宫颈癌放疗后生活及性生活质量分析

目的 调查宫颈癌放疗患者生活质量、性生活质量及其影响因素。方法 本研究纳入2013-2018年间北京协和医院放疗科诊治的87例疗前未绝经宫颈癌患者,采用宫颈癌生活质量评估量表及女性性功能指标量表进行评估。收集患者人口学及治疗资料,采用多元线性回归分析其影响因素。结果 生活质量总分平均值为114(100~126),其中生理状况19(16~21)、社会家庭状况21(18~24)、情感状况19(17~21),功能状况19(14~22),附加关注状况39(34~43);放疗结束时间是影响总分(P=0.034)、生理状况(P=0)、功能状况(P=0.008)的因素,社会家庭状况是影响社会家庭维度的因素(P=0.010)。性生活总分平均值为8.0(5.0~20.5分),其中性欲望1.8(1.2~3.0)、性唤醒1.5(0~2.7)、阴道润滑0.3(0~3.6)、性高潮0(0~3.6)、满意度3.2(2.0~4.0)、性交痛0(0~3.6)。97%受调查者总分<27分(84/87),存在性功能障碍。年龄是影响性唤醒(P=0.005)、阴道润滑(P=0.039)的因素,职业是影响性交痛(P=0.004)的因素。结论 未绝经宫颈癌患者的生活质量受多因素影响,应积极处理放疗相关并发症以提高患者生活及性生活质量。

Analysis of quality of life and sexual quality of life in cervical cancer patients undergoing radiotherapy

Objective To investigate the quality of life,sexual quality of life and its influencing factors in cervical cancer patients undergoing radiotherapy. Methods Pre-menopausal patients of 87 cases were diagnosed with cervical cancer treated with radiotherapy at Peking Union Medical College Hospital from December 2013 to December 2018 were recruited in this study. The functional assessment of cancer therapy-cervix (FACT-Cx V4.0) and the female sexual function index (FSFI) were evaluated. Demographic and treatment data were collected. The influencing factors were analyzed by multiple linear regression analysis. Results The total score of quality of life was 114(100-126),19(16-21) for physiology,21(18-24) for social/family,19(17-21) for emotion,19(14-22) for function and 39(34-43) for additional attention,respectively. The end time of radiotherapy was the influencing factor of the total score (P=0.034),physiology (P=0) and function (P=0.008). Family was the influencing factor of social family dimension (P=0.010). The total score of FSFI was 8.0(5.0-20.5),1.8(1.2-3.0) for sexual desire,1.5(0-2.7) for sexual arousal,0.3(0-3.6) for vaginal lubrication,0(0-3.6) for orgasm,3.2(2-4) for satisfaction and 0(0-3.6) for sexual pain,respectively. The total score was less than 27 in 97%(84/87) of the patients and had sexual dysfunction. Age was the influencing factor of sexual arousal (P=0.005) and vaginal lubrication (P=0.039). Occupation was the influencing factor of sexual pain (P=0.004). Conclusions The quality of life of premenopausal patients with cervical cancer is affected by multiple factors. Radiotherapy-related complications should be actively treated to improve the quality of life and sexual life of patients.