Sethia Rishabh, Yumusakhuylu Ali C, Ozbay Isa, Diavolitsis Virginia, Brown Nicole V, Zhao Songzhu, Wei Lai, Old Matthew, Agrawal Amit, Teknos Theodoros N, Ozer Enver
College of Medicine, The Ohio State University, Columbus, Ohio, U.S.A.
Department of Otolaryngology-Head and Neck Surgery, Marmara University Faculty of Medicine, Istanbul, Turkey.
Laryngoscope. 2018 Feb;128(2):403-411. doi: 10.1002/lary.26796. Epub 2017 Aug 3.
OBJECTIVES/HYPOTHESIS: To compare quality of life (QOL) of patients who underwent transoral robotic surgery (TORS) alone, with adjuvant radiation therapy (RT), or adjuvant chemoradiation therapy (CRT) in the treatment of oropharyngeal squamous cell cancer (OPSCCA).
Prospective cohort study.
Medical records were reviewed for 111 patients treated for OPSCCA from 2008 to 2015. Patients were administered the Head and Neck Cancer Inventory (HNCI) to evaluate QOL preoperatively, and at 3 weeks, 3 months, 6 months, and 1 year postsurgery. QOL data were compared between 13 patients treated with TORS alone, 31 with adjuvant RT, and 67 with adjuvant CRT by a linear mixed effects model.
Mean follow-up was 35 months. The HNCI response rates at 3 weeks and 3, 6, and 12 months were 80%, 60%, 55%, and 46%, respectively. TORS alone reported significantly higher eating scores than adjuvant RT or CRT at 3 and 6 months, and higher speech scores compared to adjuvant CRT at 3 months and adjuvant RT at 6 months. TORS alone and adjuvant RT reported less social disruption compared to adjuvant CRT at 3 months. Adjuvant CRT had consistently lower overall QOL scores until 6 months. No TORS-alone patient required percutaneous endoscopic gastrostomy, and no study patient required tracheostomy during treatment.
TORS alone maintained higher QOL than adjuvant RT or CRT in eating, social function, speech, and overall QOL postsurgery. QOL and functional metrics were better for 6 months in TORS-alone patients, and at 12 months, the differences were not significant.
目的/假设:比较单纯接受经口机器人手术(TORS)、辅助放疗(RT)或辅助放化疗(CRT)治疗口咽鳞状细胞癌(OPSCCA)患者的生活质量(QOL)。
前瞻性队列研究。
回顾了2008年至2015年接受OPSCCA治疗的111例患者的病历。患者在术前、术后3周、3个月、6个月和1年接受头颈癌量表(HNCI)评估以评价生活质量。通过线性混合效应模型比较了13例单纯接受TORS治疗的患者、31例接受辅助RT治疗的患者和67例接受辅助CRT治疗的患者的生活质量数据。
平均随访35个月。术后3周、3个月、6个月和12个月时,HNCI的应答率分别为80%、60%、55%和46%。单纯TORS组在术后3个月和6个月时进食评分显著高于辅助RT或CRT组,在术后3个月时言语评分高于辅助CRT组,在术后6个月时高于辅助RT组。单纯TORS组和辅助RT组在术后3个月时社会功能障碍程度低于辅助CRT组。辅助CRT组在术后6个月内总体生活质量评分一直较低。单纯TORS组患者均未需要经皮内镜下胃造口术,治疗期间无研究患者需要气管造口术。
单纯TORS在术后进食、社会功能、言语及总体生活质量方面维持了比辅助RT或CRT更高的生活质量。单纯TORS组患者术后6个月生活质量和功能指标较好,术后12个月时差异无统计学意义。
4。《喉镜》,2018年,第128卷,第403 - 411页。