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直肠癌患者放疗和手术对功能和生活质量(QOL)的影响。

Effects of radiation and surgery on function and quality of life (QOL) in rectal cancer patients.

机构信息

St. Paul's Hospital, Vancouver, BC, Canada; University of British Columbia, Vancouver, BC, Canada.

West China Hospital, Chengdu, China.

出版信息

Am J Surg. 2018 May;215(5):863-866. doi: 10.1016/j.amjsurg.2018.01.014. Epub 2018 Jan 31.

Abstract

Pre-operative radiotherapy (PRT) and total mesorectal excision surgery (TME) for rectal cancer yield the lowest risk for local recurrence. However, both treatments negatively impact quality of life (QOL). To understand individual treatment effects, we ask whether PRT affects function and quality of life before TME. Function and QOL were prospectively assessed in 26 patients using EORTC QLQ-C30/-CR38, and Wexner scale at three time points: before PRT, 6 weeks after PRT and before TME, and one year after stoma closure. Wexner score did not change post-PRT but did increase post-TME (p < .01). Micturition score did not change with PRT or TME (p = .29). Sexual function score improved post-PRT (p = .03) but did not change post-TME. Global health status did not change post-treatments (p = .45). Future perspective improved post-surgery (p = .04). PRT did not affect micturition, bowel function, or QOL. Future perspective improved despite increased bowel problems and fecal incontinence. QOL was maintained after curative rectal cancer treatments, radiation and TME surgery. This information may help patients and physicians better understand effects of PRT and TME treatments for rectal cancer.

摘要

术前放疗 (PRT) 和全直肠系膜切除术 (TME) 可降低直肠癌局部复发风险。然而,这两种治疗方法都对生活质量 (QOL) 产生负面影响。为了了解个体治疗效果,我们探讨 PRT 是否会影响 TME 之前的功能和生活质量。通过 EORTC QLQ-C30/-CR38 和 Wexner 量表,在三个时间点前瞻性评估了 26 例患者的功能和 QOL:PRT 前、PRT 后 6 周和 TME 前,以及造口关闭 1 年后。Wexner 评分在 PRT 后没有变化,但在 TME 后增加(p <.01)。PRT 或 TME 均未改变排尿评分(p =.29)。性功能评分在 PRT 后改善(p =.03),但在 TME 后没有变化。治疗后总体健康状况没有变化(p =.45)。未来展望在手术后改善(p =.04)。PRT 并未影响排尿、肠道功能或 QOL。尽管肠道问题和粪便失禁增加,但未来展望有所改善。直肠癌治疗(放疗和 TME 手术)后 QOL 得以维持。这些信息可能有助于患者和医生更好地了解 PRT 和 TME 治疗直肠癌的效果。

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