同期放化疗对食管癌患者近期生存质量的影响

背景与目的：食管癌在临床确诊时大多病变较广泛，难以达到根治目的，因此改善其生存质量尤为重要。同期放化疗对食管癌有较好疗效，但其对食管癌生存质量的影响国内报道较少，笔者旨在评价同期放化疗对食管癌患者近期生存质量的影响。方法：应用欧洲癌症研究治疗组织的癌症患者生存质量自评核心量表（EORTCQLQ—C30）汉化中文版进行生存质量评价。食管鳞癌随机分为同期放化疗组（CRT）26例和后程加速超分割组（LAHF）26例，所有患者在治疗前、放疗第4周、放疗完成时、放疗后1个月、放疗后3个月共5次进行生存质量的测定。结果：CRT组和LAHF组在放疗过程中至放疗结束后1个月短时间降低了总体健康状况、躯体功能、角色功能、社会功能，但与放疗前相比均未有显著性差异（P〉0．05）；而CRT组在放疗后3个月显著改善了总体健康状况、躯体功能和角色功能，评分均值分别提高了12．0±3．7（P=0．012）、8．1±2．9（P=0．023）和14．8±5．2（P=0．015）。虽然CRT组在治疗过程中加重了恶心呕吐、疼痛和食欲丧失症状，但治疗后恢复较快。结论：同期放化疗显著改善了食管癌患者近期生存质量的总体健康状况领域、躯体功能领域和角色功能领域，以生存质量的观点出发，同期放化疗是一种可行的治疗手段。

The effect on short-term quality of life in patients with esophageal carcinoma received concurrent chemoradiotherapy

Background and purpose: Most of the patients with esophageal cancers were late stage cases when diagnosed clinically. Since the prognosis is very poor, it is extremely important to improve the quality of life (QOL) of these patients. Concurrent chemoradiotherapy is an effective modality for esophageal cancer. However, effects on quality of life of chemoradiotherapy are rarely reported domestically. Our purpose was to assess the immediate effect on the quality of life in patients with primary esophageal carcinoma. Methods: QOL was assessed by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) Chinese edition. Fifty-two patients were randomized to receive either concurrent chemoradiotherapy (CRT) or late course accelerated hyperfractionated radiotherapy (LAHF). QOL questionnaires were given before therapy and at the 4th week during radiotherapy, the completion of radiotherapy, and then after 1 and 3 months after the completion of radiotherapy, respectively. Results: It has been observed that the scores of global health status, physical functioning,role functioning and social functioning during the radiotherapy and from completion of radiotherapy to 1 month post radiotherapy in CRT and LAHF groups, deteriorated temporarily, but it were not significant when compared with those before radiotherapy (P>0.05). However, global health status scores, physical functioning scores, role functioning scores were significantly improved in patients who received CRT at 3 months post radiotherapy. Mean scores were improved by 12.0±3.7 (P=0.012),8.1±2.9 (P=0.023) and 14.8±5.2 (P=0.015), respectively. Nausea and vomiting, pain and appetite loss scales scores rapidly recovered to the baseline level after therapy, although they were worsened during therapy.Conclusion: Global health status scores, physical functioning scores and role functioning scores were significantly improved at 3 months after radiotherapy in patients treated by CRT. In terms of QOL, CRT is a feasible modality for esophageal cancer.