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头颈部癌放疗患者唾液分泌率与生活质量关系的探索性研究

Explorative study on quality of life in relation to salivary secretion rate in patients with head and neck cancer treated with radiotherapy.

作者信息

Almståhl Annica, Alstad Torgny, Fagerberg-Mohlin Bodil, Carlén Anette, Finizia Caterina

机构信息

Department of Oral Microbiology and Immunology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Department of Oral Prosthetics, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

出版信息

Head Neck. 2016 May;38(5):782-91. doi: 10.1002/hed.23964. Epub 2015 Jun 20.

Abstract

BACKGROUND

Radiotherapy (RT) to the head and neck region often results in oral complications. In this explorative study, the pretreatment and posttreatment (6 months and 12 months) quality of life (QOL) was analyzed for patients with head and neck cancer. The associations between QOL and salivary secretion rates were analyzed.

METHODS

In 29 patients (19 men and 10 women; mean age, 59 ± 8 years), the stimulated whole salivary secretion and buccal minor gland secretion were measured. The patients completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30-questions (EORTC-QLQ-C30) and Quality of Life Questionnaire-Core 30 Head and Neck 35-questions (EORTC-QLQ-C30-H&N35) and the Hospital Anxiety and Depression Scale (HADS).

RESULTS

One year after the completion of RT, patients with hyposalivation (≤0.7 mL/min) reported clinically meaningful, but not statistically significant differences, in cognitive functioning, insomnia, swallowing, social eating, dry mouth, sticky saliva, and use of painkillers. Statistically significant differences were found for emotional functioning, sticky saliva, and dyspnea (p < .05). Thirty-three percent of them had a HADS score suggesting anxiety problems, compared with 8% for those with whole stimulated salivary secretion rates >0.7 mL/min.

CONCLUSION

RT in the head and neck region, also using intensity-modulated RT, is associated with many aspects of life, such as cognitive functioning, insomnia, dry mouth, and sticky saliva, especially for those with hyposalivation.

摘要

背景

对头颈部区域进行放射治疗(RT)常常会导致口腔并发症。在这项探索性研究中,分析了头颈部癌患者放疗前及放疗后(6个月和12个月)的生活质量(QOL)。分析了生活质量与唾液分泌率之间的关联。

方法

对29例患者(19例男性和10例女性;平均年龄59±8岁)测量了刺激后的全唾液分泌和颊部小唾液腺分泌。患者完成了欧洲癌症研究与治疗组织生活质量问卷核心30题(EORTC-QLQ-C30)、生活质量问卷核心30题头颈部35题(EORTC-QLQ-C30-H&N35)以及医院焦虑抑郁量表(HADS)。

结果

放疗结束1年后,唾液分泌减少(≤0.7 mL/分钟)的患者在认知功能、失眠、吞咽、社交进食、口干、唾液黏稠及使用止痛药方面报告了具有临床意义但无统计学显著差异的情况。在情绪功能、唾液黏稠和呼吸困难方面发现了统计学显著差异(p<0.05)。其中33%的患者HADS评分提示存在焦虑问题,而全唾液刺激分泌率>0.7 mL/分钟的患者这一比例为8%。

结论

头颈部区域的放疗,包括使用调强放疗,与生活的多个方面相关,如认知功能、失眠、口干和唾液黏稠,尤其是对于唾液分泌减少的患者。

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