Schulze T, Wust P, Gellermann J, Hildebrandt B, Riess H, Felix R, Rau B
Department of Surgery and Surgical Oncology, Robert-Rössle-Klinik, Charité, Campus Buch, Universitätsmedizin Berlin, Berlin, Germany.
Int J Hyperthermia. 2006 Jun;22(4):301-18. doi: 10.1080/02656730600665504.
The present study compares quality of life (QoL) after neoadjuvant radiochemotherapy with or without hyperthermia in patients with advanced rectal cancer.
Between April 1994 and May 1999, 137 patients were treated by neoadjuvant radiochemotherapy with (69 patients (50.4%)) or without (68 patients (49.6%)) hyperthermia. Forty-six patients (33.6%) filled-out a 'Gastrointestinal Quality of Life Index' (GIQLI) questionnaire at four time points (before and after neoadjuvant therapy, early after surgery and after long-term follow-up) and were included in the present study.
There were no statistically significant differences in the global GIQLI index between patients treated with neoadjuvant radiochemotherapy with and without hyperthermia at any time point. The longitudinal analysis of GIQLI values in both treatment groups showed specific profiles that were identical in both treatment groups. Occurrence of severe toxicity during the neoadjuvant therapy in both arms lead to a significant temporary reduction of QoL scores at TP2 without any detrimental long-term effects. Patients with sphincter preservation and patients with sphincter resection reported similar QoL scores during long-term follow-up.
Neoadjuvant radiochemotherapy with and without hyperthermia has similar effects on the QoL of patients with locally advanced rectal cancer. The addition of hyperthermia during the neoadjuvant therapy with the potentially associated inconveniences has no negative effects on QoL.
本研究比较了新辅助放化疗联合或不联合热疗治疗晚期直肠癌患者后的生活质量(QoL)。
1994年4月至1999年5月期间,137例患者接受了新辅助放化疗,其中69例(50.4%)联合热疗,68例(49.6%)未联合热疗。46例患者(33.6%)在四个时间点(新辅助治疗前后、术后早期和长期随访后)填写了“胃肠道生活质量指数”(GIQLI)问卷,并纳入本研究。
在任何时间点,接受新辅助放化疗联合热疗和未联合热疗的患者之间,全球GIQLI指数均无统计学显著差异。两个治疗组GIQLI值的纵向分析显示出特定的模式,且两个治疗组相同。两个治疗组新辅助治疗期间严重毒性反应的发生均导致TP2时QoL评分显著暂时降低,但无任何长期有害影响。保留括约肌和切除括约肌的患者在长期随访期间报告的QoL评分相似。
新辅助放化疗联合或不联合热疗对局部晚期直肠癌患者的QoL有相似影响。新辅助治疗期间加用热疗以及可能伴随的不便对QoL没有负面影响。