单次大剂量肝区放射照射治疗原发性肝癌肝区疼痛患者效果研究*

doi:10.3969/j.issn.1672-5069.2023.02.030

摘要/Abstract

摘要： 目的探讨单次大剂量肝区放射照射治疗原发性肝癌(PLC)出现肝区疼痛患者对生存质量的影响。方法 2018年6月～2021年6月我院收治的PLC出现肝区疼痛患者76例,采用随机数字表法将其分为观察组38例和对照组38例,给予两组患者支持治疗,观察组在此治疗的基础上行单次大剂量肝区放射照射治疗。随访60 d。应用疼痛简明量表(BPI)评估疼痛,应用欧洲组织癌症研究和治疗量表(EORTCQLQ-C30)评估生存质量。结果在治疗后1 m,观察组BPI评分为(1.7±0.8)分,显著低于对照组【(3.4±1.3)分,P＜0.05】; EORTCQLQ-C30的功能领域和总体健康状况/生命质量领域评分分别为(47.2±7.0)分和(12.7±1.2)分,显著高于对照组【分别为(35.6±6.0)分和(8.6±0.8)分,P＜0.05】,而症状和单项测量评分分别为(10.2±2.2)分和(15.4±3.1)分,显著低于对照组【分别为(18.1±5.0)分和(19.6±4.2)分,P＜0.05】;在放疗期间,未发生放疗死亡事件,出现恶心呕吐、乏力和纳差等症状24例(63.2%),发热8例(21.1%),上消化道出血9例(23.7%),白细胞减少3例(7.0%),均无2级以上不良反应发生,经积极治疗后症状均在1周内好转;治疗后随访60 d,观察组病死率为44.7%,对照组为55.3%,经Kaplan-Meier生存分析显示两组生存率无显著性差异(Log-Rank=0.497,P=0.481)。结论采用单次大剂量肝区放射照射治疗PLC出现肝区疼痛患者能明显缓解疼痛,改善生存质量,作为姑息治疗措施,值得一试。

关键词: 原发性肝癌, 肝区疼痛, 放疗, 生存质量

Abstract: Objective The aim of this study was to investigate the effect of single high dose of hepatic irradiation on amelioration of hepatic pain in patients with primary liver cancer (PLC). Methods 76 patients with PLC and hepatic pain were encountered in our hospital between June 2018 and June 2021, and were divided randomly into observation and control group, with 38 cases in each group. All the patients received supporting treatment, and those in the observation group received a single dose of large dose of liver irradiation. The brief pain inventory (BPI) and the European organization for research and treatment of cancer (EORTCQLQ-C30) score were evaluated. Results One month after enrollment, the BPI score in irradiation-treated patients was (1.7±0.8), significantly lower than [(3.4±1.3), P＜0.05] in the control; the functional and overall health status/quality of life aspects by the EORTCQLQ-C30 were(47.2±7.0) and (12.7±1.2), both significantly higher than [(35.6±6.0) and (8.6±0.8), respectively, P＜0.05], while the symptom and single measurement item scores were (10.2±2.2) and (15.4±3.1), significantly lower than [(18.1±5.0) and (19.6±4.2), respectively, P＜0.05] in the control group; the common symptoms after irradiation were nausea and vomiting, fatigue and anorexia in 24 cases(63.2%), fever in 8 cases (21.1%), upper gastrointestinal bleeding in 9 cases (23.7%) and leucopenia in 3 cases(7.0%), which were ameliorated gradually after in time management; at the end of 60 day followed-up, the fatality rate in the irradiation-treated group was 44.7%, and that in the control was 55.3%, not significantly different by Kaplan-Meier analysis (Log-Rank=0.497, P=0.481). Conclusion A single high-dose of hepatic irradiation in patients with PLC and liver pain could gain a good therapeutic relieve pain effect and relatively improve the quality of life in this circumstance.

Key words: Hepatoma, Liver pain, Radiation therapy, Quality of life

顾凯, 吴晓晨, 朱逸明. 单次大剂量肝区放射照射治疗原发性肝癌肝区疼痛患者效果研究^*[J]. 实用肝脏病杂志, 2023, 26(2): 270-273.

Gu Kai, Wu Xiaochen, Zhu Yiming. Single high dose of hepatic irradiation in ameliorating hepatic pain in patients with primary liver cancer[J]. Journal of Practical Hepatology, 2023, 26(2): 270-273.

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单次大剂量肝区放射照射治疗原发性肝癌肝区疼痛患者效果研究^*

Single high dose of hepatic irradiation in ameliorating hepatic pain in patients with primary liver cancer

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