| 耿冲,孙苏平,叶涛,惠华,王敏,仝少冬,王强.通过骨痛量表分析放疗前后肝癌骨转移患者的生活质量及影响因素[J].中华放射医学与防护杂志,2020,40(3):216-220 |
| 通过骨痛量表分析放疗前后肝癌骨转移患者的生活质量及影响因素 |
| Analyzing quality of life and influencing factors in patients with bone metastasis of hepatocellular carcinoma before and after radiotherapy by bone pain scale |
| 投稿时间：2019-08-21 |
| DOI：10.3760/cma.j.issn.0254-5098.2020.03.010 |
| 中文关键词: 肝癌骨转移 放疗 骨痛量表 生活质量 |
| 英文关键词:Bone Metastasis of Hepatocellular Carcinoma Radiotherapy Bone Pain Scale Quality of Life |
| 基金项目:江苏省青年医学重点人才基金（QNRC2016396） |
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| 中文摘要: |
| 目的 通过分析肝癌骨转移患者的癌症治疗评估量表-骨痛量表（FACT-BP），研究放疗对肝癌骨转移患者生活质量的影响，分析临床因素对放疗后生活质量的影响。方法 回顾性收集2013年1月至2018年12月徐州市肿瘤医院43例肝癌骨转移患者放疗前后FACT骨痛量表，从生活质量总体评分、总体功能状态、疼痛程度、躯体功能、社会心理等5个方面分析放疗前后生活质量评分变化，并对比分析生活质量未改善的患者各方面评分；比较各临床因素与放疗后生活质量改善率的相关性。结果 放疗后患者各方面生活质量评分较放疗前均有提高，且差异有统计学意义（t=7.621、5.887、9.407、7.785、4.487，P<0.05）。生活质量未改善患者中，放疗前后生活质量总体评分、社会心理评估评分均降低明显，存在明显差异（t=3.381、4.982，P<0.05）。各临床因素中，骨转移部位软组织块、放疗处方剂量对患者放疗后生活质量改善有明显影响（χ2=5.180、7.457，P<0.05）。放疗前骨转移部位是否存在软组织肿块，放疗后生活质量改善率分别为50.00%、85.00%。放疗处方剂量<40 Gy及≥ 40 Gy，放疗后生活质量改善率分别为44.44%、84.00%。多因素分析发现骨转移部位软组织块、放疗处方剂量、疼痛数字评分法（NRS）疼痛评分对生活质量改善的影响有相关性（OR=0.296、0.020、1.592，P<0.05）。结论 骨转移部位的放疗能明显改善肝癌骨转移患者生活质量。社会心理状态可影响患者生活质量。放疗处方剂量≥ 40 Gy更可能改善骨转移部位存在软组织肿块患者的生活质量。 |
| 英文摘要: |
| Objective To study the effect of radiotherapy on the quality of life (QOL) of patients with bone metastasis of hepatocellular carcinoma by analyzing the Function Assessment of Cancer Treatment(FACT), and to analyze the influence of clinical factors on the improvement of the QOL after radiotherapy. Methods The FACT bone pain scale in 43 patients with bone metastasis of hepatocellular carcinoma before and after radiotherapy was retrospectively analyzed. The changes in QOL score before and after radiotherapy were analyzed by T test from five aspects:overall QOL score, general functional status, pain degree, physical function and social psychology. Further analysis was made on the scores of patients whose QOL had not been improved. Chi-square test was used to analyze the correlation between clinical factors and QOL improvement after radiotherapy. Results After radiotherapy, the QOL of patients were improved in all aspects compared with those before radiotherapy, and there were statistical differences (t=7.621,5.887,9.407,7.785,4.487, P<0.05). In patients whose QOL did not improve after radiotherapy, the scores of overall QOL and psychosocial assessment decreased significantly, and there were significant differences (t=3.381,4.982, P<0.05). Among the clinical factors, soft tissue mass at bone metastasis site and radiotherapy prescription dose had significant effects on the improvement of patients' life after radiotherapy (χ2=5.180,7.457, P<0.05). Whether there were soft tissue masses in bone metastases before radiotherapy, the improvement rates of QOL after radiotherapy were 50.00% and 85% respectively. The improvement rates of QOL after radiotherapy were 44.44% and 84% in patients with prescription dose of <40 Gy and ≥ 40 Gy respectively. Multivariate analysis showed that soft tissue mass at bone metastasis site, the dose of radiotherapy prescription and numeric rating scale (NRS) of pain had more significant effects on QOL (OR=0.296,0.020,1.592, P<0.05). Conclusions Radiotherapy at bone metastasis sites can significantly improve the QOL of liver cancer patients with bone metastasis. Psychosocial status can affect the QOL of patients. In the case of soft tissue mass in bone metastasis site, the prescription dose of radiotherapy (≥ 40 Gy) can better improve the QOL. |
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