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中国癌症防治杂志

中国癌症防治杂志 ›› 2017, Vol. 9 ›› Issue (4): 289-295.doi: 10.3969/j.issn.1674-5671.2017.04.09

• 鼻咽癌专栏 • 上一篇    下一篇

时辰化疗联合调强放疗对局部晚期鼻咽癌患者生命质量和营养状况的影响

  

  1. 贵州医科大学；贵州医科大学附属肿瘤医院 贵州省肿瘤医院
  • 出版日期:2017-08-25 发布日期:2017-09-12
  • 通讯作者: 金风。E-mail：jinf8865@yeah.net
  • 基金资助:

    贵州省科技厅社发攻关项目（黔科合SY字〔2015〕3049）

Effects of chrono-chemotherapy combined with intensity-modulated radiotherapy on quality of life and nutritional status of patients with locally advanced nasopharyngeal carcinoma

  1. Guizhou Medical University；Cancer Hospital of Guizhou Medical University，Guizhou Cancer Hospital
  • Online:2017-08-25 Published:2017-09-12
  • Contact: Jin Feng. E-mail： jinf8865@yeah.net

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摘要：

目的 观察时辰化疗联合调强放疗与常规化疗联合调强放疗对局部晚期鼻咽癌患者生命质量和营养状况的影响。方法 将85例局部晚期鼻咽癌患者随机分为试验组42例和对照组43例。试验组诱导化疗及同步化疗时在固定时间采用时辰化疗，对照组采用常规化疗，同步放疗均采用调强放疗。采用EORTC QLQ-C30、QLQ-H&N35、NRS 2002和PG-SGA量表观察两组患者治疗前后生命质量和营养状况的变化。结果 诱导化疗后试验组患者总健康状况评分明显高于对照组（P＜0.05）；恶心呕吐、食欲丧失、便秘、吞咽困难和体重增加等症状领域得分低于对照组（P＜0.05）；同步放化疗结束后，试验组患者在总健康状况、降低恶心呕吐等领域得分明显优于对照组，差异有统计学意义（P＜0.05）。NRS 2002与PG-SGA量表评估结果显示，两组患者治疗结束后发生营养不良例数明显增加，对照组增加病例数多于试验组。结论  同步放化疗治疗局部晚期鼻咽癌患者采用时辰化疗，恶心呕吐、总体健康状况及生命质量均优于常规化疗，可能是更合理的治疗模式。

关键词: 鼻咽肿瘤, 时辰化疗, 调强放疗, 生命质量, 营养状况

Abstract:

Objective To compare the effects of chrono-chemotherapy combined with intensity-modulated radiotherapy（IMRT） or conventional chemotherapy combined with IMRT on the quality of life and nutritional status of patients with locally advanced nasopharyngeal carcinoma（NPC）. Methods A total of 85 patients with locally advanced NPC were randomly divided into an experimental group（n=42） and control group（n=43）. The patients in the experimental group were treated with chrono-chemotherapy at fixed times during induction chemotherapy and concurrent chemotherapy. The control group received routine intravenous drip and concurrent radiotherapy，and IMRT was applied to both groups. Quality of life and nutritional status before and after treatment were analyzed using EORTC，QLQ-C30，QLQ-H&N35，NRS 2002 and PG-SGA scales. Results Total health score after induction chemotherapy was significantly higher in the experimental group than in the control group（P<0.05），and scores for nausea and vomiting，loss of appetite，constipation，dysphagia and weight gain was significantly lower（P<0.05）. After the end of radio- and chemotherapy，the experimental group was significantly better than the control group in general health status，nausea and vomiting and other outcomes（P<0.05）. NRS 2002 and PG-SGA results showed a significant increase in both groups in the number of malnutrition cases after the end of treatment，with a larger number of cases in the control group. Conclusion Outcomes related to nausea and vomiting，overall health status and quality of life in patients with locally advanced NPC may be superior with chrono-chemotherapy than with conventional chemotherapy.

Key words: Nasopharyngeal neoplasm, Chrono chemotherapy, Intensity modulated radiation therapy, Quality of life, Nutritional status