手術對脊柱轉移性腫瘤患者晚期生命質量的影響_《中國循證醫學雜志》

作者：

吳娟 ^1,3# , 鄭偉 ^2# , 吳志鵬 ² , 胡曉媛 ³ ,  郭強 ³ , 肖建如 ²

1.中國人民解放軍成都軍區總醫院藥劑科（成都 610083）；2.中國人民解放軍第二軍醫大學附屬長征醫院骨科（上海 200003）；3.中國人民解放軍第二軍醫大學訓練部（上海 200433）;

關鍵詞：

脊柱轉移性腫瘤手術治療生存時間生命質量

DOI：

10.7507/1672-2531.20120162

視頻：

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目的　探討手術治療對脊柱轉移性腫瘤患者晚期生命質量的影響，以及手術是否能延長此類患者的生存時間。
方法　以第二軍醫大學附屬長征醫院臨床確診的轉移性脊柱腫瘤患者為研究對象，按其是/否接受手術分為手術組和非手術組。分別于確診時，治療后第1、3、6、9個月，應用FACT-G（Functional Assessment of Cancer Therapy-General）癌癥患者生命質量評價量表進行5次生命質量測評并記錄每位患者的生存時間，比較兩組患者的生存時間以及生命質量的變化情況來評價脊柱手術的治療效果。
結果　共納入312例脊柱轉移性腫瘤患者，其中手術組147例，非手術組165例。兩組患者生存率差異無統計學意義（χ2=3.167，P=0.075）。在9個月內兩組患者生命質量方面，手術組患者在生理、情感、功能以及總體狀況方面的得分均高于非手術組。
結論　手術治療能顯著提高脊柱轉移性腫瘤患者的生命質量，但不能延長患者的生存時間。

引用本文： 吳娟,鄭偉,吳志鵬,胡曉媛,郭強,肖建如. 手術對脊柱轉移性腫瘤患者晚期生命質量的影響. 中國循證醫學雜志, 2012, 12(9): 1041-1046. doi: 10.7507/1672-2531.20120162 復制

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14.	Kaya E, Feuer D. Prostate cancer: palliative care and pain relief. Prostate Cancer Prostatic Dis, 2004, 7(4): 311-315.
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16.	楊銳, 陳釩, 戚宜晶, 等. 寧養院患者的臨終關懷和藥物治療. 中國現代藥物應用, 2008, 2(1): 48-50.
17.	黃少卿, 蔡澤玲, 陳碧素, 等. 國內寧養家居護理現況. 實用醫技雜志, 2006, 13(12): 2143-2144.
18.	Findlay GF. Adverse effects of the management of malignant spinal cord compression. Neurol Neurosurg Psychiatry, 1984, 47(8): 761-768.
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20.	Choi D, Crockard A, Bunger C, et al. Review of metastatic spine tumour classification and indications for surgery: the consensus statement of the Global Spine Tumour Study Group. Eur Spine J. 2010, 19(2): 215-222.
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1. Bilsky MH, Lis E, Raizer J, et al. The diagnosis and treatment of metastatic spinal tumor. Oncologist, 1999, 4(6): 459-469.
2. Gasbarrini A, Cappuccio M, Mirabile L, et al. Spinal metastases: treatment evaluation algorithm. Eur Rev Med Pharmacol Sci, 2004, 8: 265-274.
3. 胡有谷, 黨耕町, 唐天駟主譯. 脊柱外科學. 第2版. 北京: 人民衛生出版社, 2005: 1909-1942.
4. Tanaka M, Nakahara S, ITO Y, et al. Surgical treatment of metastatic vertebral tumors. Acta Med. Okayama, 2009, 63(6): 145-150.
5. Donthineni R, Ofluoglu O. Spine Oncology: Daedalus, Theseus, and the Minotaur. Orthop Clin N Am, 2009, 40: 169-171.
6. Cheung YB, Goh C, Wee J, et al. Measurement properties of the Chinese language version of the Functional Assessment of Cancer Therapy-General in a Singaporean population. Ann Acad Med Singapore, 2009, 38(3): 225-229.
7. Kemmler G, Holzner B, Kopp M, et al. Comparison of two quality-of-life instruments for cancer patients: the Functional Assessment of Cancer Therapy–General and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30. J Clin Oncol, 1999, 17(9): 2932-2940.
8. Bonomi AE, Cella DF, Hahn EA, et al. Multilingual translation of the Functional Assessment of Cancer Therapy (FACT) quality of life measurement system. Qual Life Res, 1996, 5(3): 309-320.
9. Heffernan N, Cella D, Webster K, et al. Measuring health-related quality of life in patients with hepatobiliary cancers: the Functional Assessment of Cancer Therapy–Hepatobiliary Questionnaire. J Clin Oncol, 2002, 20(9): 2229-2239.
10. Dapueto JJ, Servente L, Francolino C, et al. Determinants of quality of life in patients with cancer: a south American study. Cancer, 2005, 103(5):1072-1081.
11. 周乃康. 肺癌治療模式探討與見解. 中華臨床醫師雜志（電子版）, 2009, 3(5): 1-3.
12. Tsuya A, Fukuoka M. Bone metastases in lung cancer. Clin Calcium, 2008, 18(4): 455-459.
13. Mcarthur HL, Hudis CA. Has first-line therapy had an impact on general outcome in metastatic breast cancer? Future Oncol, 2007, 3(4): 411-418.
14. Kaya E, Feuer D. Prostate cancer: palliative care and pain relief. Prostate Cancer Prostatic Dis, 2004, 7(4): 311-315.
15. Patchell RA, Tibbs PA, Regine WF, et al. Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial. Lancet, 2005, 366: 643-648.
16. 楊銳, 陳釩, 戚宜晶, 等. 寧養院患者的臨終關懷和藥物治療. 中國現代藥物應用, 2008, 2(1): 48-50.
17. 黃少卿, 蔡澤玲, 陳碧素, 等. 國內寧養家居護理現況. 實用醫技雜志, 2006, 13(12): 2143-2144.
18. Findlay GF. Adverse effects of the management of malignant spinal cord compression. Neurol Neurosurg Psychiatry, 1984, 47(8): 761-768.
19. Kocialkowski A, Webb JK. Metastatic spinal tumors: survival after surgery. Eur Spine J, 1992, 1(1): 43-48.
20. Choi D, Crockard A, Bunger C, et al. Review of metastatic spine tumour classification and indications for surgery: the consensus statement of the Global Spine Tumour Study Group. Eur Spine J. 2010, 19(2): 215-222.
21. Loblaw DA, Perry J, Chambers A, et al. Systematic review of the diagnosis and management of malignant extradural spinal cord compression: the cancer care Ontario practice guidelines initiative’s neuro-oncology disease site group. J Clin Oncol, 2005, 23(9): 2028-2037.

《中國循證醫學雜志》

手術對脊柱轉移性腫瘤患者晚期生命質量的影響

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《中國循證醫學雜志》

手術對脊柱轉移性腫瘤患者晚期生命質量的影響

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