手术对脊柱转移性肿瘤患者晚期生命质量的影响_《中国循证医学杂志》

作者：

吴娟 ^1,3# , 郑伟 ^2# , 吴志鹏 ² , 胡晓媛 ³ ,  郭强 ³ , 肖建如 ²

1.中国人民解放军成都军区总医院药剂科（成都 610083）；2.中国人民解放军第二军医大学附属长征医院骨科（上海 200003）；3.中国人民解放军第二军医大学训练部（上海 200433）;

关键词：

脊柱转移性肿瘤手术治疗生存时间生命质量

DOI：

10.7507/1672-2531.20120162

视频：

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摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的　探讨手术治疗对脊柱转移性肿瘤患者晚期生命质量的影响，以及手术是否能延长此类患者的生存时间。
方法　以第二军医大学附属长征医院临床确诊的转移性脊柱肿瘤患者为研究对象，按其是/否接受手术分为手术组和非手术组。分别于确诊时，治疗后第1、3、6、9个月，应用FACT-G（Functional Assessment of Cancer Therapy-General）癌症患者生命质量评价量表进行5次生命质量测评并记录每位患者的生存时间，比较两组患者的生存时间以及生命质量的变化情况来评价脊柱手术的治疗效果。
结果　共纳入312例脊柱转移性肿瘤患者，其中手术组147例，非手术组165例。两组患者生存率差异无统计学意义（χ2=3.167，P=0.075）。在9个月内两组患者生命质量方面，手术组患者在生理、情感、功能以及总体状况方面的得分均高于非手术组。
结论　手术治疗能显著提高脊柱转移性肿瘤患者的生命质量，但不能延长患者的生存时间。

引用本文： 吴娟,郑伟,吴志鹏,胡晓媛,郭强,肖建如. 手术对脊柱转移性肿瘤患者晚期生命质量的影响. 中国循证医学杂志, 2012, 12(9): 1041-1046. doi: 10.7507/1672-2531.20120162 复制

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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, 党耕町, 唐天驷主译. 脊柱外科学. 第2版. 北京: 人民卫生出版社, 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. 肺癌治疗模式探讨与见解. 中华临床医师杂志（电子版）, 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. 杨锐, 陈钒, 戚宜晶, 等. 宁养院患者的临终关怀和药物治疗. 中国现代药物应用, 2008, 2(1): 48-50.
17. 黄少卿, 蔡泽玲, 陈碧素, 等. 国内宁养家居护理现况. 实用医技杂志, 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.

《中国循证医学杂志》

手术对脊柱转移性肿瘤患者晚期生命质量的影响

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《中国循证医学杂志》

手术对脊柱转移性肿瘤患者晚期生命质量的影响

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