Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan; School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
School of Nursing, The University of Hong Kong, HKSAR, China.
Eur J Oncol Nurs. 2019 Aug;41:1-6. doi: 10.1016/j.ejon.2019.05.003. Epub 2019 May 15.
This study examined the prognostic associations of pre-treatment quality of life (QoL) with overall survival (OS) and distant metastasis-free survival (DFMS) among patients with head and neck cancer (HNC) who underwent free flap reconstruction.
A cohort of 127 HNC patients who received free flap reconstruction between November 2010 and June 2014 at a hospital were recruited. Pre-treatment QoL was measured by the University of Washington Quality of Life Questionnaire, which contains six physical domains, including speech, swallowing, appearance, saliva, taste and chewing, as well as the six social-emotional domains of pain, activity, recreation, shoulder, mood, and anxiety. Cox regression analyses were performed.
Results showed that pre-treatment QoL was predictive of OS and DMFS. Of the domains, swallowing, chewing, speech, taste, saliva, pain and shoulder were demonstrated to be significant predictors of OS. Additionally, swallowing, chewing, speech, pain and activity were demonstrated making significant contributions to DMFS.
Our data supported that physical domains of pre-treatment QoL were predictors for OS and DFMS in HNC patients with free-flap reconstruction. Longitudinal studies are warranted to clarify the prognostic abilities of social-emotional domains. Information on pre-treatment QoL should be taken into account to individualize care plan for these patients, and hence prolong their survival.
本研究旨在探讨头颈部癌症（HNC）患者接受游离皮瓣重建术后，治疗前生活质量（QoL）与总生存（OS）和远处无转移生存（DFMS）的预后相关性。
回顾性分析了 2010 年 11 月至 2014 年 6 月在我院接受游离皮瓣重建术的 127 例 HNC 患者的临床资料。采用华盛顿大学生活质量问卷（University of Washington Quality of Life Questionnaire）评估患者治疗前的 QoL，该问卷包含 6 个生理领域，包括言语、吞咽、外观、唾液、味觉和咀嚼，以及 6 个社会心理领域，包括疼痛、活动、娱乐、肩部、情绪和焦虑。采用 Cox 回归分析。
结果显示，治疗前 QoL 是 OS 和 DMFS 的预测因子。在各个领域中，吞咽、咀嚼、言语、味觉、唾液、疼痛和肩部被证明是 OS 的显著预测因子。此外，吞咽、咀嚼、言语、疼痛和活动对 DMFS 也有显著影响。
我们的数据支持游离皮瓣重建术后，HNC 患者治疗前的生理 QoL 领域是 OS 和 DFMS 的预测因子。需要进行纵向研究来阐明社会心理领域的预后能力。应该考虑治疗前 QoL 信息，为这些患者制定个体化的护理计划，从而延长其生存时间。
