化疗期不同时间服用甲羟孕酮改善肺癌患者的生活质量

目的观察肺癌患者不同时间服用甲羟孕酮后对改善化疗期所致的食欲减退、恶心、体质量改变等生活质量的作用,并进行对比研究。方法全组102例肺癌患者均经细胞学或病理学明确诊断。分为3组:第Ⅰ组:化疗前≥3d开始服用甲羟孕酮(32例);第Ⅱ组:化疗同一天或化疗前<3d开始服用甲羟孕酮(37例);第Ⅲ组:化疗结束服用甲羟孕酮(33例)。甲羟孕酮25mg,3次/d,连服10～14d;化疗选用以长春地辛、顺伯、异环磷酰胺为主的方案,辅助5-羟色胺受体拮抗剂控制化疗引起的胃肠道反应。结果在化疗期间食量不减或增加者69例,Ⅰ组为91%(29/32),Ⅱ组为68%(25/37),Ⅲ组为45%(15/33);Ⅰ组与Ⅱ组、Ⅲ组相比较差异有显著性(P<0.05,tⅡ=2.28;tⅢ=4.22)。食量减少者33例,Ⅰ组发生率9%(3/32),Ⅱ组发生率32%(12/37),Ⅲ组发生率55%(18/33),其中Ⅰ、Ⅱ组减少幅度轻,恢复时间快。接受化疗时50%未发生恶心,其中Ⅰ组(63%)明显优于Ⅱ组(49%)Ⅲ组(39%)。体质量不变或增加者70例,其中Ⅰ组为88%(28/32);Ⅱ组为70%(26/37);Ⅲ组为48%(16/33)。Ⅰ组与Ⅲ组相比较差异有显著性(P<0.05,t=3.58)。结论化疗前提前服用甲羟孕酮更能发挥其抗胃肠道反应,改善生活质量的作用。

Medroxyprogesterone acetate in improvement of quality of life of patient with lung cancer during the period of chemotherapy

Aim To compare the effect of medroxyprogesterone acetate on the quality of life of patients with lung cancer at different time during the period of chemotherapy. Methods 102 patients with metaphase or late lung cancer, 64 males and 38 females, aged 42- 78 years old, including 58 cases of adenocarcinoma, 28 cases of squamous carcinoma, 11 cases of adeno squamous carcinoma, were divided into three groups: Group I (32 cases) taking medroxyprogesterone acetate at 3 days or more before chemotherapy; Group II (37 cases) taking medroxyprogesterone acetate at the same time of chemotherapy or less than 3 days before chemotherapy; Group III (33 cases) taking medroxyprogesterone acetate after chemotherapy. All patients took medroxyprogesterone acetate 25 mg three times a day for 10- 14 days. Vindesine, Cisplatin and Ifosfamide were selected in the chemotherapy, assisting 5 HT receptor antagonist to control the response of gastrointestinal tract. Results The rates of the patient with normal appetite or auxo appetite during chemotherapy were 91% ( 29/32) ,68% ( 25/37) and 45% ( 15/33) in Group I, II and III respectively, with a significant difference between group I and group II or III( t=2.28, 4.22,P< 0.05) .The rates of the patients with decreased appetite were 9% ( 3/32) , 32% ( 12/37) and 55% ( 18/33) . The appetite decreased less and recovered more quickly in Group I and II, compared with Group III. The rate of the patients without nausea was 63% in Group I significantly higher than those in Group II (49% )and III (39% ). The rates of the patients with normal or increased body weight were 88% , 70% and 48% in Group I, II and III respectively, with a significant difference between Group I and Group III (t=3.58, P< 0.05). Conclusion Medroxyprogesterone acetate taken before chemo therapy has a positive effect in releasing the response of gastrointestinal tract and improving the quality of life.