Ohlwein S, Kruse E, Steiner W, Kiese-Himmel C
Abt. Phoniatrie/Pädaudiologie, Georg-August-Universität Göttingen, Göttingen.
Laryngorhinootologie. 2005 Apr;84(4):253-60. doi: 10.1055/s-2005-860990.
Quality of life is a relevant criterion for therapeutical outcome in laryngeal carcinoma patients. The aim of this study was to assess the self-related complaints in quality of life and functional outcome of voice among persons who had undergone laryngeal cancer surgery.
The examination took place 67 months (SD 34.8) after the last surgery, on average and finishing of 60 therapy sessions (median). First a measurement with the Goettinger Hoarseness Diagram (GHD) was carried out. Next the subjects answered self-reported standardized questionnaires for life quality in oncological patients on the same day: EORTC-QLQ-C30 and 3 scales of the German Fragebogen zur Lebenszufriedenheit (health-related fulfillment, fulfillment with work/occupation, fulfillment with social environment). For disease-related symptoms of different head and neck domains the EORTC-HandN35 was administered.
Forty-four patients (37 males, 7 females) who were treated primarily with minimal invasive laser surgery followed by functional voice rehabilitation (Goettinger Konzept). Mean age: 60.1 (SD 9.7) years.
The acoustic voice quality according to the GHD showed a significant correlation with self-reported "Somatic Functioning" (- 0.32, p = 0.04) and "Social Functioning" (- 0.38, p = 0.01) in the EORTC-QLQ-C30 as well as with the symptom scales "Speech" (0.45, p < 0.0024) resp. "Social Contact" (0.45, p = 0.0021) in the EORTC-HandN35. Also hoarseness and health-related fulfillment (- 0.36, p = 0.02) as well as fulfillment with work/occupation (- 0.33, p = 0.03) correlated significantly. On the other hand, there was no significant association between the GHD and the assessment of global quality of life.
Postoperative phonatory reductions in patients with laser surgically treated laryngeal carcinoma have only a slight influence on overall quality of life. The same is true for the GHD. Assessment of self-reported quality of life in recommendation of oncologic treatment may not be able to replace the objective findings, but may be useful to detect other problems, e.g. psychosocial.
生活质量是喉癌患者治疗结果的一个相关标准。本研究的目的是评估接受喉癌手术患者生活质量中与自身相关的主诉以及嗓音功能结果。
检查在最后一次手术后平均67个月(标准差34.8)、中位完成60次治疗疗程时进行。首先使用哥廷根嘶哑图(GHD)进行测量。接下来,受试者在同一天回答关于肿瘤患者生活质量的自我报告标准化问卷:欧洲癌症研究与治疗组织生活质量问卷核心30条目(EORTC-QLQ-C30)以及德国生活满意度问卷的3个量表(与健康相关的满意度、对工作/职业的满意度、对社会环境的满意度)。对于不同头颈区域的疾病相关症状,使用欧洲癌症研究与治疗组织头颈癌问卷(EORTC-HandN35)。
44例患者(37例男性,7例女性),主要接受微创激光手术治疗,随后进行功能性嗓音康复(哥廷根概念)。平均年龄:60.1(标准差9.7)岁。
根据GHD得出的声学嗓音质量与EORTC-QLQ-C30中的自我报告“躯体功能”(-0.32,p = 0.04)和“社会功能”(-0.38,p = 0.01)以及EORTC-HandN35中的症状量表“言语”(0.45,p < 0.0024)和“社会接触”(0.45,p = 0.0021)显著相关。此外,嘶哑与与健康相关的满意度(-0.36,p = 0.02)以及对工作/职业的满意度(-0.33,p = 0.03)也显著相关。另一方面,GHD与总体生活质量评估之间没有显著关联。
接受激光手术治疗的喉癌患者术后发声能力下降对总体生活质量的影响较小。GHD情况也是如此。在肿瘤治疗推荐中,自我报告的生活质量评估可能无法取代客观检查结果,但可能有助于发现其他问题,例如心理社会问题。