Loimu V, Mäkitie A A, Bäck L J, Sintonen H, Räsänen P, Roine R, Saarilahti K
Department of Oncology, Helsinki University Central Hospital and University of Helsinki, P.O.Box 180, 00029 HUCH, Helsinki, Finland,
Eur Arch Otorhinolaryngol. 2015 Sep;272(9):2415-23. doi: 10.1007/s00405-014-3169-1. Epub 2014 Jul 2.
Oncological treatment of head and neck carcinoma is associated with high morbidity. Measuring of health-related quality of life (HRQoL) is crucial in this patient group but there is no consensus on which measure would be preferable to be used. In this study, HRQoL was measured with the generic 15D, which has not been used before for assessing this patient population. It is a prospective cohort study among 64 patients with laryngeal, pharyngeal or nasal cavity carcinoma treated with definitive (chemo) radiotherapy between November 2007-July 2012. HRQoL was assessed with the 15D before and at 3, 6 and 12 months after the treatment onset. HRQoL results of the patients were compared with those of the age-standardized general population. Overall HRQoL declined significantly during the first 3 months after the treatment onset but then gradually improved towards the end of the follow-up. At baseline or at 12 months, no significant differences were detected in overall HRQoL between the patients and the general population. Dimensions reflecting mental well-being showed gradual improvement, exceeding the baseline scores at the end of the follow-up. Nevertheless, on these dimensions, the patient group presented with consistently lower scores compared with the general population. The mean HRQoL was lower among patients with pharyngeal carcinoma compared with the laryngeal carcinoma patients. The 15D instrument is feasible for evaluation of HRQoL in oncologically treated head and neck cancer patients. It seems to detect differences among different patient subgroups. Multidisciplinary supportive management of this patient population is recommended to ensure improved mental well-being.
头颈部癌的肿瘤治疗会带来较高的发病率。在这一患者群体中,测量健康相关生活质量(HRQoL)至关重要,但对于使用哪种测量方法更为合适尚无共识。在本研究中,使用通用的15D量表来测量HRQoL,此前尚未用其评估过这一患者群体。这是一项对2007年11月至2012年7月期间接受根治性(化疗)放疗的64例喉癌、咽癌或鼻腔癌患者进行的前瞻性队列研究。在治疗开始前以及治疗开始后3个月、6个月和12个月时,使用15D量表评估HRQoL。将患者的HRQoL结果与年龄标准化的普通人群进行比较。总体HRQoL在治疗开始后的前3个月显著下降,但随后在随访结束时逐渐改善。在基线或12个月时,患者与普通人群在总体HRQoL方面未检测到显著差异。反映心理健康的维度显示出逐渐改善,在随访结束时超过了基线分数。然而,在这些维度上,患者组的得分始终低于普通人群。与喉癌患者相比,咽癌患者的平均HRQoL较低。15D量表对于评估接受肿瘤治疗的头颈部癌患者的HRQoL是可行的。它似乎能够检测不同患者亚组之间的差异。建议对这一患者群体进行多学科支持性管理,以确保改善心理健康。