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局部晚期胸段食管癌患者的姑息性放疗与生活质量:来自印度中部的单中心经验

Palliative radiotherapy and quality of life in patients with locally advanced thoracic esophageal cancer: a single centre experience from Central India.

作者信息

Bandhate Kamal, Diwan Ashok

机构信息

Department of Radiation Oncology, Government Medical College and Hospital, Hanuman Nagar, Ajni Rd, Medical Chowk, Ajni, Nagpur, Maharashtra, India.

出版信息

Rep Pract Oncol Radiother. 2022 Mar 22;27(1):104-112. doi: 10.5603/RPOR.a2021.0136. eCollection 2022.

DOI:10.5603/RPOR.a2021.0136
PMID:35402038
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8989437/
Abstract

BACKGROUND

Patients with locally advanced esophageal squamous cell carcinoma (LAESCC ) have decreased quality of life (QoL) and, thus, require palliative external beam radiotherapy (EBRT). The present study was performed to evaluate the QoL in patients with LAESCC undergoing palliative EBRT.

MATERIALS AND METHODS

This was a prospective, observational study performed over a period of 18 months (from December 2018 to May 2020) in the Department of Radiation Oncology. Seventy patients with LAESCC received EBRT (30 Gy in 10 fractions, at 3 Gy per fraction over 2 weeks). Patients were followed-up at monthly intervals for 3 months. The dysphagia and odynophagia scores were calculated at baseline and follow-up visits. The QoL was assessed with 18-item EORTC QLQ-OES questionnaire at baseline and 3 months.

RESULTS

Over the study period, significant decrease in mean dysphagia and odynophagia score was observed (p-value < 0.0001). On post-hoc analysis, significant decrease in both dysphagia and odynophagia score was observed between baseline and at the end of study and between various follow-up visits (p-value < 0.0001). Moreover, there was a significant increase in mean body weight (p-value < 0.0001). At 3 months, there was a significant decrease in dysphagia (p-value < 0.0001), eating (p-value < 0.0001), reflux (p-value = 0.005), pain (p-value < 0.0001), and saliva (p-value = 0.01) domains of EORTC QLQ-OES18 questionnaire.

CONCLUSION

In patients with LAESCC, EBRT leads to significant decrease in dysphagia and odynophagia, and increase in body weight. These changes indirectly lead to improved QoL.

摘要

背景

局部晚期食管鳞状细胞癌(LAESCC)患者的生活质量(QoL)下降,因此需要姑息性外照射放疗(EBRT)。本研究旨在评估接受姑息性EBRT的LAESCC患者的生活质量。

材料与方法

这是一项在放射肿瘤学部门进行的为期18个月(从2018年12月至2020年5月)的前瞻性观察研究。70例LAESCC患者接受了EBRT(30 Gy,分10次,每次3 Gy,共2周)。患者每月随访1次,共随访3个月。在基线和随访时计算吞咽困难和吞咽痛评分。在基线和3个月时使用18项EORTC QLQ-OES问卷评估生活质量。

结果

在研究期间,观察到平均吞咽困难和吞咽痛评分显著降低(p值<0.0001)。事后分析显示,在基线和研究结束时以及各次随访之间,吞咽困难和吞咽痛评分均显著降低(p值<0.0001)。此外,平均体重显著增加(p值<0.0001)。在3个月时,EORTC QLQ-OES18问卷的吞咽困难(p值<0.0001)、进食(p值<0.0001)、反流(p值=0.005)、疼痛(p值<0.0001)和唾液(p值=0.01)领域均有显著下降。

结论

在LAESCC患者中,EBRT可导致吞咽困难和吞咽痛显著降低,体重增加。这些变化间接导致生活质量改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1f7/8989437/8e3a68b152c9/rpor-27-1-104f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1f7/8989437/744729a9ba99/rpor-27-1-104f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1f7/8989437/105852862747/rpor-27-1-104f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1f7/8989437/8e3a68b152c9/rpor-27-1-104f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1f7/8989437/744729a9ba99/rpor-27-1-104f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1f7/8989437/105852862747/rpor-27-1-104f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1f7/8989437/8e3a68b152c9/rpor-27-1-104f3.jpg

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本文引用的文献

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Radiother Oncol. 2021 Feb;155:73-79. doi: 10.1016/j.radonc.2020.10.009. Epub 2020 Oct 14.
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Esophageal carcinoma: An epidemiological analysis and study of the time trends over the last 20 years from a single center in India.食管癌:来自印度单一中心的过去20年时间趋势的流行病学分析与研究。
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Short-Course External Beam Radiotherapy Versus Brachytherapy for Palliation of Dysphagia in Esophageal Cancer: A Matched Comparison of Two Prospective Trials.
短程外照射放疗与近距离放疗治疗食管癌吞咽困难的疗效比较:两项前瞻性试验的匹配比较。
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