巴西南部局部晚期头颈部癌症患者功能下降的预测因素。

Predictors of functional decline in locally advanced head and neck cancer patients from south Brazil.

机构信息

Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.

出版信息

Head Neck. 2010 Sep;32(9):1217-25. doi: 10.1002/hed.21322.

DOI:10.1002/hed.21322

PMID:20054850

Abstract

BACKGROUND

Functional decline in Brazilian patients with head and neck squamous cell carcinoma (HNSCC) is associated with impaired recovery, quality of life, and health care costs.

METHODS

Sixty patients enrolled at the regional oncology center in Curitiba, Brazil, were assessed over 6 months for toxicities, nutritional status, anthropometry, fatigue, stress, and functionality.

RESULTS

Severe mid-arm and mid-calf circumference depletion accompanied weight loss. Total fatigue score increased 64% (p < .001), as did perceived stress and serum cortisol (p = .01). Instrumental activities of daily living (IADL) dependence doubled, and activities of daily living (ADL) dependence quadrupled (p < .001). Difficulty chewing or swallowing, weight loss, fatigue, perceived stress, and IADL dependence accounted for 48.2% of ADL dependence.

CONCLUSIONS

The physical and psychological impact of HNSCC and its treatment are universally experienced; yet, screening and intervention for symptoms such as fatigue and stress are not typical clinical practice. Moreover, assessment of functional status is usually limited to chewing and swallowing. This study identified symptoms that require systematic intervention and randomized trials with functional independence as the outcome.

摘要

背景

巴西头颈部鳞状细胞癌（HNSCC）患者的功能下降与恢复不良、生活质量下降和医疗保健费用增加有关。

方法

巴西库里蒂巴地区肿瘤中心共招募了 60 名患者，在 6 个月的时间里对他们的毒性、营养状况、人体测量学、疲劳、压力和功能进行了评估。

结果

中臂和小腿中段周长严重减少伴随着体重减轻。总疲劳评分增加了 64%（p<0.001），同时感知压力和血清皮质醇也增加（p=0.01）。工具性日常生活活动（IADL）的依赖性增加了一倍，而日常生活活动（ADL）的依赖性增加了四倍（p<0.001）。咀嚼或吞咽困难、体重减轻、疲劳、感知压力和 IADL 的依赖性占 ADL 依赖性的 48.2%。