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[1]吴刚,杨文宇,周慧君,等.食管癌患者生存质量对其预后影响的前瞻性随访研究[J].医学研究与战创伤救治(原医学研究生学报),2016,18(06):601-605.[doi:10.3969/j.issn.1672-271X.2016.06.012]
　WU Gang,YANG Wen-yu,ZHOU Hui-jun,et al.A prospective investigation into effect of quality of life on prognosis for patients with esophageal cancer[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2016,18(06):601-605.[doi:10.3969/j.issn.1672-271X.2016.06.012]
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食管癌患者生存质量对其预后影响的前瞻性随访研究()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第18卷
期数:
2016年06期
页码:
601-605
栏目:
出版日期:
2016-11-20

文章信息/Info

Title:
A prospective investigation into effect of quality of life on prognosis for patients with esophageal cancer
作者:
吴刚1; 杨文宇2; 周慧君3; 吴金通3
1. 350025福建福州，南京军区福州总医院病案室；2. 335000江西鹰潭，解放军73861部队卫生处；3.351100福建莆田，南京军区福州总医院95临床部放疗科
Author(s):
WU Gang1;  YANG Wen-yu2;  ZHOU Hui-jun3;  WU Jin-tong3.
1. Office of Medical Record, Fuzhou General Hospital of Nanjing Military Command, Fuzhou, Fujian 350025, China；2. Department of Medical Affair, PLA 73861 Division, Yingtan, Jiangxi 335000, China; 3. Department of Radiotherapy, First Affiliated Hospital of
关键词:
食管癌; 生存质量; EORTC量表; 前瞻性研究; COX风险系数模型
Keywords:
esophageal neoplasms;  quality of life;  EORTC questionnaire;  prospective study;  COX regression model
分类号:
R735.1
DOI:
10.3969/j.issn.1672-271X.2016.06.012
文献标志码:
A
摘要:
目的 探讨基线生存质量和治疗后生存质量变化对食管癌患者生存期的影响。方法 本研究为前瞻性随访研究。选取2009年5月-2010 年5月南京军区福州总医院95临床部确诊的食管癌患者，分为手术组和放化疗组。两组共有98例患者经过6个月高强度食管癌治疗后仍然存活。这个存活样本通过欧洲肿瘤研究和治疗组织(EORTC)的量表(EORTC QLQ-C30和EORTC QLQ-OES18)来测量基线生存质量和治疗后６个月生存质量的变化。随后按计划继续随访患者的生存质量直到患者死亡、失访和研究结束（2014年5月）。用COX 风险系数模型分析生存质量数据和生存时间的关系。结果 COX 风险系数模型发现，在控制其他混杂因素之后，基线生存质量中的躯体功能评分可显著预测食管癌患者的生存时间(P=0.002),基线的躯体功能评分每提高10分，患者的死亡风险降低11%(95%可信区间5%～17%)。如果在模型中考虑存活6个月后的生存质量，情绪功能评分是显著性变量。它每提高10分可降低35%的死亡风险(95%可信区间20%～47%, P<0.01)。结论 基线和治疗后生存质量是重要的预测食管癌患者生存时间的数据。临床上应提倡使用患者师存质量数据来提高医生的医疗决策。
Abstract:
Objective o investigate the predictive value of baseline QoL scores and QoL improvement after treatment in patients with esophageal cancer. Methods We conducted a prospective study in First Affiliated Hospital of Fuzhou Military General Hospital from 2009 to 2014 with a sample of 98 patients who survived the initial 6-month esophageal cancer treatment. Baseline QoL were measured with the European Organisation for Research and Treatment of Cancer (EORTC) core questionnaire (EORTC QLQ-C30) and the oesophageal module (EORTC QLQ-OES18). Then patients were divided into two groups. Surgical group consisted of patients who had their stomach removed by operations while medical group comprised patients receiving chemo therapy only. Both groups measured QoL at scheduled time throughout the study period or patients died. Survival analysis and Cox′s models were used to quantify the impact of baseline QoL variables and QoL improvement on patients′ survival. ResultsAfter adjusting for confounders, Cox regression found that physical function of QoL before treatment was significantly associated with survival time (P=0.002). Every 10 points increasing in physical function was associated with 11% (95% confidence intervals 5%–17%) reduction in the likelihood of death. When considering QoL at 6-month survival in the model, emotional function become a significant variable and was related to 35% reduction in likelihood of death (95% confidence intervals 20%-47%, P＜0.01). ConclusionQoL scores at baseline and after initial treatment are important to predict the survival of patients with esophageal cancer. This type of data should be used by clinicians in their management of patients with esophageal cancer.

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备注/Memo

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更新日期/Last Update: 2016-11-20