Sakthivel P, K Irugu D V, Singh C A, Verma H, Yogal R, Jat B, Chadran A, Sikka K, Thakar A, Sharma S C
Department of Otorhinolaryngology and Head and Neck Surgery, All Institute of Medical Sciences, New Delhi, India.
Indian J Cancer. 2017 Apr-Jun;54(2):447-452. doi: 10.4103/ijc.IJC_236_17.
To evaluate the quality of life (QOL) outcome measures in disease-free survivors of pathological T1/T2 tongue cancers and to compare QOL in patients treated with only surgery and with adjuvant treatment.
Cross-sectional survey.
All pathological T1/T2 anterior tongue cancer cases with follow-up from January 2011 till December 2015, who had locoregionally controlled disease with a minimum disease-free survival period of 1 year, were included in the study.
A total of 36 patients, 28 are males and 8 are females with an age range of 24-66 years (median age of 43) were enrolled in the study. The patients were divided into two groups with (n = 26) and without adjuvant postoperative radiotherapy (RT) (n = 10) and the University of Washington-QOL questionnaire version 4 for physical and social domains, global questions and three important domains were analyzed. On the physical and social domain scores, the surgery-alone group outscored the combined modality group on all scales and the differences were statistically significant for specific physical domains such as saliva (0.0001), taste (P = 0.0001), chewing (P = 0.0004), swallowing (P = 0.0026), and social domains such as mood (0.0001), pain (P = 0.0001), and shoulder function (P = 0.0061). The overall global QOL scores were also better for the surgical group compared with group which received adjuvant RT but was not statistically significant. All patients chose saliva as their top priority domain in the group which received radiation, and 60% chose "swallowing ability" as the preferred top priority domain in the only surgical group.
Although locoregional control and disease-free survival are the major treatment-related endpoints for cancer management, QOL outcome measures have to assess to determine the impact of a treatment modality on patients well-being and for better rehabilitation of cancer-free patients.
评估病理T1/T2期舌癌无病生存者的生活质量(QOL)结局指标,并比较单纯手术治疗患者与接受辅助治疗患者的生活质量。
横断面调查。
纳入2011年1月至2015年12月随访的所有病理T1/T2期舌前部癌病例,这些病例局部区域疾病得到控制,无病生存期至少为1年。
共36例患者纳入研究,其中男性28例,女性8例,年龄范围为24 - 66岁(中位年龄43岁)。患者分为两组,一组接受辅助术后放疗(RT)(n = 26),另一组未接受辅助术后放疗(n = 10),并对华盛顿大学QOL问卷第4版的身体和社会领域、总体问题及三个重要领域进行分析。在身体和社会领域得分方面,单纯手术组在所有量表上的得分均高于联合治疗组,在唾液(0.0001)、味觉(P = 0.0001)、咀嚼(P = 0.0004)、吞咽(P = 0.0026)等特定身体领域以及情绪(0.0001)、疼痛(P = 0.0001)、肩部功能(P = 0.0061)等社会领域,差异具有统计学意义。与接受辅助放疗的组相比,手术组的总体生活质量得分也更高,但差异无统计学意义。在接受放疗的组中,所有患者均将唾液选为最优先领域,在单纯手术组中,60%的患者选择“吞咽能力”作为首选的最优先领域。
尽管局部区域控制和无病生存是癌症治疗相关的主要终点,但生活质量结局指标必须进行评估,以确定治疗方式对患者幸福感的影响,并促进无癌患者的更好康复。