Petruson Karin M, Silander Ewa M, Hammerlid Eva B
Department of Otorhinolaryngology Head and Neck Surgery, Sahlgrenska University Hospital, S-413 45 Göteborg, Sweden.
Head Neck. 2005 Apr;27(4):302-10. doi: 10.1002/hed.20172.
The purpose of this prospective study was to evaluate whether a relationship exists between malnutrition (> or =10% weight loss) and health-related quality of life (HRQL) in patients with head and neck cancer and whether weight loss can be predicted with HRQL questionnaires.
Weight and HRQL were monitored in 49 patients. HRQL was assessed longitudinally, using the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30), the EORTC Head and Neck Cancer module (QLQ-H&N35), and the Hospital Anxiety and Depression Scale (HADS).
At diagnosis, those patients who had a weight loss greater than 10% (n = 20) after treatment scored significantly worse on 15 of 28 HRQL variables than did patients who lost less (n = 29). The largest difference (Delta > or =20) was found for role functioning, fatigue, loss of appetite, global quality of life, sticky saliva, and swallowing. Differences in HRQL persisted even after 3 years. The fatigue scale was the only significant predictor of weight loss (p = .005) at diagnosis.
Patients with head and neck cancer who are at risk of severe weight loss developing during treatment may be detected with the aid of HRQL questionnaires at diagnosis.
这项前瞻性研究的目的是评估头颈癌患者的营养不良（体重减轻≥10%）与健康相关生活质量（HRQL）之间是否存在关联，以及体重减轻是否可以通过HRQL问卷进行预测。
对49例患者的体重和HRQL进行监测。使用欧洲癌症研究与治疗组织生活质量核心问卷（EORTC QLQ-C30）、EORTC头颈癌模块（QLQ-H&N35）和医院焦虑抑郁量表（HADS）对HRQL进行纵向评估。
在诊断时，治疗后体重减轻超过10%的患者（n = 20）在28个HRQL变量中的15个变量上的得分明显低于体重减轻较少的患者（n = 29）。在角色功能、疲劳、食欲减退、总体生活质量、唾液黏稠和吞咽方面发现了最大差异（Δ≥20）。即使在3年后，HRQL的差异仍然存在。疲劳量表是诊断时体重减轻的唯一显著预测因素（p = 0.005）。
在诊断时借助HRQL问卷可能检测出治疗期间有发生严重体重减轻风险的头颈癌患者。
