颈部清扫术后的短期和长期生活质量
Short-term and long-term quality of life after neck dissection.
作者信息
Shah S, Har-El G, Rosenfeld R M
机构信息
Department of Otolaryngology, State University of New York, Health Science Center at Brooklyn, 134 Atlantic Avenue, Brooklyn, New York 11201, USA.
出版信息
Head Neck. 2001 Nov;23(11):954-61. doi: 10.1002/hed.1138.
INTRODUCTION
Quality of life (QOL) is an important outcome measure in cancer therapy. Neck dissection (ND) morbidity has been well studied, but no study has focused on the quality of life after ND specifically.
METHODS
Fifty-one patients who have undergone ND completed a 6-item quality-of-life survey with a 7-point frequency and interference response scale. General QOL and comorbidity biases were evaluated with the SF-12 questionnaire and the Charlson comorbidity index.
RESULTS
The following symptoms were the most commonly experienced after surgery: neck tightness (71%), numbness or burning of the ear (57%), and shoulder discomfort (53%). However, interference with daily activities was reported by only 37%, 32%, and 33% of patients with these symptoms, respectively. Within 2 years of surgery, interference with daily activities decreased to 17%, 18%, and 12%, respectively. QOL after ND was negatively associated with previous radiation, previous chemotherapy, tumor stage, and more radical neck surgery but was positively associated with time after surgery. Shoulder discomfort and neck tightness had the greatest affect on QOL.
CONCLUSIONS
Our results suggest that patients should receive preoperative counseling regarding the morbidities from ND and the possible short-term and long-term impact on QOL. Further studies evaluating the relationship between primary tumor characteristics and quality of life after ND need to be undertaken.
引言
生活质量(QOL)是癌症治疗中的一项重要疗效指标。颈部清扫术(ND)的发病率已得到充分研究,但尚无研究专门关注颈部清扫术后的生活质量。
方法
51例接受过颈部清扫术的患者完成了一项包含6个项目的生活质量调查,采用7分频率和干扰反应量表。使用SF - 12问卷和查尔森合并症指数评估总体生活质量和合并症偏差。
结果
术后最常出现的症状如下:颈部紧绷感(71%)、耳部麻木或烧灼感(57%)以及肩部不适(53%)。然而,分别只有37%、32%和33%出现这些症状的患者报告日常活动受到干扰。在术后2年内,日常活动受到干扰的比例分别降至17%、18%和12%。颈部清扫术后的生活质量与既往放疗、既往化疗、肿瘤分期以及更根治性的颈部手术呈负相关,但与术后时间呈正相关。肩部不适和颈部紧绷感对生活质量的影响最大。
结论
我们的结果表明,应向患者提供关于颈部清扫术发病率以及对生活质量可能产生的短期和长期影响的术前咨询。需要进一步开展研究以评估原发性肿瘤特征与颈部清扫术后生活质量之间的关系。