Nair C Krishnan, George P S, Rethnamma K S, Bhargavan R, Abdul Rahman S, Mathew A P, Muralee M, Cherian K, Augustine P, Ahamed M I
Department of Surgical Oncology, Regional Cancer Centre, Trivandrum, India.
Department of Bio-Statistics, Regional Cancer Centre, Trivandrum, India.
Indian J Surg Oncol. 2014 Dec;5(4):266-73. doi: 10.1007/s13193-014-0346-z. Epub 2014 Oct 16.
Maintaining quality of life (QOL) is one of the important aims of cancer treatment. Quality of life of a cancer patient is affected by various factors, which may be disease related, patient related, or treatment related. To study changes in health-related quality of life (HRQOL) brought about by treatment of rectal cancer and factors affecting the changes using Malayalam translation of FACT-C (Functional Assessment of Cancer Therapy-Colorectal) Questionnaire. Also to detect the minimally important clinical changes (MICC) in health-related quality of life of patients with carcinoma rectum, who have undergone surgery. Forty-five patients diagnosed with carcinoma rectum, who have undergone curative surgery, were studied. HRQOL was assessed at baseline 2 weeks after surgery and 3 months after surgery. The changes in scores were correlated with various demographic factors like age, sex, marital status, number of children, number of married children, and education and occupation of the patient and spouse. Also the treatment-related factors like presence of stoma, presence of morbidity, previous treatment, stage of disease, and administration of chemotherapy before and after surgery were correlated. All the subscales of FACT-C tool, except emotional well-being, were significantly reduced 2 weeks after surgery and increased slightly above pre-treatment level 3 months after surgery. The Chronbach α values were 0.88, 0.89 and 0.86 on three occasions, respectively, establishing internal validity of the test. Baseline HRQOL scores were better in males compared to females. Among the various subscales, the drops in SWB, FWB, FACT-G, total Score and TOI were significant (P < .05).There were no significant differences in scores between patients who have undergone open surgery and minimally invasive surgery or patients who had permanent colostomy versus no colostomy. The HRQOL scores after surgery reduced 2 weeks after surgery and improved above pre-surgical levels 3 months after surgery. The approach of surgery (minimally invasive versus open) or presence or absence of permanent colostomy didn't make any significant change in HRQOL. But since the sample size of the study was small, we need further larger studies to arrive at definite conclusions.
维持生活质量（QOL）是癌症治疗的重要目标之一。癌症患者的生活质量受多种因素影响，这些因素可能与疾病、患者自身或治疗相关。本研究旨在使用FACT-C（癌症治疗功能评估-结直肠癌）问卷的马拉雅拉姆语翻译版本，研究直肠癌治疗所带来的健康相关生活质量（HRQOL）变化以及影响这些变化的因素。同时，检测接受手术治疗的直肠癌患者健康相关生活质量的最小重要临床变化（MICC）。对45例经诊断为直肠癌且接受了根治性手术的患者进行了研究。在基线、术后2周和术后3个月对HRQOL进行评估。将评分变化与各种人口统计学因素相关联，如年龄、性别、婚姻状况、子女数量、已婚子女数量以及患者及其配偶的教育程度和职业。此外，还将与治疗相关的因素进行关联，如造口的存在、并发症的存在、既往治疗、疾病分期以及手术前后化疗的实施情况。除情感健康外，FACT-C工具的所有子量表在术后2周均显著降低，术后3个月略高于治疗前水平。三次测量的Chronbach α值分别为0.88、0.89和0.86，确立了该测试的内部效度。男性的基线HRQOL评分优于女性。在各个子量表中，社会幸福感（SWB）、家庭幸福感（FWB）、FACT-G、总分和总体健康指数（TOI）的下降具有显著性（P < 0.05）。接受开放手术和微创手术的患者之间或有永久性结肠造口术与无结肠造口术的患者之间，评分无显著差异。术后HRQOL评分在术后2周降低，术后3个月高于术前水平。手术方式（微创与开放）或永久性结肠造口术的有无对HRQOL没有显著影响。但由于本研究的样本量较小，我们需要进一步开展更大规模的研究以得出明确结论。
