Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
BMC Cancer. 2011 Apr 12;11:128. doi: 10.1186/1471-2407-11-128.
With the advances in modern radiotherapy (RT), many patients with head and neck cancer (HNC) can be effectively cured, and their health-related quality of life (HR-QoL) has become an important issue. In this study, we evaluated the prognosticators of HR-QoL in a large cohort of HNC patients, with a focus on the result from technological advances in RT.
A cross-sectional investigation was conducted to assess the HR-QoL of 640 HNC patients with cancer-free survival of more than 2 years. Among them, 371 patients were treated by two-dimensional RT (2DRT), 127 by three-dimensional conformal RT (3DCRT), and 142 by intensity-modulated RT (IMRT). The EORTC QLQ-C30 questionnaire and QLQ-H&N35 module were used. A general linear model multivariate analysis of variance was used to analyze the prognosticators of HR-QoL.
By multivariate analysis, the variables of gender, annual family income, tumor site, AJCC stage, treatment methods, and RT technique were prognosticators for QLQ-C30 results, so were tumor site and RT technique for H&N35. Significant difference (p < 0.05) of HR-QoL outcome by different RT techniques was observed at 2 of the 15 scales in QLQ-C30 and 10 of the 13 scales in H&N35. Compared with 2DRT, IMRT had significant better outcome in the scales of global QoL, physical functioning, swallowing, senses (taste/smell), speech, social eating, social contact, teeth, opening mouth, dry mouth, sticky saliva, and feeling ill.
The technological advance of RT substantially improves the head-and-neck related symptoms and broad aspects of HR-QoL for HNC survivors.
随着现代放射治疗（RT）的进步，许多头颈部癌症（HNC）患者可以得到有效治疗，他们的健康相关生活质量（HR-QoL）已成为一个重要问题。在这项研究中，我们评估了大样本 HNC 患者 HR-QoL 的预后因素，重点关注 RT 技术进步的结果。
进行了一项横断面研究，以评估 640 例无癌症生存时间超过 2 年的 HNC 患者的 HR-QoL。其中，371 例患者接受二维 RT（2DRT）治疗，127 例患者接受三维适形 RT（3DCRT）治疗，142 例患者接受调强 RT（IMRT）治疗。使用 EORTC QLQ-C30 问卷和 QLQ-H&N35 模块。采用一般线性模型多变量方差分析来分析 HR-QoL 的预后因素。
通过多变量分析，性别、家庭年收入、肿瘤部位、AJCC 分期、治疗方法和 RT 技术等变量是 QLQ-C30 结果的预后因素，肿瘤部位和 RT 技术也是 H&N35 的预后因素。在 QLQ-C30 的 15 个量表中的 2 个和 H&N35 的 13 个量表中的 10 个量表中，观察到不同 RT 技术的 HR-QoL 结果存在显著差异（p<0.05）。与 2DRT 相比，IMRT 在全球 QoL、身体功能、吞咽、味觉/嗅觉、言语、社交进食、社交接触、牙齿、张口、口干、粘唾液和不适方面的评分显著更好。
RT 技术的进步显著改善了 HNC 幸存者的头颈部相关症状和广泛的 HR-QoL。
