恶性中央气道梗阻内镜治疗后的生存获益及生活质量改善
Survival and Quality of Life Benefit after Endoscopic Management of Malignant Central Airway Obstruction.
作者信息
Stratakos Grigoris, Gerovasili Vasiliki, Dimitropoulos Charalampos, Giozos Ioannis, Filippidis Filippos T, Gennimata Sofia, Zarogoulidis Paul, Zissimopoulos Athanasios, Pataka Athanasia, Koufos Nikos, Zakynthinos Spyros, Syrigos Konstantinos, Koulouris Nikos
机构信息
1. 1st Pulmonary Medicine Department of National and Kapodistrian University of Athens, "Sotiria" General Hospital Athens, Greece;
2. 1st Respiratory and Critical Care Medicine department of National and Kapodistrian University of Athens, "Evangelismos" Hospital Athens, Greece;
出版信息
J Cancer. 2016 Apr 25;7(7):794-802. doi: 10.7150/jca.15097. eCollection 2016.
BACKGROUND
Although interventional management of malignant central airway obstruction (mCAO) is well established, its impact on survival and quality of life (QoL) has not been extensively studied.
AIM
We prospectively assessed survival, QoL and dyspnea (using validated EORTC questionnaire) in patients with mCAO 1 day before interventional bronchoscopy, 1 week after and every following month, in comparison to patients who declined this approach. Material/Patients/Methods: 36 patients underwent extensive interventional bronchoscopic management as indicated, whereas 12 declined. All patients received full chemotherapy and radiotherapy as indicated. Patients of the 2 groups were matched for age, comorbidities, type of malignancy and level of obstruction. Follow up time was 8.0±8.7 (range 1-38) months.
RESULTS
Mean survival for intervention and control group was 10±9 and 4±3 months respectively (p=0.04). QoL improved significantly in intervention group patients up to the 6(th) month (p<0.05) not deteriorating for those surviving up to 12 months. Dyspnea decreased in patients of the intervention group 1 month post procedure remaining reduced for survivors over the 12th month. Patients of the control group had worse QoL and dyspnea in all time points.
CONCLUSIONS
Interventional management of patients with mCAO, may achieve prolonged survival with sustained significant improvement of QoL and dyspnea.
背景
尽管恶性中央气道阻塞（mCAO）的介入治疗已得到充分确立，但其对生存率和生活质量（QoL）的影响尚未得到广泛研究。
目的
我们前瞻性地评估了mCAO患者在介入性支气管镜检查前1天、术后1周及随后每月的生存率、生活质量和呼吸困难情况（使用经过验证的欧洲癌症研究与治疗组织问卷），并与拒绝这种治疗方法的患者进行比较。材料/患者/方法：36例患者根据需要接受了广泛的介入性支气管镜治疗，而12例患者拒绝治疗。所有患者均根据需要接受了充分的化疗和放疗。两组患者在年龄、合并症、恶性肿瘤类型和阻塞程度方面进行了匹配。随访时间为8.0±8.7（范围1 - 38）个月。
结果
干预组和对照组的平均生存期分别为10±9个月和4±3个月（p = 0.04）。干预组患者的生活质量在第6个月前显著改善（p < 0.05），对于存活至12个月的患者没有恶化。干预组患者术后1个月呼吸困难减轻，在第12个月后仍持续减轻。对照组患者在所有时间点的生活质量和呼吸困难情况均较差。
结论
mCAO患者的介入治疗可能实现延长生存期，并持续显著改善生活质量和呼吸困难情况。
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