Chandu Arun, Sun Kenneth C V, DeSilva Rajeev N, Smith Andrew C H
Oral and Maxillofacial Surgery, Austin Health, Heidelberg, Victoria, Australia.
J Oral Maxillofac Surg. 2005 Nov;63(11):1606-12. doi: 10.1016/j.joms.2005.07.012.
The outcome of management strategies for the treatment of oral cancer has always been in terms of disease-specific survival. Modern assessment of outcome now also includes assessment of quality of life (QOL). Little has been done previously in Australia to assess the QOL of patients treated primarily by surgery for oral cancer.
Twenty-two patients who had undergone primary surgical management for oral cancer underwent assessment of QOL using the European Organization for Research and Treatment of Cancer QOL questionnaire version 3 (EORTC QLQ-C30) and the University of Washington Head and Neck QOL questionnaire version 4 (UWQOL). Similar emotional domains were compared and factors affecting QOL were determined.
Fifty-five percent of patients were male and 45% were female. The mean age was 61.8 years (range, 38 to 86 years) with a mean review time of 24.6 months (SD, 20.3 months) postoperatively. Good QOL scores were experienced by most patients. A new addition to the UWQOL version 4 was the mood and anxiety domains, and these correlated well with the emotional domains of the EORTC QLQ-C30 using Spearman rank correlations. Factors significantly affecting survival included age, overall stage, neck dissection, free flap, and postoperative radiotherapy using Mann-Whitney tests (P < .05). No significant difference in QOL was found in patients reviewed at either less than or greater than 1 year.
This study confirms previous reports in the literature. It has provided us with the foundation for further investigation of QOL in patients who have been and who will be treated for oral cancer. It also gives us a new measure of outcome to compare against survival rates.
口腔癌治疗管理策略的结果一直以疾病特异性生存率来衡量。现代对结果的评估现在还包括生活质量（QOL）评估。此前在澳大利亚，很少有人对主要接受手术治疗的口腔癌患者的生活质量进行评估。
22例接受口腔癌初次手术治疗的患者使用欧洲癌症研究与治疗组织生活质量问卷第3版（EORTC QLQ-C30）和华盛顿大学头颈生活质量问卷第4版（UWQOL）进行生活质量评估。对相似的情感领域进行比较，并确定影响生活质量的因素。
55%的患者为男性，45%为女性。平均年龄为61.8岁（范围38至86岁），术后平均复查时间为24.6个月（标准差20.3个月）。大多数患者生活质量评分良好。UWQOL第4版新增了情绪和焦虑领域，使用Spearman等级相关性分析发现，这些领域与EORTC QLQ-C30的情感领域相关性良好。使用Mann-Whitney检验发现，显著影响生存率的因素包括年龄、总体分期、颈部清扫、游离皮瓣和术后放疗（P < .05）。在术后不到1年或超过1年接受复查的患者中，生活质量没有显著差异。
本研究证实了文献中的先前报道。它为我们进一步研究已接受和即将接受口腔癌治疗的患者的生活质量提供了基础。它还为我们提供了一种新的结果衡量标准，可与生存率进行比较。
