Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands.
Oral Oncol. 2011 Aug;47(8):768-74. doi: 10.1016/j.oraloncology.2011.05.012. Epub 2011 Jun 17.
To examine the impact of late treatment-related xerostomia and dysphagia on health-related quality of life (HRQOL) in head and neck cancer (HNC) patients after radiotherapy. A multi-center cross-sectional survey was performed. Patients with a follow-up of at least 6months after curative radiotherapy, without evidence of recurrent disease were eligible for inclusion. The Euroqol-5D questionnaire (EQ-5D) was filled out and toxicity was scored and converted to the RTOG scale. The EQ-5D measures generic HRQOL in terms of utility and visual analogue scale (VAS) scores. Missing data on the EQ-5D were imputed using multiple imputation. HRQOL was compared between subgroups of patients with and without toxicity. Subsequently, the impact of xerostomia and dysphagia on HRQOL was analyzed using multivariate regression analyses. Both analyses were performed separately for utility scores and VAS scores. The study population was composed of 396 HNC patients. The average utility and VAS scores were 0.85 (scale 0-1) and 75 (scale 0-100). Subgroups of patients with xerostomia and/or dysphagia showed statistically significantly lower utility and VAS scores (P=0.000-0.022). The multivariate regression model showed that xerostomia and dysphagia were negative predictors of both utility and VAS scores. Other factors which influenced HRQOL in at least one of the two regression models were: sex, tumor location and the addition of surgery to radiotherapy. Xerostomia and dysphagia diminish generic HRQOL. Moreover dysphagia affects patients' HRQOL stronger than xerostomia.
为了研究治疗后口干和吞咽困难对接受放疗的头颈部癌症（HNC）患者的健康相关生活质量（HRQOL）的影响。进行了一项多中心横断面调查。接受根治性放疗后至少 6 个月且无疾病复发证据的患者符合入组条件。患者填写欧洲五维健康量表（EQ-5D）问卷，并对毒性进行评分并转换为 RTOG 量表。EQ-5D 以效用和视觉模拟评分（VAS）的形式衡量通用 HRQOL。EQ-5D 缺失数据采用多重插补法进行填补。比较了有和无毒性患者亚组之间的 HRQOL。随后，使用多变量回归分析分析了口干和吞咽困难对 HRQOL 的影响。这两种分析分别针对效用评分和 VAS 评分进行。该研究人群由 396 例 HNC 患者组成。平均效用和 VAS 评分分别为 0.85（0-1 分）和 75（0-100 分）。有口干和/或吞咽困难的患者亚组的效用和 VAS 评分均显著降低（P=0.000-0.022）。多变量回归模型显示，口干和吞咽困难是效用和 VAS 评分的负预测因子。在至少一个回归模型中影响 HRQOL 的其他因素包括：性别、肿瘤位置以及放疗加手术。口干和吞咽困难降低了通用 HRQOL。此外，吞咽困难对患者 HRQOL 的影响大于口干。
