头颈部癌症患者在放射肿瘤学咨询时报告疼痛增加：一项生活质量分析。

Increased Pain Reporting by Head and Neck Cancer Patients at Radiation Oncology Consultation: A Quality-of-Life Analysis.

机构信息

Department of Radiation Oncology, University of Cincinnati, Cincinnati, Ohio, U.S.A.

Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, U.S.A.

出版信息

Laryngoscope. 2021 Feb;131(2):326-332. doi: 10.1002/lary.28784. Epub 2020 Jul 1.

DOI:10.1002/lary.28784

PMID:32609888

Abstract

OBJECTIVES

Head and neck cancers (HNC) are associated with significant morbidity. Quality-of-life (QoL) analyses can assist with understanding subjective factors shaping the patient experience. Here, we assess for patient and/or tumor factors associated with increased pain reporting at the time of initial radiation oncology consultation at a single institution in 2015.

STUDY DESIGN

Prospective cross-sectional questionnaire research.

METHODS

All new patient consultations in 2015 were offered the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire Core-30 (EORTC QLQ-C30) survey. HNC patients were also offered the EORTC QLQ-HN35 module. Retrospective chart review was performed on patients who completed the surveys. Patient demographics, tumor characteristics, and QoL responses were analyzed for potential associations. Statistical analyses were conducted using SAS v9.4 (SAS Institute, Cary, NC), with P < .05 considered significant.

RESULTS

Of 771 new patient consultations, 137 consultations were for HNC patients. Of those, 62 patients completed both surveys. HNC patients reported greater pain relative to all other disease sites (odds ratio [OR]: 2.05; P < .01). On univariate analysis of the EORTC QLQ-C30 data, increased pain was found to be associated with tumor size > 4 cm (OR: 3.05; P ≤ .05). The EORTC QLQ-HN35 data revealed lymph node involvement to be independently associated with pain (OR: 3.12; P ≤ .05). On multivariate analysis, increased pain was associated with lack of pain medication prescription at the time of consultation (P ≤ .05) and age ≥ 65 years (P ≤ .05).

CONCLUSION

Patients with HNC reported significantly more pain at consultation than patients with other primary malignancies. Understanding factors contributing to subjective pain may allow providers to potentially address these symptoms proactively to improve patients' QoL.

LEVEL OF EVIDENCE

2c - Outcomes research. Laryngoscope, 131:326-332, 2021.

摘要

目的

头颈部癌症（HNC）与显著的发病率有关。生活质量（QoL）分析可以帮助了解影响患者体验的主观因素。在这里，我们评估了 2015 年在一家机构进行初始放射肿瘤学咨询时与疼痛报告增加相关的患者和/或肿瘤因素。

研究设计

前瞻性横断面问卷调查研究。

方法

2015 年所有新患者咨询均提供欧洲癌症研究与治疗组织生活质量问卷核心 30 项（EORTC QLQ-C30）调查。HNC 患者还提供 EORTC QLQ-HN35 模块。对完成调查的患者进行回顾性图表审查。分析患者人口统计学、肿瘤特征和 QoL 反应，以寻找潜在关联。使用 SAS v9.4（SAS Institute，Cary，NC）进行统计分析，P < .05 被认为具有统计学意义。

结果

在 771 例新患者咨询中，有 137 例咨询是针对 HNC 患者的。其中，62 例患者同时完成了两项调查。HNC 患者报告的疼痛比其他所有疾病部位都要严重（优势比 [OR]：2.05；P < .01）。对 EORTC QLQ-C30 数据进行单因素分析发现，疼痛增加与肿瘤大小>4 cm 相关（OR：3.05；P ≤ .05）。EORTC QLQ-HN35 数据显示淋巴结受累与疼痛独立相关（OR：3.12；P ≤ .05）。多因素分析显示，咨询时缺乏疼痛药物处方（P ≤ .05）和年龄≥65 岁（P ≤ .05）与疼痛增加相关。