Aarstad Hans Jørgen, Østhus Arild Andrè, Aarstad Helene Hersvik, Lybak Stein, Aarstad Anne Kari Hersvik
Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway.
Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, 5020, Bergen, Norway.
Eur Arch Otorhinolaryngol. 2018 Jan;275(1):207-217. doi: 10.1007/s00405-017-4800-8. Epub 2017 Nov 20.
To evaluate the 5- and 10-year survival prediction of health-related quality of life (HRQoL) scores obtained at diagnosis and at 6, 9 and 12 months after diagnosis in a cohort of curable head and neck squamous cell carcinoma (HNSCC) patients.
HNSCC patients (n = 109) reported their HRQoL measured by the EORTC Quality of Life Questionnaire (QLQ) general (C30) questionnaire. At diagnosis, the included patients were below 78 years of age and at diagnosis planned treated with curative intent. Clinical variables and self-reported smoking, alcohol consumption and socio-demographic information were registered. From diagnostic blocks, we found 22 patients to be human papillomavirus (HPV) positive. New HRQoL scores were not obtained if the patient treatment changed from curative to palliative throughout the HRQoL data acquisition. Survival was determined from the National Population Register of Norway.
Decreased survival with low HRQoL scores from EORTC QLQ scores was demonstrated with HRQoL scores obtained from different time points of the four time points studied. These survival predictions were mostly independent of HPV status, gender, age, TNM stage, tumor site, alcohol consumption, present smoking status and whether comorbidities were present at diagnosis; as well as to some extent with an adjustment of the same HRQoL score/index obtained at diagnosis. The specific indices "physical function", "general pain" and "sleep disturbance" were in particular predictive of survival.
HRQoL scores obtained throughout the first year after diagnosis contained prognostic power to overall survival when measured both at 5 and 10 years of observation.
评估一组可治愈的头颈部鳞状细胞癌（HNSCC）患者在诊断时以及诊断后6、9和12个月获得的健康相关生活质量（HRQoL）评分的5年和10年生存预测情况。
HNSCC患者（n = 109）报告了通过欧洲癌症研究与治疗组织生活质量问卷（QLQ）通用（C30）问卷测量的HRQoL。诊断时，纳入的患者年龄在78岁以下，且诊断时计划进行根治性治疗。记录临床变量以及自我报告的吸烟、饮酒情况和社会人口统计学信息。从诊断组织块中，我们发现22名患者人乳头瘤病毒（HPV）呈阳性。如果患者在整个HRQoL数据采集过程中治疗从根治性变为姑息性，则不再获取新的HRQoL评分。生存情况由挪威国家人口登记处确定。
在研究的四个时间点的不同时间点获得的HRQoL评分表明，欧洲癌症研究与治疗组织QLQ评分中HRQoL得分低与生存率降低相关。这些生存预测大多独立于HPV状态、性别、年龄、TNM分期、肿瘤部位、饮酒情况、当前吸烟状态以及诊断时是否存在合并症；并且在一定程度上与诊断时获得的相同HRQoL评分/指数的调整有关。具体指标“身体功能”、“总体疼痛”和“睡眠障碍”对生存具有特别的预测性。
诊断后第一年获得的HRQoL评分在5年和10年观察期测量时对总体生存具有预后价值。
