Maxwell Jessica H, Mehta Vikas, Wang Hong, Cunningham Diana, Duvvuri Umamaheswar, Kim Seungwon, Johnson Jonas T, Ferris Robert L
Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, U.S.A.
Laryngoscope. 2014 Jul;124(7):1592-7. doi: 10.1002/lary.24508. Epub 2013 Dec 18.
OBJECTIVES/HYPOTHESIS: To determine posttreatment quality of life (QOL) in head and neck cancer patients, stratifying by human papillomavirus (HPV)/p16 status and primary treatment modality.
Retrospective study.
One hundred and seventy-seven patients (N=177) with head and neck squamous cell carcinoma and known HPV/p16 status were included. All patients completed at least one baseline or posttreatment University of Washington QOL survey. QOL scores were averaged and compared across patients, stratifying by HPV/p16 status and primary treatment modality (surgical vs. nonsurgical). In the analysis, p16 was used as a surrogate marker for HPV.
Of the 177 patients, 80 (45.2%) were p16-positive and 49.7% of subsites were oropharyngeal. Nearly 60% (105/177) of patients underwent primary surgery, 26.7% (28/105) of patients with transoral robotic or laser techniques. The remainder 40.7% of patients underwent primary radiation and/or chemotherapy. Overall, QOL scores were better for p16-positive patients compared to p16-negative patients at baseline (P=0.008), at 6 months posttreatment (P=0.034), and at greater than 1 year posttreatment (P=0.013). P16-positive patients had better QOL scores in speech (P=0.0009), chewing (P=0.0004), and swallowing (P=0.021) after 1 year posttreatment compared to p16-negative patients. Primary treatment modality did not affect overall QOL or any of the 12 QOL categories in p16-positive patients at any time point. At over 1 year posttreatment, QOL was at or above baseline in both p16-positive treatment groups.
The p16-positive patients had better baseline and posttreatment overall QOL compared to p16-negative patients. The overall and category specific QOL scores for p16-positive patients were not affected by primary treatment modality.
目的/假设：确定头颈部癌症患者治疗后的生活质量（QOL），并根据人乳头瘤病毒（HPV）/p16状态和初始治疗方式进行分层。
回顾性研究。
纳入177名头颈部鳞状细胞癌患者且已知其HPV/p16状态。所有患者至少完成了一次华盛顿大学QOL基线或治疗后调查。对QOL评分进行平均，并在患者中进行比较，根据HPV/p16状态和初始治疗方式（手术与非手术）进行分层。在分析中，p16用作HPV的替代标志物。
177名患者中，80名（45.2%）为p16阳性，49.7%的亚部位为口咽。近60%（105/177）的患者接受了初始手术，26.7%（28/105）的患者采用经口机器人或激光技术。其余40.7%的患者接受了初始放疗和/或化疗。总体而言，在基线时（P=0.008）、治疗后6个月（P=0.034）以及治疗后超过1年（P=0.013），p16阳性患者的QOL评分均高于p16阴性患者。与p16阴性患者相比，p16阳性患者在治疗后1年的言语（P=0.0009）、咀嚼（P=0.0004）和吞咽（P=0.021）方面的QOL评分更高。初始治疗方式在任何时间点均未影响p16阳性患者的总体QOL或12个QOL类别中的任何一项。在治疗后超过1年时，两个p16阳性治疗组的QOL均处于或高于基线水平。
与p16阴性患者相比，p16阳性患者的基线和治疗后总体QOL更好。p16阳性患者的总体和特定类别QOL评分不受初始治疗方式的影响。
4级。
