Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital, Camperdown, Australia; Cancer Nursing Research Unit, Sydney Nursing School, University of Sydney, Sydney, Australia.
Laryngoscope. 2014 Jan;124(1):151-8. doi: 10.1002/lary.24136. Epub 2013 Aug 5.
OBJECTIVES/HYPOTHESIS: To examine changes in health-related quality of life among oropharyngeal cancer patients by stages and across treatment types among advanced cancer patients.
Individual prospective cohort study.
All newly diagnosed patients with oropharyngeal cancer treated with curative intent were routinely assessed. The European Organization for Research and Treatment of Cancer (EORTC) both the Main Module quality-of-life questionnaire (QLQ-C30) and the Head and Neck Cancer (HNC) Module (QLQ-H&N35) were administered at diagnosis and 3, 6, and 12 months thereafter. Complete case analysis was used following assessment of missing data. The proportion of patients with clinically significant deterioration (changes of ≥ 10 points) from baseline were calculated for each follow-up time point and compared by stage (I/II vs. III/IV) and then treatment type (chemotherapy and radiotherapy [CRT] vs. surgery and postoperative radiotherapy [S&PORT]).
Deterioration in most domains was most frequent for stage III/IV patients at 3 months (both modules), whereas stage I/II patients experienced this at 6 months (QLQ-C30) and 12 months (H&N35). Among stage III/IV patients, this happened at all time points for S&PORT patients (QLQ-C30) versus 12 months for CRT patients (H&N35). The number of patients reporting deterioration was lower for most domains at 12 months compared to earlier periods, although dry mouth remained a problem for most patients (60%-85% across treatment/stage groups).
Our preliminary findings suggest that general and disease-specific deterioration is of most concern for stage I/II patients at 6 and 12 months and at 3 months for advanced cancer patients. For stage III/IV patients receiving S&PORT, general deterioration remains a problem after diagnosis, whereas for CRT patients, disease-specific deterioration is of most concern at 12 months.
目的/假设：检查晚期癌症患者中，不同分期和治疗类型的口咽癌患者的健康相关生活质量变化。
个体前瞻性队列研究。
所有接受根治性治疗的新诊断为口咽癌的患者均接受常规评估。欧洲癌症研究与治疗组织（EORTC）同时使用了核心模块生活质量问卷（QLQ-C30）和头颈部癌症模块（QLQ-H&N35），在诊断时以及随后的 3、6 和 12 个月进行评估。在评估缺失数据后，采用完全案例分析。计算每个随访时间点从基线开始具有临床显著恶化（变化≥10 分）的患者比例，并按分期（I/II 期与 III/IV 期）和治疗类型（化疗和放疗[CRT]与手术和术后放疗[S&PORT]）进行比较。
在 3 个月时（两个模块），III/IV 期患者的大多数领域恶化最为常见，而 I/II 期患者则在 6 个月（QLQ-C30）和 12 个月（H&N35）时经历了这种情况。在 III/IV 期患者中，S&PORT 患者在所有时间点都发生了这种情况（QLQ-C30），而 CRT 患者在 12 个月时发生了这种情况（H&N35）。与早期相比，12 个月时大多数领域报告恶化的患者数量较少，但口干仍然是大多数患者的问题（在治疗/分期组中占 60%-85%）。
我们的初步发现表明，I/II 期患者在 6 个月和 12 个月以及晚期癌症患者在 3 个月时，主要关注一般和疾病特异性恶化。对于接受 S&PORT 的 III/IV 期患者，诊断后一般恶化仍然是一个问题，而对于 CRT 患者，在 12 个月时，疾病特异性恶化是最令人关注的问题。
