| 姜菲,梁军利,张尧,等.根治性放化疗后颈段食管癌长期生存者生活质量的多维度评估[J].中华放射医学与防护杂志,2026,46(7):662-669.Jiang Fei,Liang Junli,Zhang Yao,et al.A multidimensional evaluation of quality of life in long-term survivors of cervical esophageal cancer after definitive chemoradiotherapy[J].Chin J Radiol Med Prot,2026,46(7):662-669 |
| 根治性放化疗后颈段食管癌长期生存者生活质量的多维度评估 |
| A multidimensional evaluation of quality of life in long-term survivors of cervical esophageal cancer after definitive chemoradiotherapy |
| 投稿时间：2026-03-05 |
| DOI：10.3760/cma.j.cn112271-20260305-00080 |
| 中文关键词: 颈段食管癌 根治性放化疗 长期生存 生活质量 多维度评价 |
| 英文关键词:Cervical esophageal cancer Definitive chemoradiotherapy Long-term survival Quality of life Multidimensional evaluation |
| 基金项目:白求恩医学基金-研学精进项目(J202305E038A02) |
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| 中文摘要: |
| 目的 通过评估生理功能、疾病特异性症状、营养与心理状态、社会支持及疲劳程度,对接受根治性放化疗(dCRT)的颈段食管癌长期生存者(≥5年)的生活质量进行多维度评估,以优化综合管理策略并为其制定个性化延续管理方案。方法 回顾性分析河北医科大学第四医院放疗科2009年1月1日至2020年9月30日接受dCRT(照射剂量≥50 Gy)且生存≥5年的颈段食管癌患者36例。通过电话随访或门诊访视采用欧洲癌症治疗与研究组织(EORTC)QLQ-C30、QLQ-OES18量表,结合营养不良通用筛查工具(MUST)、心理痛苦管理筛查工具(DMSM)、社会支持评定量表(SSRS)及多维疲劳量表-20(MFI-20)进行评估。结果 患者中位总生存期为9.0年(5~16年)。总体生活质量的中位评分为92.0分(58.0~100.0分),但躯体功能(87.0分)和认知功能(83.0分)方面存在一定不足。吞咽困难和进食困难中位评分分别为11.0分和12.5分。心理疲乏(MFI-20)中位评分为23.5分(13.0~45.0分)。83.3%患者为低营养风险。61.1%的患者无心理痛苦。91.7%的患者社会支持中等。颈段食管癌长期生存者总体生活质量与多维疲乏总分(r=-0.870,P<0.001)及心理痛苦(r=-0.786,P<0.001)呈负相关,与社会支持总分呈正相关(r=0.353,P<0.05)。Spearman相关分析显示,生活质量与吞咽困难(rs =-0.629,P<0.001)、进食困难(rs =-0.550,P<0.05)及哽咽感(rs =-0.533,P<0.05)均呈负相关。结论 颈段食管癌患者长期生存获益显著,并维持较高的总体生活质量。然而,患者仍面临躯体功能与认知功能受损、疾病特异性症状及心理疲乏等问题,需采取针对性干预措施以改善其长期生存质量。 |
| 英文摘要: |
| Objective To multidimensionally assess the QoL of long-term CEC survivors (≥5 years) who received dCRT by evaluating physical function, disease-specific symptoms, nutritional and psychological status, social support, and fatigue levels, in order to optimize comprehensive management strategies and formulate personalized continuing care plans.Methods A retrospective analysis was conducted on 36 patients with CEC who received dCRT (radiation dose ≥50 Gy) at the Department of Radiotherapy, Fourth Hospital of Hebei Medical University between January 1, 2009 and September 30, 2020 and survived for ≥5 years. Evaluations were conducted via telephone follow-ups or outpatient visits using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 items and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Oesophageal Cancer Module 18 items, combined with the Malnutrition Universal Screening Tool, Distress Management Screening Measure, Social Support Rating Scale, and Multidimensional Fatigue Inventory-20. Results The median overall survival was 9.0 years (range, 5-16 years) The median score for overall QoL was 92.0 (range, 58.0-100.0), but physical (87.0) and cognitive (83.0) functioning showed certain deficiencies. The median scores for dysphagia and eating difficulties were 11.0 and 12.5, respectively. The median score for Multidimensional Fatigue Inventory-20 was 23.5 (range, 13.0-45.0). Additionally, 83.3% of patients had a low nutritional risk, 61.1% of patients reported no psychological distress, and 91.7% received moderate social support. The overall QoL of long-term CEC survivors was negatively correlated with the total multidimensional fatigue score (r=-0.870, P<0.001) and psychological distress (r=-0.786, P<0.001), and positively correlated with the total social support score (r=0.353, P<0.05). Spearman correlation analysis showed that QoL was negatively correlated with dysphagia (rs=-0.629, P<0.001), eating difficulties (rs=-0.550, P<0.05), and choking sensation (rs=-0.533, P<0.05). Conclusions CEC patients achieve considerable long-term survival benefits and maintain a high overall QoL. However, patients still experience challenges such as impaired physical and cognitive functioning, disease-specific symptoms, and psychological fatigue. Targeted interventions are necessary to improve their long-term quality of life. |
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