第一期下期與第二期上期之子宮頸癌經不同治療模式後的長期生活品質比較

Comparison of Long-Term Quality of Life for Patients with Stage IB-IIA Uterine Cervical Carcinoma Treated with Different Modalities

許維中(Wei-Chung Hsu) ； 詹淑卿(Sue-Ching Chan) ； 鍾娜娜(Na-Na Chung) ； 陳宇嘉(Yu-Chia Chen) ； 丁禮莉(Lai-Lei Ting) ； 陳斯榮(Szu-Jung Chen) ； 蔡崇煌(Chung-Huang Tsai) ； 王博民(Po-Ming Wang) ； 謝保群(Pao-Chun Hsieh) ； 林高德(Gau-De Lin)

《放射治療與腫瘤學》 12卷3期 (2005/09) Pp. 181-189

https://doi.org/10.6316/TRO/200512(3)181

摘要

目的：本研究之目的是比較以不同的治療方式，對第一期下期或第二期上期子宮頸癌病患長期的副作用與生活品質之差異。
材料與方法：總共有兩機構的336位第一期下期或第二期上期子宮頸癌病患被邀請參與研究。病患均在治療結束後兩年以上（介於25至218個月），選擇45-74歲的261位中、老年為研究對象。依治療方式之不同區分為手術治療、放射治療與術後放射治療三組。病患須項寫EORTC QLQ C-30生活品質量表及子宮頸癌治療後的副作用量表，並以此作為生活品質評估之依據。
結果：共有八項副作用在統計上達到顯著差異，包括：腹痛、腹瀉、便秘、血便、排尿困難、尿失禁、下肢水腫及臉潮紅。其中，手術組於便秘排尿困難及臉潮紅之副作用明顯高於其他兩組，放療組於腹瀉及血便兩項顯著較高，術後放療組則有較高的腹瀉、血便、尿失禁及下肢水腫之副作用。以EORTC QLQ-C30生活品質來比較，除了功能性尺度上的認知功能和社會功能兩項，以及症狀尺度之疲倦、噁心／嘔吐、食慾不振、便秘和經濟困難五項達到統計上的顯著水準外，其餘多項生活品質指標於三組間差異不大，均未達顯著意義。
結論：本研究顯示第一期下期或第二期上期子宮頸癌病患接受不同治療模式的副作用有所不同，但長期之整體生活品質差異不大。本文有助於臨床醫師考量病患接受治療後之生活品質的改變，也可對病患治療後的復健與支持照護上有所幫助。

關鍵字

EORTC ； 生活品質 ； 放射治療 ； 子宮頸癌

並列摘要

Purpose: To compare the difference treatment modalities for complications and long-term quality of life (QoL) in patients with stage IB and stage IIA uterine cervical carcinoma.
Materials and Methods: Three hundred and thirty-six patients of two institutions were invited to participate in this study. Inclusive patients were follow-up at least 2 years after the completion of the treatment (follow-up periods: 25-218 months) and were between ages 45-74 years. According to the treatment modalities, they were divided into 3 groups: surgery (OP), radiation therapy (RT), and surgery with postoperative radiation therapy (OP+RT). All patients were asked to complete the European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (QLQ C-30) and complications Questionnaire for the assessment of QoL.
Results: Total 8 items of complicatons were statistically significant, including abdominal pain, diarrhea, constipation, blood stools, dysuria, urine incontience, edema of lower extremities and hot flush. Constipation, dysuria, and hot flush were statistically higher in OP group; diarrhea and blood stools were highter in RT group. Significant higher complications treated by OP+RT were: diarrhea, blood stools, urine incontience and edema of lower extremities. Comparison of EORTC QLQ-C30, the majority of items showed little difference among these three treatment modalities, except cognitive functioning and social functioning in functional scales and fatique, nausea/vomiting, poor appetite, constipation and economical difficult in symptoms scales.
Conclusion: Our study revealed the different complications in stage IB and Stage IIA uterine cervical cancer patients treated by different modalities, whereas long-term QoL seem little difference among these three different modalities. These data were helpful for clinical physician not only for selecting treatment modalities when concerning with QoL changes of the patients, but also for rehabilitation and supportive care of the patients after treatment.

並列關鍵字

EORTC ； Quality of life ； Radiotherapy ； Uterine cervical cancer