Schaller Anne, Dragioti Elena, Liedberg Gunilla M, Larsson Britt
Department of Medical and Health Sciences, Division of Community Medicine, Faculty of Health Sciences, Linköping University, Pain and Rehabilitation Centre, County Council of Östergötland, Linköping.
Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden.
J Pain Res. 2017 Jul 17;10:1697-1704. doi: 10.2147/JPR.S138113. eCollection 2017.
Patients with head and neck cancer (HNC) have a potentially severe diagnosis and often suffer from tumor-related pain as well as from adverse side effects of treatment such as radiotherapy (RT). Knowledge about quality of life (QoL) during early RT in this group is limited and should be assessed in relation to diagnosis and treatment.
The purpose of this cross-sectional study was to identify potential factors that may influence QoL in patients with HNC during the early stages of RT (no later than two weeks of ongoing RT). We hypothesized that pain intensity, pain interference, catastrophizing, and mood disturbances are associated with QoL during early RT.
In this study, 54 patients (53% of eligible patients) diagnosed with HNC were consecutively recruited from the regular flow to the Pain and Rehabilitation Center at Linköping University. The patients completed self-reported questionnaires on sociodemographics, pain intensity, pain interference, anxiety, depression, pain catastrophizing, and QoL.
The patients in this study scored high for QoL, low for pain intensity, and low for pain interference. The patients reported minor depressive symptoms and anxiety symptoms. Regression analyses showed that pain intensity and depressive symptoms negatively influenced QoL.
No later than two weeks of RT, pain intensity and depression negatively influenced QoL in patients with HNC. Early screening for pain and depression in a targeted preventive strategy might maintain QoL during the course of the RT for patients with HNC. This assumption needs to be further investigated.
头颈癌(HNC)患者面临的诊断可能很严重,常遭受肿瘤相关疼痛以及放疗(RT)等治疗的不良副作用。关于该群体在放疗早期的生活质量(QoL)的知识有限,应结合诊断和治疗进行评估。
这项横断面研究的目的是确定在放疗早期(放疗开始不超过两周)可能影响头颈癌患者生活质量的潜在因素。我们假设疼痛强度、疼痛干扰、灾难化思维和情绪障碍与放疗早期的生活质量相关。
在本研究中,从林雪平大学疼痛与康复中心的常规就诊流程中连续招募了54例被诊断为头颈癌的患者(占符合条件患者的53%)。患者完成了关于社会人口统计学、疼痛强度、疼痛干扰、焦虑、抑郁、疼痛灾难化思维和生活质量的自我报告问卷。
本研究中的患者生活质量得分高,疼痛强度得分低,疼痛干扰得分低。患者报告有轻微的抑郁症状和焦虑症状。回归分析表明,疼痛强度和抑郁症状对生活质量有负面影响。
在放疗开始不超过两周时,疼痛强度和抑郁对头颈癌患者的生活质量有负面影响。在有针对性的预防策略中对头颈癌患者放疗过程中的疼痛和抑郁进行早期筛查可能有助于维持其生活质量。这一假设需要进一步研究。