Smith G I, Yeo D, Clark J, Choy E T, Gao K, Oates J, O'Brien C J
Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital, Sydney 2042, Australia.
Br J Oral Maxillofac Surg. 2006 Jun;44(3):187-92. doi: 10.1016/j.bjoms.2005.06.022. Epub 2005 Aug 10.
The aim of this study was to evaluate (by postal questionnaire) quality of life and function in patients who have had resections of oral cancer and reconstruction by radial forearm flaps. Between October 1987 and December 2002, 258 patients had reconstructions by radial forearm flaps after resection of tumours in the oral cavity. Of these, 139 surviving patients were identified from the database and were sent questionnaires comprising five sections: Functional Assessment of Cancer Therapy-General (FACT-G) and -Head and Neck (FACT-HN); University of Washington Quality of Life Scale (UWQoL); Performance Status Scale for Head and Neck Cancer (PSS-HN); and the final section addressed dental rehabilitation and morbidity at the donor site. Sixty-three questionnaires (45%) were returned. In 17 (27%), parts of the questionnaire were incomplete. The median UWQoL score was 623/900, FACT-G was 92/108, FACT-HN was 31/48, and PSS-HN showed that eating in public, understandability of speech and normality of diet were 75/100, 75/100 and 50/100, respectively. The effect of stage and site on quality of life and function did not reach statistical significance. The effect of radiotherapy on speech (p=0.036) and diet (p=0.007) was significant. Patients who worried about their cancer returning had a lower UWQoL score (p=0.016). Ninety percent regarded their arm as disfigured, but 81% felt comfortable wearing short-sleeved shirts. Sensation and function of the hand were reported as normal in 87 and 92%, respectively. We conclude that patients who have had oral cancer have a persistent reduction in quality of life and function long after completion of treatment. The effects can be assessed by postal questionnaire, but the low rate of return (45%) and difficulties with completion reduce the quality of the data. Quality of life and function are essential components of improvements in outcome.
本研究的目的是（通过邮寄问卷）评估口腔癌切除并采用桡侧前臂皮瓣重建术后患者的生活质量和功能。1987年10月至2002年12月期间，258例患者在口腔肿瘤切除后采用桡侧前臂皮瓣进行了重建。其中，从数据库中识别出139例存活患者，并向他们发送了包含五个部分的问卷：癌症治疗功能评估通用版（FACT-G）和头颈版（FACT-HN）；华盛顿大学生活质量量表（UWQoL）；头颈癌性能状态量表（PSS-HN）；最后一部分涉及牙齿修复和供区发病率。63份问卷（45%）被退回。17份问卷（27%）部分内容不完整。UWQoL评分中位数为623/900，FACT-G为92/108，FACT-HN为31/48，PSS-HN显示在公共场合进食、言语可懂度和饮食正常度分别为75/100、75/100和50/100。分期和部位对生活质量和功能的影响未达到统计学意义。放疗对言语（p = 0.036）和饮食（p = 0.007）的影响具有统计学意义。担心癌症复发的患者UWQoL评分较低（p = 0.016）。90%的患者认为其手臂有畸形，但81%的患者觉得穿短袖衬衫很舒服。分别有87%和92%的患者报告手部感觉和功能正常。我们得出结论，口腔癌患者在治疗结束后很长时间内生活质量和功能持续下降。这些影响可以通过邮寄问卷进行评估，但问卷回收率低（45%）以及填写困难降低了数据质量。生活质量和功能是改善治疗结果的重要组成部分。
