实体恶性肿瘤患者化疗耐受性预测的研究

目的 探讨实体恶性肿瘤患者化疗前医、患及家属对耐受性的预测.方法 化疗前由患者、家属及肿瘤专科工作5年以上医师对患者目前的化疗耐受性进行评分,化疗后记录患者的严重不良反应,分析不同评分与严重不良反应发生情况之间的相关性.结果 本研究共入组534例次患者,家属、患者本人、医师的平均化疗耐受性印象评分分别为(6.99±1.44)、(7.07±1.52)、(7.18±1.56)分.3~4级血液学毒性发生率为15.4%,3~4级非血液学毒性发生率为7.5%.经治医师评分与3~4级血液学毒性和非血液学毒性的偏回归系数分别为-0.095(P=0.006)和-0.077(P=0.029).家属和患者评分差异无统计学意义(P﹥0.05).结论 有经验的医师对患者耐受性的评估准确,应该在化疗前根据医师的评估对于可能出现严重不良反应的患者给予预防处理.

Study on the estimate of tolerance to chemotherapy in patients with solid malignancy

Objective To explore the tolerance scores estimated by specialists, patients and family members prior to chemotherapy for patients with solid malignancy. Method Patients, their family members and tumor specialists with over 5-year working experiences estimated the patients'chemotherapy tolerance scores before the therapy was given, and the serious adverse reactions occurred after chemotherapy were recorded, to evaluate the correlation between chemothera-py tolerance scores and the incidences of serious adverse reactions. Result A total of 534 cases of patients were enrolled in this study. The average impression score of tolerance to chemotherapy evaluated by family members, patients and spe-cialists was (6.99±1.44), (7.07±1.52) and (7.18±1.56), respectively. The incidence of grade 3-4 hematologic and non-he-matologic toxicity was 15.4%and 7.5%, respectively. The partial regression coefficient between the score evaluated by specialist and the incidence of grade 3 to 4 hematologic or non-hematologic toxicity was-0.095 (P=0.006) and-0.077 (P=0.029). There was no significant correlation between the score evaluated by family members or patients and the incidence of serious adverse reactions (P>0.05). Conclusion The estimate of patients'tolerance to chemotherapy by experienced specialist is accurate, and prophylactic treatments should be given before chemotherapy to the patients who may experi-ence serious adverse reactions according to the specialists'estimate.