Oral Oncol. 2018 Sep;84:88-94. doi: 10.1016/j.oraloncology.2018.07.006. Epub 2018 Jul 26.
The purpose of this study is to estimate the prevalence and severity of late oral morbidities in disease-free oropharyngeal cancer (OPC) survivors using patient reported outcomes.
Cross-sectional survivorship survey of patients who completed definitive treatment for oropharyngeal carcinoma > 12-months previously without evidence of recurrence, second primary malignancy, or distant metastasis after index cancer. Using MD Anderson Symptom Inventory- Head and Neck Module (MDASI-HN), scores for 4 self-reported oral morbidities: dry mouth, mucus secretions, mouth and throat sores, and teeth and gum issues were evaluated.
Among 906 survey respondents (57% response rate), (median survival time: 7 years), "dry mouth" and "problems with my mucus" were reported moderate/severe (MDASI-HN item score ≥5) in 39% and 22% of respondents, while 14% reported moderate/severe "problems with teeth and gums". Smoking at the time of survey was significantly associated with the severity of oral symptoms including "mucus" (p = 0.03), "dry mouth" (p = 0.02), "problems with my teeth and gums" (p = 0.001). All the oral morbidities symptom items significantly, positively correlated with the mean interference scores reflecting adverse impact to quality of life (QOL): "mucus" (r = 0.445, p < 0.001), "problems with teeth" (r = 0.446, p < 0.001), "mouth sores" (r = 0.321, p < 0.001) and "dry mouth" (r = 0.459, p < 0.001).
This study showed that 45.5% reported at least one late oral morbidity at moderate/severe level which negatively correlated overall function, even years after treatment.
本研究旨在通过患者报告的结果来评估无复发生存的口咽癌(OPC)幸存者的晚期口腔并发症的发生率和严重程度。
对完成根治性治疗且无复发、第二原发肿瘤或远处转移的口咽癌患者进行横断面生存调查,治疗时间超过 12 个月。采用 MD 安德森症状量表-头颈部模块(MDASI-HN)评估 4 种自我报告的口腔并发症的评分:口干、黏液分泌、口腔和咽喉溃疡以及牙齿和牙龈问题。
在 906 名调查对象(57%的回复率)中(中位生存时间:7 年),39%和 22%的患者报告“口干”和“黏液问题”为中重度(MDASI-HN 项目评分≥5),14%的患者报告“牙齿和牙龈问题”为中重度。调查时吸烟与口腔症状的严重程度显著相关,包括“黏液”(p=0.03)、“口干”(p=0.02)和“牙齿和牙龈问题”(p=0.001)。所有口腔并发症症状项目均与反映生活质量(QOL)不良影响的平均干扰评分呈显著正相关:“黏液”(r=0.445,p<0.001)、“牙齿问题”(r=0.446,p<0.001)、“口腔溃疡”(r=0.321,p<0.001)和“口干”(r=0.459,p<0.001)。
本研究显示,45.5%的患者报告至少有一种晚期口腔并发症为中重度,即使在治疗多年后,也会对整体功能产生负面影响。