Chen Jia-Hong, Huang Tzu-Chuan, Chang Ping-Ying, Dai Ming-Shen, Ho Ching-Liang, Chen Yeu-Chin, Chao Tsu-Yi, Kao Woei-Yau
Division of Hematology/Oncology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 10114, Taiwan, R.O.C .
Mol Clin Oncol. 2014 Jan;2(1):13-18. doi: 10.3892/mco.2013.216. Epub 2013 Nov 19.
Malignant bowel obstruction (MBO) is a disease with a poor prognosis, particularly in patients with advanced bowel or gynecological cancers. Multimodality teatments may be used to relieve the symptoms in patients with MBO; however, there is currently no consensus regarding the optimal treatment and no strong evidence supporting the efficacy of any treatment in improving the quality of life (QOL) and prolonging survival. We conducted a search through our medical center database of cancer registries for MBO cases between January, 1995 and December, 2008 and analyzed the clinicopathological characteristics and association between treatments and prognosis or QOL. The primary type of cancer causing MBO was found to be adenocarcinoma of colon. The overall survival time was found to be significantly higher among patients presenting with MBO as the initial symptom and improved QOL was achieved in patients who received surgical treatment. The mean survival time and the functional status of colorectal cancer patients receiving targeted therapy and chemotherapy were more satisfactory compared with those receiving surgery alone or conservative treatment. Furthermore, for end-stage cancer patients with MBO, hospice care was effective in reducing pain scores and relieving the symptoms of the disease.
恶性肠梗阻(MBO)是一种预后较差的疾病,尤其是在晚期肠道或妇科癌症患者中。多模式治疗可用于缓解MBO患者的症状;然而,目前对于最佳治疗方法尚无共识,也没有有力证据支持任何一种治疗方法在改善生活质量(QOL)和延长生存期方面的疗效。我们通过我们医疗中心的癌症登记数据库,搜索了1995年1月至2008年12月期间的MBO病例,并分析了其临床病理特征以及治疗与预后或生活质量之间的关联。发现导致MBO的主要癌症类型为结肠癌。以MBO为首发症状的患者总体生存时间显著更长,接受手术治疗的患者生活质量得到改善。与单纯接受手术或保守治疗的患者相比,接受靶向治疗和化疗的结直肠癌患者的平均生存时间和功能状态更令人满意。此外,对于患有MBO的晚期癌症患者,临终关怀在降低疼痛评分和缓解疾病症状方面有效。