Krüskemper Gertrud, Handschel Jörg
Department of Medical Psychology, Ruhr-Universität Bochum, Universitätsstr. 150, Building MA 0/145, 44780 Bochum, Germany.
Clin Oral Investig. 2012 Oct;16(5):1353-61. doi: 10.1007/s00784-011-0631-y. Epub 2011 Oct 20.
Smoking is a causative factor in oral squamous cell carcinomas (SCC). Unfortunately, only poor data exist regarding the quality of life of smokers vs non-smokers with SCC. The purpose of this study is to show a correlation between variables for comprehensive interdisciplinary rehabilitation and better patient quality of life (LQ). A total collective of 1,761 patients from 38 hospitals within the German-language area of Germany, Austria and Switzerland (DÖSAK-REHAB-STUDIE) yielding 1,652 patients' questionnaires containing 147 items were evaluated. They refer to the periods before (t1) and immediately after surgery (t2), as well as at least 6 months later (t3). LQ was determined by the patient and ranges from 0% to 100%. Significant differences were found between smokers (80%) and non-smokers (20%) with respect to diagnosis, therapy and rehabilitation. Disabilities and impairments in speech, appearance, chewing/swallowing, pain and LQ were examined. Smokers were more often and more severely affected. Differences were found in the size of the tumour, scar tissue, ingestion, functionality of the facial muscles and a numb feeling in the head and shoulder area. Smoking has a severe effect on the oral cavity. Non-smokers suffer far less from the effects of SCC and the ensuing therapy. During therapy and rehabilitation, the LQ is much higher in non-smokers. This supports the importance of enhanced efforts to inform people about the consequences of smoking so as to prevent them from smoking. Moreover, psychological support might be helpful to give up smoking.
吸烟是口腔鳞状细胞癌(SCC)的一个致病因素。不幸的是,关于SCC吸烟者与非吸烟者生活质量的可用数据很少。本研究的目的是揭示综合跨学科康复变量与更好的患者生活质量(LQ)之间的相关性。对来自德国、奥地利和瑞士德语区38家医院的1761名患者(DÖSAK - REHAB - STUDIE)进行了总体研究,共评估了1652份包含147个项目的患者问卷。这些问卷涉及手术前(t1)、手术后即刻(t2)以及至少6个月后(t3)的时间段。LQ由患者自行确定,范围为0%至100%。在诊断、治疗和康复方面,吸烟者(80%)和非吸烟者(20%)之间存在显著差异。对言语、外貌、咀嚼/吞咽、疼痛和LQ方面的残疾和损伤进行了检查。吸烟者受影响的频率更高且程度更严重。在肿瘤大小、瘢痕组织、摄入情况、面部肌肉功能以及头部和肩部区域的麻木感方面发现了差异。吸烟对口腔有严重影响。非吸烟者受SCC及其后续治疗影响的程度要小得多。在治疗和康复期间,非吸烟者的LQ要高得多。这支持了加大力度向人们宣传吸烟后果以防止他们吸烟的重要性。此外,心理支持可能有助于戒烟。