Rogers S N, Mepani V, Jackson S, Lowe D
Evidence-Based Practice Research Centre (EPRC), Faculty of Health and Social Care, Edge Hill University, St Helens Road, Ormskirk, L39 4QP, UK; Consultant Regional Maxillofacial Unit, University Hospital Aintree, Liverpool, L9 1AE, UK.
Liverpool University.
Br J Oral Maxillofac Surg. 2017 Sep;55(7):666-673. doi: 10.1016/j.bjoms.2016.09.001. Epub 2017 Jun 23.
Diagnosis of differentiated thyroid carcinoma (papillary or follicular) and its treatment may be associated with a poor health-related quality of life (HRQoL), and with fear of recurrence (FoR), and distress. To our knowledge, this is the first time a single FoR screening question (written to complement a HRQoL questionnaire), has been reported with HRQoL and levels of distress in patients treated for the disease. In April 2014 we did a cross-sectional survey of patients who had presented to the Merseyside and Cheshire thyroid cancer network between April 2009 and November 2013. Questionnaires comprised the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30, the THYCA-QoL, the Emotion Thermometers, and the new FoR screening item. A total of 249 surveys were sent and 169 patients responded (68%). The most prevalent issues included tiredness, problems with sleep and needing to rest, pain (particularly in muscles and joints), a dry mouth, hot flushes and tolerating heat, gaining weight, and feeling slowed down or weak; also, having trouble taking long walks or doing strenuous activities, feeling tense, worried, irritable, and anxious, and having difficulty remembering things. One in seven patients (95% CI 9% to 21%) responded to the single FoR question that they "had a lot of fears of recurrence that really preoccupied their thoughts" or were "fearful all the time that their cancer might return and that they struggled with this". Distress overall was relatively low. In conclusion, the HRQoL issues reported by these patients were different from those reported by patients with other cancers of the head and neck. It would be helpful to identify FoR in a subgroup of patients with differentiated thyroid cancer so that they could be given additional support.
分化型甲状腺癌（乳头状或滤泡状）的诊断及其治疗可能与健康相关生活质量（HRQoL）较差、复发恐惧（FoR）和痛苦有关。据我们所知，这是首次报道一个单一的FoR筛查问题（旨在补充一份HRQoL问卷）与该疾病患者的HRQoL及痛苦程度相关。2014年4月，我们对2009年4月至2013年11月期间就诊于默西塞德郡和柴郡甲状腺癌网络的患者进行了一项横断面调查。问卷包括欧洲癌症研究与治疗组织（EORTC）的QLQ - C30、THYCA - QoL、情绪温度计以及新的FoR筛查项目。共发放了249份调查问卷，169名患者做出了回应（68%）。最常见的问题包括疲劳、睡眠问题和需要休息、疼痛（尤其是肌肉和关节疼痛）、口干、潮热和耐热性差、体重增加、感觉行动迟缓或虚弱；此外，长时间行走或进行剧烈活动有困难、感到紧张、担忧、易怒和焦虑，以及记忆力有问题。七分之一的患者（95%可信区间9%至21%）对单一的FoR问题回答称，他们“对复发有很多担忧，这些担忧一直困扰着他们的思绪”，或者“一直担心癌症可能会复发，为此苦苦挣扎”。总体痛苦程度相对较低。总之，这些患者报告的HRQoL问题与其他头颈癌患者报告的问题不同。识别分化型甲状腺癌患者亚组中的FoR，以便为他们提供额外的支持，这将是有帮助的。
