Jellema Anke Petra, Slotman Ben J, Doornaert Patricia, Leemans C René, Langendijk Johannes A
Department of Radiation Oncology, University Medical Center, Utrecht, The Netherlands.
Int J Radiat Oncol Biol Phys. 2007 Nov 1;69(3):751-60. doi: 10.1016/j.ijrobp.2007.04.021. Epub 2007 Jun 8.
To investigate the impact of xerostomia on overall quality of life (QoL) outcome and related dimensions among head and neck cancer patients treated with primary radiotherapy.
A total of 288 patients with Stage I-IV disease without distant metastases were included. Late xerostomia according to the Radiation Therapy Oncology Group (RTOG-xerostomia) and QoL (European Organization for Research and Treatment of Cancer QLC-C30) were assessed at baseline and every 6th month from 6 months to 24 months after radiotherapy.
A significant association was found between RTOG-xerostomia and overall QoL outcome (effect size [ES] 0.07, p < 0.001). A significant relationship with global QoL, all functioning scales, and fatigue and insomnia was observed. A significant interaction term was present between RTOG-xerostomia and gender and between RTOG-xerostomia and age. In terms of gender, RTOG-xerostomia had a larger impact on overall QoL outcome in women (ES 0.13 for women vs. 0.07 for men). Furthermore, in women ES on individual scales were larger, and a marked worsening was observed with increasing RTOG-xerostomia. No different ES according to age was seen (ES 0.10 for 18-65 years vs. 0.08 for >65 years). An analysis of the impact of RTOG-xerostomia on overall QoL outcome over time showed an increase from 0.09 at 6 months to 0.22 at 24 months. With elapsing time, a worsening was found for these individual scales with increasing RTOG-xerostomia.
The results of this prospective study are the first to show a significant impact of radiation-induced xerostomia on QoL. Although the incidence of Grade > or =2 RTOG-xerostomia decreases with time, its impact on QoL increases. This finding emphasizes the importance of prevention of xerostomia.
探讨口干症对接受原发性放射治疗的头颈癌患者总体生活质量（QoL）结局及相关维度的影响。
共纳入288例无远处转移的I-IV期疾病患者。根据放射肿瘤学组（RTOG-口干症）评估晚期口干症，并在放疗后6个月至24个月期间，于基线及每6个月评估一次生活质量（欧洲癌症研究与治疗组织QLC-C30）。
发现RTOG-口干症与总体生活质量结局之间存在显著关联（效应大小[ES]0.07，p<0.001）。观察到与总体生活质量、所有功能量表、疲劳和失眠存在显著关系。RTOG-口干症与性别之间以及RTOG-口干症与年龄之间存在显著的交互项。在性别方面，RTOG-口干症对女性总体生活质量结局的影响更大（女性ES为0.13，男性为0.07）。此外，在女性中，各量表的ES更大，且随着RTOG-口干症加重，观察到明显恶化。未观察到年龄相关的ES差异（18-65岁ES为0.10，>65岁为0.08）。对RTOG-口干症随时间对总体生活质量结局的影响进行分析，结果显示从6个月时的0.09增加到24个月时的0.22。随着时间推移，随着RTOG-口干症加重，这些个体量表出现恶化。
这项前瞻性研究的结果首次表明放射性口干症对生活质量有显著影响。尽管≥2级RTOG-口干症的发生率随时间下降，但其对生活质量的影响却在增加。这一发现强调了预防口干症的重要性。
