Loughran S, Calder N, MacGregor F B, Carding P, MacKenzie K
Department of Otolaryngology, Head and Neck Surgery, Glasgow Royal Infirmary, Glasgow, UK.
Clin Otolaryngol. 2005 Feb;30(1):42-7. doi: 10.1111/j.1365-2273.2004.00919.x.
To assess whether proposed voice and quality of life (QoL) outcome measures were likely to be acceptable to patients previously treated for early glottic cancer by either radiotherapy or endoscopic resection, as well as looking for differences in QoL and voice between treatments.
Questionnaire-based cohort study.
Secondary care, three centres.
All patients treated for T1a or in situ glottic carcinoma between 1997 and 2003. Fifty-three patients were identified; those who had undergone salvage surgery or radiotherapy were excluded. A proportion refused to participate or could not be contacted and two patients had died of unrelated causes. Thirty-six patients completed the trial with 18 from each treatment arm.
Quality of voice as assessed by three questionnaires, Voice Handicap Index (VHI), Vocal Performance Questionnaire (VPQ), Voice Symptom Score (VoiSS) and perceptual analysis of voice by Grade, Roughness, Breathiness, Asthenia and Strained (GRBAS) assessment of vocal recordings. Quality of life as assessed by the Hospital Anxiety and Depression Scale (HADS), University of Washington Quality of Life Questionnaire (UW-QoL), and the Functional Assessment of Cancer Therapy (FACT) questionnaire.
All patients included in the trial were able to complete the questionnaires; however, 19% required assistance of some kind. GRBAS assessment showed no difference between groups for any criteria. All QoL questionnaires gave equivalent good scores. All of the voice questionnaires showed no statistical difference between groups except for the emotional subscale of the VoiSS which showed a significantly better score for the radiotherapy arm (P = 0.04).
All outcome measures were applicable and acceptable to the patient group. Overall QoL and voice appears similar despite treatment arm, apart from the emotional subscale of the VoiSS. A randomized controlled trial is required to further assess this question.
评估拟用的嗓音和生活质量（QoL）结局指标对于既往接受过放射治疗或内镜切除的早期声门癌患者是否可能为可接受的，同时探寻不同治疗方法之间在生活质量和嗓音方面的差异。
基于问卷的队列研究。
二级医疗保健机构，三个中心。
1997年至2003年间接受T1a期或原位声门癌治疗的所有患者。共识别出53例患者；排除了那些接受过挽救性手术或放射治疗的患者。一部分患者拒绝参与或无法联系上，还有两名患者死于无关原因。36例患者完成了试验，每个治疗组各有18例。
通过三份问卷评估嗓音质量，即嗓音障碍指数（VHI）、嗓音表现问卷（VPQ）、嗓音症状评分（VoiSS），以及通过对嗓音录音进行等级、粗糙度、气息声、无力感和紧张度（GRBAS）评估进行嗓音的感知分析。通过医院焦虑抑郁量表（HADS）、华盛顿大学生活质量问卷（UW-QoL）和癌症治疗功能评估（FACT）问卷评估生活质量。
纳入试验的所有患者均能够完成问卷；然而，19%的患者需要某种形式的协助。GRBAS评估显示，在任何标准下两组之间均无差异。所有生活质量问卷给出的分数相当。除VoiSS的情绪子量表外，所有嗓音问卷显示两组之间无统计学差异，VoiSS的情绪子量表显示放射治疗组的得分显著更高（P = 0.04）。
所有结局指标对于该患者群体都是适用且可接受的。尽管治疗组不同，但总体生活质量和嗓音似乎相似，VoiSS的情绪子量表除外。需要进行一项随机对照试验来进一步评估这个问题。
