Quality of life during potentially curative treatment for locally advanced oesophageal cancer
Quality of life during potentially curative treatment for locally advanced oesophageal cancer
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DOI：
10.1002/bjs.5888
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发表时间：
2007-11-01
影响因子：
9.6
通讯作者：
Blazeby, J. M.
中科院分区：
文献类型：
--
作者：
Avery, K. N. L.;Metcalfe, C.;Blazeby, J. M.
背景：联合放化疗与手术或不手术是国际上应用的食道癌潜在治愈的替代策略。本研究比较了选择放化疗的患者和接受包括食道切除术在内的综合治疗的患者的健康相关生活质量(HRQL)。方法：II或III期食道癌患者在基线、最差预期HRQL时间点和预期恢复时进行HRQL评估。结果：132例患者开始治疗，其中51例接受放化疗，81例接受包括手术在内的综合治疗。与选择手术的患者相比，选择接受放化疗的患者年龄更大，更有可能患有鳞状细胞癌，并且报告的HRQL较差。在治疗后最糟糕的预期时间点，两组都报告了多种症状和功能不佳，但手术与HRQL较基线相比更大的下降与放化疗有关。放化疗后6个月内HRQL基本恢复，但术后6个月仍未完全恢复，部分指标持续显著恶化。结论：放化疗对短期HRQL的负面影响小于包括手术在内的综合治疗。希望早期康复的患者应考虑明确的放化疗。
Background: Combination chemoradiotherapy with or without surgery are internationally applied alternative strategies for potential cure of oesophageal cancer. This study compared health-related quality of life (HRQL) between patients selected for chemoradiation and those who had combination treatment including oesophagectomy.Methods: Patients with stage II or III oesophageal cancer completed HRQL assessments at baseline, at the worst expected HRQL time point and at expected recovery. HRQL was compared between groups using linear regression, adjusting for age, sex, performance status, turnout stage and type, and baseline HRQL.Results: Some 132 patients began treatment, of whom 51 had chemoradiotherapy and 81 combination treatment including surgery. Patients selected for chemoradiotherapy were older, more likely to have squamous cell cancer and reported poorer HRQL than those selected for surgery. At the worst expected time point after treatment, both groups reported multiple symptoms and poor function, but surgery was associated with a greater reduction in HRQL from baseline than chemoradiotherapy. Recovery of HRQL was achieved within 6 months after chemoradiotherapy, but complete recovery had not occurred 6 months after surgery and there was persistent significant deterioration in some aspects.Conclusion: The negative treatment-related impact of chemoradiation on short-term HRQL is less than that experienced with combination treatment including surgery. Patients preferring early recovery should consider definitive chemoradiation.