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头颈部癌症患者的吞咽困难、声音问题和头痛

Dysphagia, voice problems, and pain in head and neck cancer patients.

机构信息

Department of Otolaryngology, Head and Neck Surgery, Clinic of Otolaryngology, Head and Neck Surgery, University of Leipzig, Leipzig, Germany.

Innovation Center Computer Assisted Surgery (ICCAS), University of Leipzig, Leipzig, Germany.

出版信息

Eur Arch Otorhinolaryngol. 2021 Oct;278(10):3985-3994. doi: 10.1007/s00405-020-06584-6. Epub 2021 Jan 16.

Abstract

PURPOSE

Head and neck cancer (HNC) and its treatment can leave devastating side effects with a relevant impact on physical and emotional quality of life (QoL) of HNC patients. The objectives were to examine the amount of dysphagia, voice problems, and pain in HNC patients, the impact of sociodemographic, behavioral, and clinical factors on these symptoms, the psychometric properties of the EAT-10, and the relationship between these symptoms and QoL variables.

METHODS

HNC patients attending for regular follow-up from 07/2013 to 09/2019 completed questionnaires (Eating Assessment Tool-10 (EAT-10); questions from the EORTC QLQ-C30 and EORTC H&N35) on dysphagia, voice problems, pain, fatigue, and QoL collected with the software OncoFunction. Associations between prognostic factors and symptoms were tested with analyses of variance (ANOVAs). Associations between the symptom scales and QoL variables were expressed with Pearson correlations.

RESULTS

Of 689 patients, 54.9% suffered from dysphagia, the EAT-10 proved to be a reliable measure. The mean voice score was 37.6 (± 33.9) [range 0-100], the mean pain score 1.98 (± 2.24) [range 0-10]. Trimodality treatment was associated with the highest dysphagia scores. Dysphagia, voice problems, and pain significantly correlated with each other, the highest association was found for dysphagia and pain (r = 0.51). QoL was strongly correlated with dysphagia and pain (r = - 0.39 and r = - 0.40, respectively), while the association with voice problems was weaker (r = - 0.28).

CONCLUSION

Dysphagia is an important symptom in HNC patients greatly affecting patients' QoL and significantly correlating with voice problems and pain.

摘要

目的

头颈部癌症(HNC)及其治疗可能会导致严重的副作用,对 HNC 患者的身体和情绪生活质量(QoL)产生重大影响。本研究的目的是检查 HNC 患者吞咽困难、声音问题和疼痛的程度,社会人口统计学、行为和临床因素对这些症状的影响,EAT-10 的心理测量特性,以及这些症状与 QoL 变量的关系。

方法

2013 年 7 月至 2019 年 9 月期间,定期接受随访的 HNC 患者完成了问卷调查(吞咽评估工具-10(EAT-10);EORTC QLQ-C30 和 EORTC H&N35 的问题),内容包括吞咽困难、声音问题、疼痛、疲劳和生活质量,这些问题都是使用 OncoFunction 软件收集的。使用方差分析(ANOVAs)检验预后因素与症状之间的关系。用 Pearson 相关系数表示症状量表与 QoL 变量之间的关系。

结果

在 689 名患者中,54.9%的患者有吞咽困难,EAT-10 被证明是一种可靠的测量工具。平均声音评分为 37.6(±33.9)[范围 0-100],平均疼痛评分为 1.98(±2.24)[范围 0-10]。三联疗法与最高的吞咽困难评分相关。吞咽困难、声音问题和疼痛彼此之间显著相关,其中吞咽困难和疼痛的相关性最高(r=0.51)。QoL 与吞咽困难和疼痛密切相关(r=-0.39 和 r=-0.40),而与声音问题的相关性较弱(r=-0.28)。

结论

吞咽困难是 HNC 患者的一个重要症状,极大地影响了患者的生活质量,与声音问题和疼痛显著相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/849c/8382612/c84bc902b8ac/405_2020_6584_Fig1_HTML.jpg

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