Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne Victoria, Australia.
Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne Victoria, Australia.
Int J Radiat Oncol Biol Phys. 2020 Jan 1;106(1):146-156. doi: 10.1016/j.ijrobp.2019.09.001. Epub 2019 Sep 12.
Human papillomavirus (HPV)-associated oropharyngeal cancer (OPC) commonly affects people of working age, yet there is limited data regarding the return-to-work experience in this cohort. This study aimed to investigate the proportion of survivors currently working after completion of radiation therapy and to explore potential facilitators and barriers to working after treatment.
A cross-sectional, single-institutional study was undertaken at the Peter MacCallum Cancer Centre, a comprehensive cancer center in Melbourne, Victoria, Australia. Eligible participants were 18 to 65 years old at diagnosis, were employed at or within the 3 months before diagnosis, and had completed curative treatment for HPV-associated OPC ≥4 months before enrollment. Participants completed a paper-based survey to assess baseline demographics, employment status, and quality of life (QOL; Functional Assessment of Cancer Therapy Head and Neck). Open-ended questions explored factors affecting return to work. Associations between current employment status and various disease, treatment, and demographic variables and with QOL were examined. Free-text items were analyzed by summarizing content analysis.
Of 93 participants approached, 68 responded (73.1%). Mean age was 54.1 years (range, 39-64 years), and 89.7% were male. Most participants (67.6%) had stage II disease and were treated with chemoradiation (85.3%). Mean time after treatment was 2.6 years (range, 0.3-9.1 years). Fifty-eight of 68 participants (85.3%) were working at enrollment; median time to return to work was 6.0 months (interquartile range, 4-10 months); 45 (77.6%) were in the same role and 35 (60.3%) worked the same number of hours. Ten participants were not working, 3 had retired, 5 reported persistent and significant treatment toxicity preventing employment. Survivors currently working reported higher physical, functional, and global QOL scores. Access to leave and support from treating doctors were facilitators for return to work, whereas fatigue was frequently reported as a barrier to returning to work.
With time, the majority of participants with HPV-associated OPC will return to work after radiation therapy. Attention to symptom management and support from the workplace may enable more successful return to work.
人乳头瘤病毒（HPV）相关口咽癌（OPC）通常影响处于工作年龄的人群，但有关这一人群治疗后重返工作岗位的经验数据有限。本研究旨在调查放射治疗完成后幸存者目前的工作比例，并探讨治疗后工作的潜在促进因素和障碍。
这项在澳大利亚维多利亚州墨尔本彼得麦卡伦癌症中心进行的横断面、单机构研究纳入了以下患者：诊断时年龄在 18 至 65 岁之间，在诊断前 3 个月内就业，并且在入组前至少完成了 4 个月的 HPV 相关 OPC 根治性治疗。参与者完成了一份纸质问卷调查，以评估基线人口统计学、就业状况和生活质量（癌症治疗头颈部功能评估量表）。开放性问题探讨了影响重返工作的因素。分析了当前就业状况与各种疾病、治疗和人口统计学变量以及生活质量之间的关联。通过总结内容分析对自由文本项目进行了分析。
在接触的 93 名参与者中，有 68 名（73.1%）做出了回应。平均年龄为 54.1 岁（范围 39-64 岁），89.7%为男性。大多数参与者（67.6%）为 II 期疾病，接受了放化疗（85.3%）。治疗后平均时间为 2.6 年（范围 0.3-9.1 年）。68 名参与者中有 58 名（85.3%）在入组时正在工作；中位重返工作时间为 6.0 个月（四分位距 4-10 个月）；45 名（77.6%）从事相同的角色，35 名（60.3%）工作时间相同。10 名参与者未工作，3 名已退休，5 名报告持续且严重的治疗毒性阻碍了就业。目前正在工作的幸存者报告了更高的身体、功能和总体生活质量评分。获得休假和接受治疗医生的支持是重返工作的促进因素，而疲劳则经常被报告为重返工作的障碍。
随着时间的推移，大多数 HPV 相关 OPC 幸存者在放射治疗后将重返工作岗位。对症状管理的关注以及工作场所的支持可能会使更多人成功重返工作岗位。
