Bajwa Harjot Kaur, Singareddy Rohith, Alluri Krishnam Raju
Department of Radiation Oncology, Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, India.
Department of Radiation Oncology, Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, India.
Brachytherapy. 2016 May-Jun;15(3):381-386. doi: 10.1016/j.brachy.2016.02.002. Epub 2016 Mar 3.
The aim of the study was to assess the impact of high-dose-rate (HDR) interstitial brachytherapy on quality of life (QOL) in oral cancer.
Thirty-two patients of oral cancer treated at our institute from January 2010 to December 2014 with radical radiotherapy (external beam radiotherapy + brachytherapy) were included for analysis; 30 patients received external beam radiotherapy (50-54 Gy) and HDR brachytherapy boost (18-24.5 Gy); 2 patients received radical HDR brachytherapy (31.5 Gy). Quality of life (QOL) was assessed by Telugu, Hindi, and English versions of EORTC Quality of Life Core-30 and EORTC Quality of Life Head and Neck Module (QLQ H&N35) before treatment, at 3 months, 6 months, 1 year, and 2 years after treatment.
Of the 32 patients, 2 patients died and 1 patient progressed on followup; 2 patients were re-irradiation cases. On excluding these cases, 27 patients were available for analysis. The followup duration was 6-55 months. At the time of analysis, 91% (29) patients were disease free, 3% (1) progressed, and 6% (2) died. At the end of 2 years, none of the QLQ-C30 functional scores fell below the baseline. Pain, swallowing, sensory, speech, social contact, and social eating worsened at 3 months but improved over 2 years (p < 0.001). Sexuality and financial status showed delayed improvement (p < 0.001). Among the head and neck parameters, dry mouth and sticky saliva were significant determinants of QOL with delayed improvement (p < 0.001). The impact of age, sex, and tumor stage and on QOL was analyzed. Women reported a poorer QOL for physical and emotional parameters, social eating, weight loss, and fatigue. Tumor stage significantly affected QOL, with early stages showing a better QOL.
Almost all patients regained normal function after treatment and reported an excellent QOL at 2 years. However, tumor stage significantly affected the QOL.
本研究旨在评估高剂量率（HDR）组织间近距离放射治疗对口腔癌患者生活质量（QOL）的影响。
纳入2010年1月至2014年12月在我院接受根治性放疗（外照射放疗+近距离放射治疗）的32例口腔癌患者进行分析；30例患者接受外照射放疗（50 - 54 Gy）及HDR近距离放射治疗增敏（18 - 24.5 Gy）；2例患者接受根治性HDR近距离放射治疗（31.5 Gy）。在治疗前、治疗后3个月、6个月、1年和2年，采用泰卢固语、印地语和英语版的欧洲癌症研究与治疗组织生活质量核心问卷30（EORTC QLQ-C30）及欧洲癌症研究与治疗组织头颈部模块生活质量问卷（QLQ H&N35）评估生活质量。
32例患者中，2例患者死亡，1例患者在随访中病情进展；2例患者为再程放疗病例。排除这些病例后，27例患者可供分析。随访时间为6 - 55个月。在分析时，91%（29例）患者无疾病进展，3%（1例）病情进展，6%（2例）死亡。在2年结束时，QLQ-C30功能评分均未降至基线以下。疼痛、吞咽、感觉、言语、社交接触和社交进食在3个月时恶化，但在2年内有所改善（p < 0.001）。性功能和经济状况改善延迟（p < 0.001）。在头颈部参数中，口干和唾液黏稠是生活质量的重要决定因素，改善延迟（p < 0.001）。分析了年龄、性别和肿瘤分期对生活质量的影响。女性在身体和情感参数、社交进食、体重减轻和疲劳方面的生活质量较差。肿瘤分期显著影响生活质量，早期患者的生活质量较好。
几乎所有患者在治疗后恢复了正常功能，2年时生活质量良好。然而，肿瘤分期显著影响生活质量。
