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乳腺癌和卵巢癌治疗后患者的性生活和生活质量。

Sexual activity and quality of life in patients after treatment for breast and ovarian cancer.

机构信息

Department of Obstetrics and Gynecology, University Medical Center Freiburg, Freiburg, Germany.

Department of Obstetrics and Gynecology, University Medical Center Aachen, Aachen, Germany.

出版信息

Arch Gynecol Obstet. 2019 Jan;299(1):191-201. doi: 10.1007/s00404-018-4922-2. Epub 2018 Nov 1.

Abstract

OBJECTIVE

Sexual activity (SA) and functioning (SF) are important factors influencing quality of life (QoL). Anticancer treatment can cause or promote sexual dysfunctions. In this study we analyzed the SA, SF and QoL in patients after completion of treatment for breast cancer (BC) and ovarian cancer (OC).

METHODS

In this retrospective multicenter study 396 BC patients and 93 OC patients aged between 18 and 70 years were surveyed at least 24 months after cancer diagnosis and compared to 60 healthy women. Data were collected through validated questionnaires (Sexual Activity Questionnaire, Female Sexual Function Index-d, EORTC Quality of Life Questionnaire-C30).

RESULTS

45.9% of BC patients and 56.5% of OC patients reported SA. SF and well-being of sexually active BC patients were not influenced by the type and radicality of surgery or the administration of chemotherapy. Patients who received antihormonal therapy at the time of evaluation showed a lower frequency of SA (p = 0.007), less satisfaction (p = 0.003) and more discomfort during SA (p = < 0.001) compared to healthy controls but no differences in experiencing orgasms, health status, QoL and global health status. In contrast, BC patients without antihormonal therapy showed only a higher discomfort score (p = 0.028) than healthy controls and estimated their health status and QoL significantly better than patients who received antihormonal therapy (p = 0006). In general, SA was associated with a better health status (p = 0.007), a better QoL (p = 0.004) and a better global health status (p = 0.004) in BC patients. Sexually active OC patients showed no significant differences in SF, QoL and health status compared to healthy controls.

CONCLUSIONS

Compared to healthy controls BC patients showed limitations in SF with a lower SA rate and more discomfort. Antihormonal therapy was an important factor influencing SF and well-being. Breast and OC survivors reported good physical and psychical health without differences in QoL and health status compared to controls. This might be explained by a change of perspective on life difficulties and altered priorities through a life threatening disease.

摘要

目的

性行为(SA)和功能(SF)是影响生活质量(QoL)的重要因素。抗癌治疗会导致或促进性功能障碍。本研究分析了乳腺癌(BC)和卵巢癌(OC)治疗后患者的 SA、SF 和 QoL。

方法

本回顾性多中心研究调查了 396 名 BC 患者和 93 名 OC 患者,这些患者在癌症诊断后至少 24 个月,年龄在 18 至 70 岁之间,并与 60 名健康女性进行了比较。数据通过验证后的问卷(性行为问卷、女性性功能指数-d、EORTC 生活质量问卷-C30)收集。

结果

45.9%的 BC 患者和 56.5%的 OC 患者报告了 SA。接受过不同类型和根治性手术或化疗的 BC 患者的 SF 和性健康状况不受影响。接受评估时抗激素治疗的患者报告 SA 频率较低(p=0.007)、满意度较低(p=0.003)和 SA 期间不适程度较高(p<0.001),与健康对照组相比,但在体验性高潮、健康状况、QoL 和总体健康状况方面无差异。相比之下,未接受抗激素治疗的 BC 患者仅在不适评分方面(p=0.028)高于健康对照组,且对自身健康状况和 QoL 的估计明显好于接受抗激素治疗的患者(p=0.0006)。一般来说,BC 患者的 SA 与更好的健康状况(p=0.007)、更好的 QoL(p=0.004)和更好的总体健康状况(p=0.004)相关。与健康对照组相比,活跃的 OC 患者在 SF、QoL 和健康状况方面没有显著差异。

结论

与健康对照组相比,BC 患者在 SF 方面存在限制,SA 率较低,不适程度较高。抗激素治疗是影响 SF 和健康状况的重要因素。乳腺癌和卵巢癌幸存者报告的身体和心理都健康,与对照组相比,QoL 和健康状况没有差异。这可能是由于对生活困难的看法发生了变化,以及通过威胁生命的疾病改变了优先事项。

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