moderate and 23 cases (25.00%) of severe CINV. Multivariate logistic regression analysis showed that history of stomach diseases (OR=2.438,95%CI 1.106-5.372), history of motion sickness (OR=3.051,95%CI 1.460-6.376), chemotherapy regimen containing cisplatin(OR=3.678,95%CI 1.519-8.911), anxiety (OR=2.542,95%CI 1.174-5.508), depression (OR=2.333,95%CI 1.098-4.959) and CRF (OR=2.769,95%CI 1.232-6.221) were independent risk factors for CINV (all P<0.05). There were statistical differences in CRF level and MFI-20 score among the patients with different severities of CINV (P<0.05). Conclusion For elderly patients with gynecologic cancer, history of stomach diseases, history of motion sickness, chemotherapy regimen containing cisplatin, anxiety, depression and CRF are independent risk factors for CINV, and CRF level is closely associated with the severity of CINV.