Tang Yu, Qu Jintao, Wu Juan, Liu Huan, Chu Tongwei, Xiao Jianru, Zhou Yue
Department of Orthopaedic Surgery, Affiliated Xinqiao Hospital, The Third Military Medical University, Chongqing, People's Republic of China.
Department of Orthopaedic Surgery, No. 44 Military Hospital, Guizhou, People's Republic of China.
J Bone Joint Surg Am. 2016 Mar 2;98(5):396-402. doi: 10.2106/JBJS.O.00629.
Recently, more clinicians have realized the importance of quality of life in the treatment decision-making process. The goal of this study was to determine whether surgery for patients with spinal metastases from non-small-cell lung cancer (NSCLC) could improve their quality of life and prolong survival.
The study included 133 patients who had been treated for NSCLC spinal metastases between 2010 and 2014. These patients were divided into two groups according to whether or not they had received spinal surgery. Their quality of life was assessed with use of the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire at the initial diagnosis (baseline) and at one, three, six, and nine months after the diagnosis. The survival times of all patients were also collected.
Of the 133 patients, eighty-six (forty-five in the surgery group and forty-one in the non-surgery group) survived for nine months and were assessed at all of the follow-up intervals. The surgery group had significantly higher total, physical well-being, emotional well-being, and functional well-being quality-of-life scores at each follow-up time point as compared with baseline (p < 0.001) as well as compared with the non-surgery group (p < 0.001). A log-rank test demonstrated that the surgery group had longer survival than the non-surgery group (p = 0.020).
The results of this study indicate that surgical treatment improved the quality of life of patients with NSCLC spinal metastases over the nine-month assessment period. The surgery group had a better quality of life and longer survival than the non-surgery group.
最近,越来越多的临床医生意识到生活质量在治疗决策过程中的重要性。本研究的目的是确定非小细胞肺癌(NSCLC)脊柱转移患者接受手术是否能改善其生活质量并延长生存期。
该研究纳入了2010年至2014年间接受NSCLC脊柱转移治疗的133例患者。这些患者根据是否接受脊柱手术分为两组。在初始诊断(基线)时以及诊断后1个月、3个月、6个月和9个月,使用癌症治疗功能评估通用量表(FACT-G)问卷对他们的生活质量进行评估。还收集了所有患者的生存时间。
在133例患者中,86例(手术组45例,非手术组41例)存活9个月,并在所有随访间隔进行了评估。与基线相比(p < 0.001)以及与非手术组相比(p < 0.001),手术组在每个随访时间点的总体、身体状况、情绪状况和功能状况生活质量评分均显著更高。对数秩检验表明,手术组的生存期比非手术组更长(p = 0.020)。
本研究结果表明,在9个月的评估期内,手术治疗改善了NSCLC脊柱转移患者的生活质量。手术组的生活质量优于非手术组,生存期也更长。