头颈部肿瘤患者功能状态评分与放射治疗急性放射性损伤及近期效果的相关性

摘要

目的：探讨头颈部肿瘤患者功能状态( PS)评分与放射治疗急性放射性损伤及近期效果的相关性。方法对在我院首次行根治性放射治疗的头颈部肿瘤37例采用Zubrod-ECOG-WHO( ZPS 5分法)评分标准评估放射治疗前PS评分，于放射治疗结束后1个月评估近期效果，采用多元Logistic回归分析分析患者放射治疗前PS评分、放射剂量与急性放射性损伤的相关性，同时分析患者放射治疗前PS评分与放射治疗近期效果的相关性。结果多元Lo-gistic回归分析显示放射治疗前PS评分、放射剂量与口干、放射性皮炎、黏膜炎、味觉障碍、咽炎或咽喉炎、疲劳及吞咽困难有明显相关性，差异有统计学意义( P=0．001或P<0．001)；放射剂量与厌食有相关性，差异有统计学意义( P<0．001)。放射治疗结束后1个月本组完全缓解(CR)者占32.43%，部分缓解者占37.84%，稳定者占21.62%，进展者占8.11%。多元Logistic回归分析显示放射治疗前PS评分与放射治疗近期效果有明显相关性，差异有统计学意义(P<0．001)。结论头颈部肿瘤患者放射治疗前PS评分越高、放射剂量越大，急性放射性损伤越严重；放射治疗前PS评分越高近期治疗效果越差。%Objective To analyze the performance state ( PS) score of patients with the head and neck cancer and its relationship with acute radiation toxicity and short-term efficacy. Methods 37 patients with head and neck tumors underwent radical radiotherapy for the first time in our hospital and Zubrod-ECOG-WHO ( ZPS, 5 scores method) score standard was used to evaluate PS scores before radiotherapy. We evaluated recent effects of radiotherapy one month after treatment respec-tively. Logistic regression for the analysis of relationship among PS scores before radiotherapy of patients was used to evaluate the dose of radiation and acute radiation toxicity simultaneously and to analyze the correlation between PS score before radio-therapy and recent efficacy. Results Logistic regression analysis showed that PS score before radiotherapy and radiation dose were significantly correlated with mouth drying, radiodermatitis, mucositis, dysgeusia, pharyngitis or sore throat, fatigue and swallowing difficulty. The difference was statistically significant (P=0. 001 or P<0. 001). Radiation dose was positively cor-related with anorexia and the difference was significant (P<0. 001). We recorded 32. 43% of complete remission after one month of radiotherapy, partial remission accounted for 37. 84%, 21. 62%, which was in a stable stage and 8. 11% was in progress. Logistic regression analysis showed a significant correlation between PS score before radiotherapy and recent efficacy after radiotherapy. The difference was statistically significant (P<0. 001). Conclusion High scores of PS scores before ra-diotherapy in patients with head and neck cancer and large dose of radiation therapy may lead to severe acute radiation toxcity, and high scores of PS scores before radiotherapy may lead to poor short-term efficacy.