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评估接受不可逆电穿孔(IRE)治疗局部晚期胰腺癌(LAPC)患者的生活质量。

Quality of life assessment for patients undergoing irreversible electroporation (IRE) for treatment of locally advanced pancreatic cancer (LAPC).

机构信息

Department of Surgery, Division of Surgical Oncology, University of Louisville, Louisville, KY, USA.

Department of Surgery, Division of Surgical Oncology, University of Louisville, Louisville, KY, USA.

出版信息

Am J Surg. 2019 Sep;218(3):571-578. doi: 10.1016/j.amjsurg.2019.03.020. Epub 2019 Apr 1.

Abstract

BACKGROUND

IRE is a non-thermal ablative modality that has been shown to be safe and efficacious in LAPC and liver tumors, but few studies have shown its effects on patients' (QOL). The goal of this study is to evaluate quality-of-life (QOL) before and after irreversible electroporation (IRE) therapy for treatment of locally advanced pancreatic carcinoma (LAPC).

METHODS

Between 11/2014 and 12/2016, patients scheduled for IRE therapy for LAPC were offered QOL questionnaires (EORTC QLQ-C30 V2.0) before surgery and 1,3 and 6-months after surgery. Descriptive statistics, one-way ANOVA and effect-size calculations were used in analysis of the 15 modules.

RESULTS

Eight-four prospective patients were enrolled with a median age of 59.08 years (range 27.38-75.72) all who completed 6 months QOL surveys. Global health status scale showed lower average score at 3 and 6 months(p = 0.001). Symptoms scales constipation and insomnia showed higher averages at 3 months (p = 0.007 and p = 0.003 respectively), while dyspnea had higher average at 6 months (p < 0.001). Finally, changes were noted with worse diarrhea symptoms scale at 1 and 3 months (p < 0.001). Otherwise all QOL side effects were normalized at 3 months after IRE.

CONCLUSIONS

The preponderance of symptoms at 3-6 months, symptom profile, and the use of additional therapy on majority of patients suggests other interrelated clinical factors influenced results (e.g. chemotherapy toxicity). This demonstrates that IRE therapy does not adversely affect QOL in the short term in patients with LAPC.

摘要

背景

IRE 是一种非热消融模式,已被证明在 LAPC 和肝脏肿瘤中是安全有效的,但很少有研究表明其对患者(生活质量)的影响。本研究的目的是评估不可逆电穿孔(IRE)治疗局部晚期胰腺癌(LAPC)前后的生活质量(QOL)。

方法

在 2014 年 11 月至 2016 年 12 月期间,为接受 IRE 治疗 LAPC 的患者提供了生活质量问卷(EORTC QLQ-C30 V2.0),在手术前和手术后 1、3 和 6 个月进行了问卷调查。在分析 15 个模块时使用了描述性统计、单因素方差分析和效应大小计算。

结果

共纳入 84 例拟行 IRE 治疗的前瞻性患者,中位年龄为 59.08 岁(范围 27.38-75.72),所有患者均完成了 6 个月的 QOL 调查。全球健康状况量表在 3 个月和 6 个月时的平均得分较低(p=0.001)。症状量表便秘和失眠在 3 个月时的平均得分较高(分别为 p=0.007 和 p=0.003),而呼吸困难在 6 个月时的平均得分较高(p<0.001)。最后,在 1 个月和 3 个月时腹泻症状量表的变化更差(p<0.001)。IRE 治疗后 3 个月,所有 QOL 副作用均恢复正常。

结论

3-6 个月时症状较多、症状谱以及大多数患者使用额外治疗表明,其他相关临床因素影响了结果(例如化疗毒性)。这表明,IRE 治疗在短期内不会对 LAPC 患者的生活质量产生不利影响。

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