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复发性鼻咽癌挽救性鼻咽切除术后患者的生活质量。

Quality of life of patients after salvage nasopharyngectomy for recurrent nasopharyngeal carcinoma.

机构信息

Division of Head and Neck Surgery, Department of Surgery, University of Hong Kong Medical Center, Queen Mary Hospital, Hong Kong SAR, China.

出版信息

Cancer. 2012 Aug 1;118(15):3710-8. doi: 10.1002/cncr.26719. Epub 2011 Dec 16.

Abstract

BACKGROUND

The objective of this study was to examine the quality of life (QOL) of patients who underwent salvage nasopharyngectomy for residual or recurrent nasopharyngeal carcinoma and to justify the value of the procedure.

METHODS

A self-reported, health-related QOL questionnaire was used to assess the QOL of patients after salvage nasopharyngectomy. The effects of potential complications after surgery also were evaluated.

RESULTS

Between 2003 and 2011, 185 patients underwent salvage nasopharyngectomy using the maxillary swing approach. Curative resection was achieved in 80% of patients. There were no significant changes in mean global health system scores after surgery, except after palliative resection requiring postoperative adjuvant chemoradiation. Social functioning scores were the lowest of the 5 functioning scales in all patient groups. Palatal fistula significantly affected social eating and weight loss, and osteoradionecrosis caused more pain and nasal discharge, severely affecting the social life of patients.

CONCLUSIONS

The QOL of patients after maxillary swing salvage nasopharyngectomy was good. The current results indicated that attention must be paid to the factors that adversely affect QOL after surgery, such as palliative resection, and complications like trismus, palatal fistula and osteoradionecrosis.

摘要

背景

本研究旨在探讨接受挽救性鼻咽切除术的残留或复发性鼻咽癌患者的生活质量(QOL),并论证该手术的价值。

方法

采用自我报告的健康相关 QOL 问卷评估挽救性鼻咽切除术后患者的 QOL。还评估了手术后潜在并发症的影响。

结果

2003 年至 2011 年间,185 例患者采用上颌摆动入路接受挽救性鼻咽切除术。80%的患者达到了根治性切除。除了需要术后辅助放化疗的姑息性切除外,术后全球健康系统评分的平均值没有明显变化。在所有患者群体中,社会功能评分均是 5 个功能评分中最低的。腭瘘显著影响社会进食和体重减轻,放射性骨坏死导致更多疼痛和鼻腔分泌物,严重影响患者的社会生活。

结论

上颌摆动挽救性鼻咽切除术后患者的 QOL 良好。目前的结果表明,必须注意手术后对 QOL 产生不利影响的因素,如姑息性切除以及诸如牙关紧闭、腭瘘和放射性骨坏死等并发症。

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