二级胶质瘤长期幸存者的健康相关生活质量：疾病复发和卡诺夫斯基体能状态的影响
Health-related quality of life in long-term survivors with Grade II gliomas: the contribution of disease recurrence and Karnofsky Performance Status.
作者信息
Okita Yoshiko, Narita Yoshitaka, Miyahara Ruriko, Miyakita Yasuji, Ohno Makoto, Shibui Soichiro
机构信息
Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo Department of Neurosurgery, Osaka National Hospital, National Hospital Organization, Osaka.
Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo
出版信息
Jpn J Clin Oncol. 2015 Oct;45(10):906-13. doi: 10.1093/jjco/hyv115. Epub 2015 Jul 31.
OBJECTIVE
Although the number of long-term survivors of glioma has increased, there has been little research on the health-related quality of life of long-term survivors of Grade II glioma following treatment with surgery, radiotherapy and chemotherapy. In this study, we aimed to document the health-related quality of life of people diagnosed with Grade II glioma who had survived >10 years with no evidence of disease at the time of the health-related quality of life survey.
METHODS
To investigate the health-related quality of life of Grade II glioma survivors without evidence of disease, we surveyed 50 patients 0-20 years after their initial treatments. Each patient completed a multi-part health-related quality of life questionnaire. Based on these surveys, we examined the relationships between health-related quality of life scores and time since initial treatment, Karnofsky Performance Scale scores at the time of the survey, and history of recurrence, radiotherapy and chemotherapy.
RESULTS
Excepting bladder control, long-term survivors maintained their quality of life as determined by comparing patients surveyed < 5 and ≥ 10 years after their initial treatment (P < 0.05). Neither radiotherapy nor chemotherapy at the initial treatment was observed to affect health-related quality of life. However, a history of recurrence was significantly associated with deteriorations in many health-related quality of life functional and symptom scores. The Karnofsky Performance Scale scores of patients with a history of recurrence were significantly lower than those without it (P = 0.02). This deterioration was observed in both univariate and multivariate analyses.
CONCLUSIONS
Our results indicate that declines in health-related quality of life among long-term survivors of Grade II glioma mainly result from impaired Karnofsky Performance Scale, which is a consequence of disease recurrence.
目的
尽管神经胶质瘤长期存活者的数量有所增加，但对于接受手术、放疗和化疗后的Ⅱ级神经胶质瘤长期存活者的健康相关生活质量，相关研究却很少。在本研究中，我们旨在记录那些被诊断为Ⅱ级神经胶质瘤且存活超过10年、在进行健康相关生活质量调查时无疾病证据者的健康相关生活质量。
方法
为调查无疾病证据的Ⅱ级神经胶质瘤存活者的健康相关生活质量，我们在他们初次治疗后的0至20年对50名患者进行了调查。每位患者都完成了一份多部分的健康相关生活质量问卷。基于这些调查，我们研究了健康相关生活质量得分与初次治疗后的时间、调查时的卡氏功能状态评分以及复发史、放疗史和化疗史之间的关系。
结果
除膀胱控制外，通过比较初次治疗后<5年和≥10年接受调查的患者发现，长期存活者的生活质量得以维持（P<0.05）。未观察到初次治疗时的放疗或化疗会影响健康相关生活质量。然而，复发史与许多健康相关生活质量功能和症状得分的恶化显著相关。有复发史患者的卡氏功能状态评分显著低于无复发史者（P = 0.02）。在单变量和多变量分析中均观察到了这种恶化情况。
结论
我们的结果表明，Ⅱ级神经胶质瘤长期存活者健康相关生活质量的下降主要源于卡氏功能状态受损，而这是疾病复发的结果。
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