McQuellon R P, Loggie B W, Fleming R A, Russell G B, Lehman A B, Rambo T D
Comprehensive Cancer Center, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1082, USA.
Eur J Surg Oncol. 2001 Feb;27(1):65-73. doi: 10.1053/ejso.2000.1033.
This study assessed the functional status and quality of life (QOL) of patients with disseminated peritoneal cancer (DPC) before and after cytoreductive surgery plus intraperitoneal hyperthermic chemotherapy (IPHC).
Patients with confirmed or suspected diagnosis of gastro-intestinal cancer including stomach, pancreas, hepatobiliary and colorectal cancer with peritoneal implants were enrolled in the study. Sixty-four patients completed the Functional Assessment of Cancer Therapy-Colon (FACT-C) scale and several other instruments at baseline. Forty-eight, 40, 39 and 31 patients were assessed at approximately 2 weeks post-surgery, and 3, 6 and 12 months respectively.
There was a significant overall effect on the physical (P=0.0025), emotional (P<0.0001) and functional well-being (P=0.0044) subscales and the FACT-C (P=0.0076). Physical and functional well-being scores decreased at post-surgery follow-up and increased relative to baseline at 3, 6 and 12 months. Nineteen per cent, 46%, 59% and 74% of patients resumed greater than 50% of their normal activities post-operatively at 3, 6 and 12 months respectively. A percentage of patients reported depressive symptoms: baseline (28%), post-operatively (33%), 3 months (23%), 6 months (21%) and 12 months (29%).
Cytoreductive surgery followed by IPHC was well tolerated. Most patients returned to baseline or better levels of functioning within 3 months post-treatment.
本研究评估了减瘤手术联合腹腔内热化疗(IPHC)前后播散性腹膜癌(DPC)患者的功能状态和生活质量(QOL)。
确诊或疑似诊断为胃肠道癌(包括胃癌、胰腺癌、肝胆癌和结直肠癌伴腹膜种植转移)的患者纳入本研究。64例患者在基线时完成了癌症治疗功能评估-结肠(FACT-C)量表及其他几种测评工具。分别于术后约2周、3个月、6个月和12个月对48例、40例、39例和31例患者进行评估。
在身体(P=0.0025)、情绪(P<0.0001)和功能健康(P=0.0044)分量表以及FACT-C(P=0.0076)方面均有显著的总体效应。术后随访时身体和功能健康评分下降,在3个月、6个月和12个月时相对于基线有所增加。分别有19%、46%、59%和74%的患者在术后3个月、6个月和12个月恢复了超过其正常活动量的50%。一定比例的患者报告有抑郁症状:基线时(28%)、术后(33%)、3个月时(23%)、6个月时(21%)和12个月时(29%)。
减瘤手术联合IPHC耐受性良好。大多数患者在治疗后3个月内恢复到基线或更好的功能水平。