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非小细胞肺癌姑息性放疗后的生活质量:一项前瞻性研究。

Quality of life after palliative radiotherapy in non-small cell lung cancer: a prospective study.

作者信息

Langendijk J A, ten Velde G P, Aaronson N K, de Jong J M, Muller M J, Wouters E F

机构信息

Radiotherapeutisch Instituut Limburg, Heerlen, The Netherlands.

出版信息

Int J Radiat Oncol Biol Phys. 2000 Apr 1;47(1):149-55. doi: 10.1016/s0360-3016(99)00540-4.

DOI:10.1016/s0360-3016(99)00540-4
PMID:10758317
Abstract

PURPOSE

The purpose of this study was to investigate changes in respiratory symptoms and quality of life (QoL) in patients with locally advanced and metastatic non-small cell lung cancer (NSCLC) receiving thoracic radiotherapy. Additionally, the correlation between the level of symptom relief and objective tumor response was investigated.

METHODS AND MATERIALS

Sixty-five patients were entered in this prospective study. The EORTC QLQ-C30 and EORTC QLQ-LC13 were used to investigate changes in QoL. Assessments were performed before radiotherapy and 2 weeks, 6 weeks, and 3 months after radiotherapy.

RESULTS

The QoL response rates were excellent for hemoptysis (79%); good for arm/shoulder pain (56%), chest wall pain (53%), and cough (49%); moderate for dyspnea (39%); and minimal for the general symptoms fatigue (22%) and appetite loss (11%). The QoL response rates for the five functioning scales of the QLQ-C30 varied from 35% for role functioning to 57% for emotional functioning. Global QoL improved in 37% of the cases. In general, there was a tendency for better palliation of symptoms and improvement of QoL among patients with an objective tumor response than among those without objective tumor response, which was statistically significant for dyspnea (p = 0.02) and social functioning (p = 0.04).

CONCLUSIONS

This study confirms that conventional thoracic radiotherapy offers palliation of respiratory symptoms and improved QoL in a substantial proportion of patients with locally advanced and metastatic NSCLC. Tumor reduction is only one of the mechanisms by which palliation of symptoms and improvement of QoL is achieved.

摘要

目的

本研究旨在调查接受胸部放疗的局部晚期和转移性非小细胞肺癌(NSCLC)患者的呼吸症状和生活质量(QoL)变化。此外,还研究了症状缓解程度与客观肿瘤反应之间的相关性。

方法和材料

65例患者纳入本前瞻性研究。采用欧洲癌症研究与治疗组织生活质量核心问卷(EORTC QLQ-C30)和欧洲癌症研究与治疗组织肺癌问卷(EORTC QLQ-LC13)调查生活质量变化。在放疗前以及放疗后2周、6周和3个月进行评估。

结果

咯血的生活质量反应率极佳(79%);手臂/肩部疼痛(56%)、胸壁疼痛(53%)和咳嗽(49%)的反应率良好;呼吸困难的反应率中等(39%);一般症状疲劳(22%)和食欲减退(11%)的反应率极低。QLQ-C30五个功能量表的生活质量反应率从角色功能的35%到情绪功能的57%不等。37%的病例总体生活质量得到改善。总体而言,有客观肿瘤反应的患者比无客观肿瘤反应的患者在症状缓解和生活质量改善方面有更好的趋势,这在呼吸困难(p = 0.02)和社会功能(p = 0.04)方面具有统计学意义。

结论

本研究证实,传统胸部放疗可使相当一部分局部晚期和转移性NSCLC患者的呼吸症状得到缓解,生活质量得到改善。肿瘤缩小只是实现症状缓解和生活质量改善的机制之一。

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