Gupta Bhawna, Kumar Narinder, Johnson Newell W
School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia.
Senior advisor, Department of Orthopaedics, Military Hospital, Kirkee, Pune, India.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2017 May;123(5):550-558. doi: 10.1016/j.oooo.2017.01.013. Epub 2017 Feb 9.
The aim of this study was to measure quality of life (QOL) in patients with upper aerodigestive tract (UADT) cancer in comparison with hospital-based controls. We also assessed the impact of various clinical predictors at time of diagnosis of disease/cancer on QOL in these patients.
A case-control study was conducted (N = 480) with 240 UADT cancer cases and 240 controls matched by gender and age (≥5 years) from 2 different hospitals in Pune, India. The University of Washington Quality of Life Questionnaire was used to measure QOL and was administered through face-to-face interviews. Various QOL domains were analyzed by using one-way analysis of variance and Bonferroni adjustments for post hoc comparisons.
Cases had significantly lower scores across all domains of QOL compared with controls. Overall, the most affected domains were anxiety and mood. Cancer site significantly influenced QOL, with patients with cancers of the oropharynx and hypopharynx having the worst mean scores across all domains. Patients with stage IV cancer had the worst mean scores across the majority of the QOL domains. Our findings highlight the complex interactions between individual and clinical predictors that have an impact on QOL.
QOL needs to be incorporated as an important outcome measure in an individualized approach to therapeutic and palliative care planning to enable a better quality of survival of patients with UADT cancers.
本研究旨在测量上消化道（UADT）癌症患者的生活质量（QOL），并与医院对照组进行比较。我们还评估了疾病/癌症诊断时各种临床预测因素对这些患者生活质量的影响。
进行了一项病例对照研究（N = 480），其中240例UADT癌症病例和240例对照，这些对照来自印度浦那两家不同医院，按性别和年龄（≥5岁）匹配。使用华盛顿大学生活质量问卷来测量生活质量，并通过面对面访谈进行施测。通过单向方差分析和Bonferroni校正进行事后比较，对各个生活质量领域进行分析。
与对照组相比，病例在生活质量的所有领域得分均显著较低。总体而言，受影响最大的领域是焦虑和情绪。癌症部位对生活质量有显著影响，口咽癌和下咽癌患者在所有领域的平均得分最差。IV期癌症患者在大多数生活质量领域的平均得分最差。我们的研究结果突出了个体和临床预测因素之间对生活质量有影响的复杂相互作用。
在制定个体化的治疗和姑息治疗计划时，生活质量需要作为一项重要的结局指标纳入其中，以使UADT癌症患者有更好的生存质量。
