Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Health Qual Life Outcomes. 2010 Sep 15;8:101. doi: 10.1186/1477-7525-8-101.
Concern regarding the health-related quality of life (HRQOL) of long-term survivors of thyroid cancer has risen due to the rapid increase in the incidence of thyroid cancer, which generally has an excellent prognosis. The aim of this study was to evaluate the status of HRQOL in disease-free survivors of differentiated thyroid carcinoma (DTC) and to evaluate the important determinants of HRQOL.
This was a cross-sectional study in which we interviewed consecutive disease-free survivors of DTC. Three different validated questionnaires ("EORTC QLQ-C30" for various functional domains, the "brief fatigue inventory (BFI)" and the "hospital anxiety and depression scale" (HADS)) were used. Data from a large, population based survey of 1,000 people were used as a control.
The response rate for the questionnaires was 78.9% (316/401). Disease-free survivors of DTC showed a decreased HRQOL in all five functional domains (physical, role, cognitive, emotional, and social) on the EORTC QLQ-C30 compared with controls (P < 0.01). BFI and HADS-anxiety scores also showed greater distress in disease-free survivors of DTC than in controls (P < 0.05). A multiple regression analysis for the determinants of HRQOL showed that the HADS-anxiety, HADS-depression, and BFI scores were the most significant components of decreased HRQOL.
Although disease-free survivors of DTC are expected to have disease-specific survival comparable to the general population, they experience a significantly decreased HRQOL. Anxiety, depression, and fatigue were the major determinants of the decreased HRQOL. Supportive psychological care should be integrated into the management of long-term survivors of DTC.
由于甲状腺癌的发病率迅速上升，而这种癌症通常预后良好，因此人们对长期生存的甲状腺癌患者的健康相关生活质量（HRQOL）越来越关注。本研究旨在评估分化型甲状腺癌（DTC）无病幸存者的 HRQOL 状况，并评估 HRQOL 的重要决定因素。
这是一项横断面研究，我们对连续的 DTC 无病幸存者进行了访谈。使用了三种不同的经过验证的问卷（用于各种功能领域的“EORTC QLQ-C30”，简短疲劳量表（BFI）和“医院焦虑和抑郁量表”（HADS））。还使用了一项针对 1000 人的大型人群调查的数据作为对照。
问卷的回复率为 78.9％（316/401）。与对照组相比，DTC 无病幸存者在 EORTC QLQ-C30 的所有五个功能领域（身体，角色，认知，情感和社会）中均显示出 HRQOL 下降（P <0.01）。 BFI 和 HADS-焦虑评分也显示出 DTC 无病幸存者的困扰大于对照组（P <0.05）。用于确定 HRQOL 决定因素的多元回归分析表明，HADS-焦虑，HADS-抑郁和 BFI 得分是 HRQOL 下降的最重要组成部分。
尽管 DTC 无病幸存者的疾病特异性生存率有望与普通人群相当，但他们的 HRQOL 明显下降。焦虑，抑郁和疲劳是 HRQOL 下降的主要决定因素。应将支持性心理护理纳入 DTC 长期幸存者的管理中。
