Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Otolaryngol Head Neck Surg. 2021 Mar;164(3):639-644. doi: 10.1177/0194599820941012. Epub 2020 Jul 21.
To examine the impact of treatment on disease-specific health-related quality of life (HRQOL) among patients with sporadic vestibular schwannoma (VS).
National cross-sectional study.
Tertiary referral center and the Acoustic Neuroma Association.
Adult patients with VS who completed the Penn Acoustic Neuroma Quality of Life (PANQOL) survey. Patients were classified by treatment at the most recent survey as microsurgery, radiosurgery, observation, or recently diagnosed (RD). PANQOL scores were compared among VS treatment groups and with nontumor controls using analysis of covariance.
A total of 1362 respondents with VS were analyzed. Total PANQOL scores differed significantly by treatment ( = .024) with adjusted means of 60, 63, 65, and 62 for the microsurgery, radiosurgery, observation, and RD groups, respectively. Subdomain scores for facial function, balance, hearing loss, and pain differed significantly ( < .05) by treatment. Comparisons that surpassed thresholds for clinical significance included microsurgery compared to radiosurgery and observation for facial function, microsurgery compared to observation and RD for hearing loss, and microsurgery compared to radiosurgery and observation for pain. Subdomain scores for anxiety, facial function, balance, hearing loss, energy, and pain and total PANQOL scores for nontumor controls were significantly higher (ie, more favorable) compared to the VS groups ( < .05). General health scores did not differ significantly between the nontumor controls and the VS groups ( = .19).
Differences in HRQOL among treatment modalities are small and variably exceed the minimal clinically important difference. The impact of a VS diagnosis on HRQOL supersedes that of the treatment type.
考察治疗对散发前庭神经鞘瘤（VS）患者疾病特异性健康相关生活质量（HRQOL）的影响。
全国性横断面研究。
三级转诊中心和听神经瘤协会。
完成宾夕法尼亚听神经瘤生活质量（PANQOL）调查的成年 VS 患者。根据最近一次调查中的治疗方法，将患者分为显微手术、放射外科、观察或近期诊断（RD）。使用协方差分析比较 VS 治疗组与非肿瘤对照组之间的 PANQOL 评分。
共分析了 1362 名 VS 患者。治疗方法差异显著（ =.024），显微手术、放射外科、观察和 RD 组的总 PANQOL 评分分别为 60、63、65 和 62。面部功能、平衡、听力损失和疼痛的亚域评分差异显著（ <.05）。超过临床意义阈值的比较包括：与放射外科和观察相比，显微手术的面部功能；与观察和 RD 相比，显微手术的听力损失；与放射外科和观察相比，显微手术的疼痛。与 VS 组相比（ <.05），非肿瘤对照组的焦虑、面部功能、平衡、听力损失、能量和疼痛的亚域评分以及 PANQOL 总分更高（即更有利）。非肿瘤对照组和 VS 组之间的一般健康评分无显著差异（ =.19）。
治疗方式之间的 HRQOL 差异较小，且差异程度不同，超过了最小临床重要差异。VS 诊断对 HRQOL 的影响超过了治疗类型的影响。
