Thomas Ligy, Moore Eric J, Olsen Kerry D, Kasperbauer Jan L
Department of Otorhinolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA.
Ann Otol Rhinol Laryngol. 2012 Jun;121(6):395-401. doi: 10.1177/000348941212100606.
We assessed the long-term quality of life (QOL) in patients who survived oral cavity squamous cell cancer when they were young and looked for any clinical factors that might adversely affect function and QOL.
We performed a retrospective case series and questionnaire survey in a tertiary care center. The subjects were consecutive patients treated for oral cancers during a 25-year period, when they were 40 years of age or less. The patients completed the University of Washington Quality of Life questionnaire and the M. D. Anderson Dysphagia Inventory (MDADI). We made an overall descriptive report of swallowing and QOL measures in the study population and looked for any clinical factors associated with functional outcomes.
Among the 62 patients treated over the course of 25 years, 46 were alive and disease-free. Twenty-six participated. The median follow-up duration was 14.7 years (range, 3 to 27 years). Age at diagnosis and duration of follow-up did not correlate with overall QOL or health-related QOL. Seventy-seven percent rated their overall QOL as outstanding, very good, or good. The key domains affected by cancer were appearance, mood, saliva, and shoulder function. Radiotherapy significantly adversely affected the QOL. The median MDADI scores on all 4 subscales were at least 85%. Higher T-stage and radiotherapy were significantly associated with lower scores on all subscales.
The long-term health-related QOL in this cohort was quite good. Radiotherapy and tumor stage correlated with swallowing outcomes, and only radiotherapy seemed to adversely affect the overall QOL.
我们评估了年轻时患口腔鳞状细胞癌且存活下来的患者的长期生活质量（QOL），并寻找可能对功能和生活质量产生不利影响的任何临床因素。
我们在一家三级医疗中心进行了一项回顾性病例系列研究和问卷调查。研究对象为在25年期间接受口腔癌治疗的连续患者，当时他们年龄在40岁及以下。患者完成了华盛顿大学生活质量问卷和MD安德森吞咽障碍量表（MDADI）。我们对研究人群的吞咽和生活质量测量进行了总体描述性报告，并寻找与功能结果相关的任何临床因素。
在25年期间接受治疗的62例患者中，46例存活且无疾病。26例参与了研究。中位随访时间为14.7年（范围3至27年）。诊断时的年龄和随访时间与总体生活质量或与健康相关的生活质量无关。77%的患者将其总体生活质量评为优秀、非常好或良好。受癌症影响的关键领域是外貌、情绪、唾液和肩部功能。放疗对生活质量有显著的不利影响。所有4个分量表的MDADI中位得分至少为85%。较高的T分期和放疗与所有分量表较低的得分显著相关。
该队列中与健康相关的长期生活质量相当好。放疗和肿瘤分期与吞咽结果相关，且似乎只有放疗对总体生活质量有不利影响。
