Küçük hücre dışı akciğer kanserli hastalarda solunum fonksiyonları ve yaşam kalitesi
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Date
2006
Authors
Öztürk, Gül Ayşen
Journal Title
Journal ISSN
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Publisher
Uludağ Üniversitesi
Abstract
Küçük hücre dışı akciğer karsinomu (KHDAK) tanısı ile postoperatifveya definitif radyoterapi (RT) uygulanmış ve en az iki yıl yaşayan olgularda,solunum fonksiyonları ve yaşam kalitesi (YK) üzerinde etkili faktörleribelirlemektir.Gereç ve Yöntem: UÜTF Radyasyon Onkolojisi AD, RadyoterapiMerkezi'nde 1995-2004 yılları arasında KHDAK tanısı ile postoperatif veyadefinitif amaçlı RT uygulanmış ve en az iki yıl yaşayan 28 hasta yaşamkalitesi ve pulmoner fonksiyonlar açısından değerlendirildi. Hastalarınortanca yaşı 55 (sınırlar:39-74) olup, 2 (%7)'si kadındı. Radyoterapi, 16(%57) hastaya postoperatif, 12 (%43) hastaya definitif olarak uygulanmıştı.Üç (%11) hasta evre II B, 13 (%46) hasta evre IIIA ve 12 (%43) hasta da evreIIIB idi. Solunum fonksiyon testleri (SFT) spirometre ile yapılırken, YKdeğerlendirmesi için ?European Organization for Research and Treatment ofCancer Quality of Life Core Questionnaire? (EORTC QLQ-C30) soru anketinin 3. versiyonu kullanıldı. statistiki analizler SPSS 14 paket program kullanılarak yapıldı.Bulgular: Croncbach's-alfa ile ölçülen güvenilirlik testine göre YK anketi,sosyal fonksiyon (cronbach's-α=0,56) dışındaki tüm skalalar için güvenilir bulundu (cronbach's-α>0,60). Yaşın artması ile fizik fonksiyonda azalma saptandı (p=0,045). Eğitim düzeyi ile YK arasındaki ilişki incelendiğinde eğitim düzeyi yüksek olanlarda diğerlerine göre YK daha düşük bulundu(p=0,042). Komorbid hastalık varlığı yaşam kalitesini azaltan bir faktör olarak bulundu (p=0,020). Evrenin ilerlemesiyle ağrı (p=0,044) ve yorgunluk(p=0,031) semptomunda artma görüldü. KPS ile kognitif (p=0,033) ve fizikfonksiyonlar (p=0,029) arasında pozitif ilişkili olduğu saptandı.Fizik fonksiyon ile rol (p=0,001) ve kognitif fonksiyon (p=0,050)arasında anlamlı ilişki saptandı. Global yaşam kalitesi, fonksiyonel skalalardan sadece fizik fonksiyon (p=0,025) ve semptom skalalarından ise isadece yorgunluk (p=0,031) ile ilişkili bulundu. Dispne (p=0,026), ağrı(p=0,004), yorgunluk (p=0,000), iştah kaybı (p=0,000) ve bulantı-kusma(p=0,004) semptomlarının fizik fonksiyonu anlamlı ölçüde azaltan faktörlerolduğu görüldü. Bu faktörlere ek olarak uyku bozukluğunun kişinin hayatta kirol (p=0,045) ve emosyonel (p=0,010) fonksiyonlarını anlamlı derecede düşürdüğü bulundu. SFT parametreleri ile YK anket parametreleri arasında anlamlı ilişki saptanmadı (p>0,05).Sonuç: Çalışmamızda yaşam kalitesinin yaş, evre, komorbid hastalık, eğitim seviyesi, performans durumu gibi faktörlerden etkilendiğini saptadık. Bu nedenle KHDAK'li olguların tedavi planlaması sırasında daha kaliteli bir yaşam için bu faktörlerin göz önünde bulundurulması gerekebilir.
The aim of the study is to identify the factors which influencesthe respiration functions and quality of life (QOL) in the patients who weretreated with radiotherapy definitive or postoperatively and lived at least twoyears with the diagnosis of non-small cell lung carcinoma (NSCLC) .MATERIALS AND METHODS: In the Radiotherapy Center of UludagUniversity- Department of Radiation Oncology we have examined the qualityof life and pulmonary functions of 28 patients who were treated post-operative or definitive radiotherapy between 1995-2004 years and, who livedat least two years after non-small cell lung carcinoma (NSCLC) diagnosis.The patients were at an average age of 55 (range: 39-74) and two of themwere women. Radiotherapy was applied to the 16 of the patients (57%)postoperatively and to the 12 of the patients (43%) definitively. Three of thepatients (11%) were stage II B, 13 were stage III A, and 12 of them werestage III B. QOL was investigated through the 3rd version of ?EuropeanOrganization for Research and Treatment of Cancer Quality of Life CoreQuestionnaire? (EORTC QLQ-C30), while the tests of respiration functionswere made by using spirometry. Statistical analyses were made by usingSPSS 14 program.OUTCOMES: According to the reliability test (measured throughCroncbach?s-alfa) this Quality of Life Questionnaire was reliable (cronbach?s-α>0,60) regarding all the scales except for social function (cronbach?s-α=0,56). A decrease on physical functions was identified as the ageincreased (p=0,045). When the relation between educational level and QOLwas investigated, the QOL was relatively low for the patients whoseeducational levels were higher (p=0,042). The existence of comorbid diseaseiwas found to be a factor decreasing quality of life (p=0,020). Pain and fatiguesymptoms were increased in advanced stages (p=0,044; p=0,031). It wasidentified that there was a positive relation between Karnofsky PerformanceScale (KPS) and cognitive- physical functions (p=0,033; p=0,029).A significant relationship was found between physical functions, role(p=0,001) and cognitive functions (p=0,050). Global quality of life was foundto be related only with physical functions (p=0,025) in the functional scalesand related only with fatigue (p=0,031) in the symptom scales. It was foundthat dyspnea (p=0,026), pain (p=0,004), fatigue (p=0,000), loss of apetite(p=0,000) and nausea-vomitting (p=0,004) symptoms decrease the physicalfunctions significantly. In addition to these factors, sleep disorder was foundto decrease the role (p=0,045) and the emotional (p=0,010) functions of theindividual, significantly. There was no significant relation between RespiratoryFunctional Test parameters and QOL questionnaire parameters (p>0,05).CONCLUSION: In the present study it was found that quality of life waseffected by factors such as age, stage, comorbid disease, educational leveland performance status. Hence, these factors should be considered duringthe treatment planning of patients of NSCLC in order to have a more qualifiedlife.
The aim of the study is to identify the factors which influencesthe respiration functions and quality of life (QOL) in the patients who weretreated with radiotherapy definitive or postoperatively and lived at least twoyears with the diagnosis of non-small cell lung carcinoma (NSCLC) .MATERIALS AND METHODS: In the Radiotherapy Center of UludagUniversity- Department of Radiation Oncology we have examined the qualityof life and pulmonary functions of 28 patients who were treated post-operative or definitive radiotherapy between 1995-2004 years and, who livedat least two years after non-small cell lung carcinoma (NSCLC) diagnosis.The patients were at an average age of 55 (range: 39-74) and two of themwere women. Radiotherapy was applied to the 16 of the patients (57%)postoperatively and to the 12 of the patients (43%) definitively. Three of thepatients (11%) were stage II B, 13 were stage III A, and 12 of them werestage III B. QOL was investigated through the 3rd version of ?EuropeanOrganization for Research and Treatment of Cancer Quality of Life CoreQuestionnaire? (EORTC QLQ-C30), while the tests of respiration functionswere made by using spirometry. Statistical analyses were made by usingSPSS 14 program.OUTCOMES: According to the reliability test (measured throughCroncbach?s-alfa) this Quality of Life Questionnaire was reliable (cronbach?s-α>0,60) regarding all the scales except for social function (cronbach?s-α=0,56). A decrease on physical functions was identified as the ageincreased (p=0,045). When the relation between educational level and QOLwas investigated, the QOL was relatively low for the patients whoseeducational levels were higher (p=0,042). The existence of comorbid diseaseiwas found to be a factor decreasing quality of life (p=0,020). Pain and fatiguesymptoms were increased in advanced stages (p=0,044; p=0,031). It wasidentified that there was a positive relation between Karnofsky PerformanceScale (KPS) and cognitive- physical functions (p=0,033; p=0,029).A significant relationship was found between physical functions, role(p=0,001) and cognitive functions (p=0,050). Global quality of life was foundto be related only with physical functions (p=0,025) in the functional scalesand related only with fatigue (p=0,031) in the symptom scales. It was foundthat dyspnea (p=0,026), pain (p=0,004), fatigue (p=0,000), loss of apetite(p=0,000) and nausea-vomitting (p=0,004) symptoms decrease the physicalfunctions significantly. In addition to these factors, sleep disorder was foundto decrease the role (p=0,045) and the emotional (p=0,010) functions of theindividual, significantly. There was no significant relation between RespiratoryFunctional Test parameters and QOL questionnaire parameters (p>0,05).CONCLUSION: In the present study it was found that quality of life waseffected by factors such as age, stage, comorbid disease, educational leveland performance status. Hence, these factors should be considered duringthe treatment planning of patients of NSCLC in order to have a more qualifiedlife.
Description
Keywords
Küçük hücre dışı akciğer kanseri, Radyoterapi, Solunum fonksiyonları, Yaşam kalitesi, Non-small cell lung cancer, Radiotherapy, Respiratoryfunctions, Quality of life
Citation
Öztürk, G. A. (2006). Küçük hücre dışı akciğer kanserli hastalarda solunum fonksiyonları ve yaşam kalitesi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.