Słowik-Gabryelska A, Szczepanik A, Kalicka A
Katedry i Kliniki Chorób Płuc, Nowotworów i Gruźlicy Akademii Medycznej w Bydgoszczy.
Pol Merkur Lekarski. 1999 Jan;6(31):18-22.
The intensity of complains, short survival and great number of patients makes many oncologists to apply chemotherapy in advanced non-small cell lung cancer/NSCLC/. The achieved median duration of life after chemotherapy was 6 to 12 month. From the other hand non small cell lung cancer chemotherapy is a big burden even to healthy persons. It can worsen the quality of life. That was the reason we evaluated the quality of life after chemotherapy in advanced non small cell lung cancer patients. Taking into account, that the evaluation of quality of life, used in most diseases is useless in advanced NSCLC patients, for appreciation the quality of life in these cases the lung cancer symptoms scale/LCSS/was adopted. In 110 non small cell lung cancer patients in stage IIIB and IV, who received combined chemotherapy by Le Chevalier/Vindesine, Cisplatin, Cyclophosphamide, Lomustin/or by Rosell/Mitomycin, Cyclophosphamide, Cisplatin/the quality of life was evaluated. In 20-persons control group all patients received the symptomatic treatment. In observed group of 110 patients, tumor regressions after 4 courses of chemotherapy allowed to resect cancer in 14 cases, to apply radiotherapy in 42 and to continue chemiotherapy in 23 persons. In every person from above mentioned group the quality of life was evaluated on the basis of intensity of cancer symptoms, accordingly to LCSS. The intensity of cancer symptoms was compared before and after treatment. There were compared; the innensity of complains, weakness, appetite, malnutrition, and hematological, neurological, performans state as well as respiratory sufficiency, infections, cardiac disorders and pain. Apart it, the side effects of applied therapy were assessed in 5 degree scale. The level of hemoglobin, the number of leucocytes, thrombocytes, bilirubine and transaminases in peripheral blood, hematurie, proteinurie, bleedings, appetite, nausea, vomitings, diarrhea, mucosal lesions, infections, skin lesions, cardiac lesions, neurological lesions, respiratory disorders, allergy, alopecia. It was established that, chemotherapy in the most patients improved the performance status and minimized cancer symptoms especially, after good response to treatment. After anticancer therapy more frequently severe infections and cardiac disorders, independently to results of treatment were seen. In non-responders, the cancer symptoms were intensified by side effects of antineoplastic-therapy. In this group of patients the severe side effects of therapy more frequently were seen.
患者的强烈诉求、较短的生存期以及庞大的患者数量使得许多肿瘤学家对晚期非小细胞肺癌（NSCLC）患者采用化疗。化疗后达到的中位生存期为6至12个月。另一方面，非小细胞肺癌化疗即使对健康人来说也是一个巨大负担，它会降低生活质量。这就是我们评估晚期非小细胞肺癌患者化疗后生活质量的原因。考虑到大多数疾病中使用的生活质量评估方法在晚期非小细胞肺癌患者中无用，为评估这些患者的生活质量，采用了肺癌症状量表（LCSS）。对110例ⅢB期和Ⅳ期非小细胞肺癌患者进行了评估，这些患者接受了勒谢瓦利耶方案（长春地辛、顺铂、环磷酰胺、洛莫司汀）或罗塞尔方案（丝裂霉素、环磷酰胺、顺铂）的联合化疗，同时对20人的对照组所有患者进行了对症治疗。在110例患者的观察组中，4个疗程化疗后肿瘤缩小，14例患者得以切除肿瘤，42例患者接受了放疗，23例患者继续化疗。根据LCSS，基于癌症症状的严重程度对上述组中的每个人的生活质量进行了评估。比较了治疗前后癌症症状的严重程度，包括抱怨程度、虚弱程度、食欲、营养不良、血液学指标、神经学指标、身体状况以及呼吸功能、感染、心脏疾病和疼痛。此外，采用5级量表评估了所用治疗的副作用，包括外周血中血红蛋白水平、白细胞、血小板数量、胆红素和转氨酶水平、血尿、蛋白尿、出血、食欲、恶心、呕吐、腹泻、黏膜病变、感染、皮肤病变、心脏病变、神经病变、呼吸障碍、过敏、脱发。结果表明，大多数患者化疗后身体状况得到改善，癌症症状尤其是对治疗反应良好后得到最小化。抗癌治疗后更频繁地出现严重感染和心脏疾病，且与治疗结果无关。在无反应者中，肿瘤症状因抗肿瘤治疗的副作用而加重，在这组患者中更频繁地出现严重的治疗副作用。
