同期调强放疗联合内分泌治疗对局部晚期前列腺癌乏力症状的影响

发布时间：2018-03-16 16:26

  本文选题：前列腺癌　切入点：癌症相关性乏力　出处：《肿瘤防治研究》2016年06期 　论文类型：期刊论文

【摘要】：目的评价调强放疗联合内分泌治疗对局部晚期前列腺癌乏力症状的影响。方法对符合纳入标准的局部晚期前列腺癌患者采用同期三维适形调强放疗联合内分泌治疗。采用FSI(Fatigue Symptom Inventory)量表进行长期问卷随访,调查时间分别为治疗前(A)、治疗结束后(B)、治疗结束3月(C)、12月(D)、24月(E)、36月(F)、48月(G)。随访内容包括疲劳程度、对生活质量影响程度及上周疲劳持续时间3个维度。Logistic多分类回归模型评价危险因素。结果共97例局部晚期前列腺癌患者纳入研究。中位随访时间43.9月。乏力指数与PSA水平、Gleason评分、ECOG评分及文化程度相关(P0.05);年龄和临床分期与乏力指数无关(P0.05);多分类回归分析显示P S A水平和E C O G评分是癌症相关性乏力的独立危险因素。疲劳程度在各个随访时间点未体现出差异(P0.05),但最严重疲乏程度发生在时间点B和C;时间点C、D、E、F和G的疲乏对生活影响积分均高于基线评价,且差异有统计学意义(P0.05),尤其是对日常活动影响积分、注意力积分和情绪积分。疲乏持续时间呈现波动状态,时间点D、E、F呈明显上升,差异有统计学意义(P0.05)。结论ECOG评分高、Gleason≥8分、PSA20ng/ml、且文化程度高的局部晚期前列腺癌患者,在接受同期放疗联合内分泌治疗后,要关注乏力对生活质量产生的影响,特别是在对日常活动、注意力和情绪方面。
[Abstract]:Objective to evaluate the effect of intensity modulated radiotherapy (IMRT) combined with endocrine therapy on the symptoms of locally advanced prostate cancer. Methods three dimensional conformal intensity modulated radiotherapy combined with endocrine therapy was used in patients with locally advanced prostate cancer. The long-term questionnaire was followed up with FSI(Fatigue Symptom inventory. The time of investigation was before treatment, after treatment, after treatment, after treatment, on March, on December, 24 months, 36 months, 36 months, and 48 months, respectively. The follow-up included the degree of fatigue. Logistic multiple regression model was used to evaluate the risk factors. Results 97 patients with locally advanced prostate cancer were included in the study. The median follow-up time was 43.9 months. There was no correlation between age and clinical stage and fatigue index (P 0.05). Multiple classification regression analysis showed that PSA level and ECOG score were independent risk factors of cancer related fatigue. There was no significant difference in fatigue at all follow-up time points (P 0.05), but the most severe fatigue occurred at time points B and C, and the scores of fatigue effects on life at time points C and G were higher than those at baseline. The difference was statistically significant (P 0.05), especially for the scores of daily activity, attention and emotion. Conclusion the patients with advanced prostate cancer with high ECOG score (Gleason 鈮，

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