Lewis Shirley, Salins Naveen, Kadam Amrit, Rao Raghavendra
Department of Radiation Oncology, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India.
Indian J Palliat Care. 2013 May;19(2):88-92. doi: 10.4103/0973-1075.116703.
Distress is commonly seen in head and neck cancer patients undergoing radiotherapy. Causal factors of distress are multifactorial; which encompasses physical, psychological, spiritual, and existential factors with complex interrelationship among the factors.
Thirty patients undergoing head and neck radiotherapy were included in the study. Patients were screened for pain scores, distress scores, physical and psychological symptoms, and spiritual and emotional distress.
Significant increasing trend seen for pain score, distress score, and total number of symptoms during 2(nd) week, 4(th) week, and on completion of radiotherapy treatment (all P's < 0.001) compared to pretreatment. Those who had chemotherapy (CT) along with radiation had significantly greater pain score (t = 5.54, P = 0.03) and distress score (t = 3.9, P = 0.05) at 2 weeks into radiotherapy compared to those who did not receive CT. There was significantly higher grade of skin toxicity in those with spiritual distress (Somers' d = 0.36, P = 0.02) and higher grade of mucositis in those with existential distress (d = 0.34, P = 0.02) at 4 weeks into radiotherapy.
Positive correlation between distress score and pain score and occurrence of physical symptoms. Increasing trend seen for pain score, distress score, and total number of symptoms during 2(nd) week, 4(th) week, and completion of radiotherapy treatment compared to pretreatment. Increase in distress score in those with existential and spiritual distress.
在接受放疗的头颈癌患者中，痛苦情绪很常见。痛苦的成因是多方面的，包括身体、心理、精神和生存因素，这些因素之间存在复杂的相互关系。
本研究纳入了30例接受头颈放疗的患者。对患者进行疼痛评分、痛苦评分、身体和心理症状以及精神和情绪痛苦的筛查。
与治疗前相比，在放疗第2周、第4周以及放疗结束时，疼痛评分、痛苦评分和症状总数均呈现显著上升趋势（所有P值均<0.001）。与未接受化疗的患者相比，同时接受化疗（CT）和放疗的患者在放疗2周时的疼痛评分（t = 5.54，P = 0.03）和痛苦评分（t = 3.9，P = 0.05）显著更高。在放疗4周时，存在精神痛苦的患者皮肤毒性分级显著更高（Somers' d = 0.36，P = 0.02），存在生存痛苦的患者黏膜炎分级更高（d = 0.34，P = 0.02）。
痛苦评分与疼痛评分以及身体症状的发生之间呈正相关。与治疗前相比，在放疗第2周、第4周以及放疗结束时，疼痛评分、痛苦评分和症状总数均呈现上升趋势。存在生存和精神痛苦的患者痛苦评分增加。
