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目的探讨甲地孕酮(MPA)在肿瘤化疗期间及化疗后对改善晚期直肠癌患者生活质量的作用。方法搜集新疆医科大学第一附属医院2007年6月—2010年2月收治的143例晚期直肠癌患者,将其随机分为单纯化疗(对照组)及化疗联合MPA(试验组),观察治疗期间及化疗后食欲、食量、体质量变化,化疗毒副作用及全身情况变化。结果试验组47例(64.4%)进食量增加,42例(57.5%)体质量增加;对照组10例(14.3%)进食量增加,6例(8.6%)体质量增加,两组比较差异均有统计学意义(P=0.0001)。试验组53例(72.6%)体力状况(KPS)评分改善,对照组13例(18.6%)KPS评分改善,两组比较差异有统计学意义(P=0.0001)。两组腹泻发生率比较差异无统计学意义(P=0.304),而试验组恶心、呕吐的发生率尤其是Ⅲ～Ⅳ度恶心、呕吐的发生率较对照组均明显减轻,差异有统计学意义(P<0.05)。两组血红蛋白下降,发生Ⅲ～Ⅳ度贫血及平均恢复时间,白细胞计数下降,发生Ⅲ～Ⅳ度白细胞计数下降及平均恢复时间比较差异均有统计学意义(P<0.05)。两组血小板计数下降,发生Ⅲ～Ⅳ度血小板计数下降及平均恢复时间比较差异无统计学意义(P>0.05)。试验组31例(42.5%)出现脱发反应,对照组39例(55.7%)出现脱发反应,两组比较差异有统计学意义(P<0.05)。结论 MPA可明显降低晚期直肠癌患者化疗时消化道毒副作用,提高食欲,改善患者的化疗期间及化疗后生活质量。
Objective To investigate the effect of megestrol (MPA) on the quality of life of advanced rectal cancer patients during chemotherapy and after chemotherapy. Methods A total of 143 patients with advanced rectal cancer who were admitted to the First Affiliated Hospital of Xinjiang Medical University from June 2007 to February 2010 were randomly divided into simple chemotherapy (control group) and chemotherapy combined with MPA (experimental group) And after chemotherapy, appetite, food intake, body weight changes, side effects of chemotherapy and systemic conditions change. Results In the experimental group, the food intake increased in 47 cases (64.4%) and the body mass increased in 42 cases (57.5%). In the control group, the food intake increased in 10 cases (14.3%) and the body weight increased in 6 cases (8.6% There was statistical significance (P = 0.0001). The KPS scores improved in 53 cases (72.6%) in the experimental group, while the KPS scores improved in 13 cases (18.6%) in the control group. There was significant difference between the two groups (P = 0.0001). The incidence of diarrhea was no significant difference between the two groups (P = 0.304), while the incidence of nausea and vomiting in the experimental group, especially the incidence of nausea and vomiting Ⅲ ~ Ⅳ degrees were significantly reduced compared with the control group, the difference was statistically significant (P <0.05). Two groups of hemoglobin decreased, Ⅲ ~ Ⅳ degree of anemia and average recovery time, white blood cell count decreased, Ⅲ ~ Ⅳ grade white blood cell count decreased and the average recovery time difference was statistically significant (P <0.05). Platelet count decreased in both groups, and the incidence of Ⅲ ~ Ⅳ platelet count decreased and the average recovery time was no significant difference (P> 0.05). In the test group, hair loss occurred in 31 cases (42.5%) and hair loss in 39 cases (55.7%) in the control group. There was significant difference between the two groups (P <0.05). Conclusions MPA can significantly reduce the gastrointestinal side effects of chemotherapy in patients with advanced rectal cancer, improve appetite and improve the quality of life of patients after chemotherapy and chemotherapy.