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口腔鳞状细胞癌患者的口腔及总体健康相关生活质量——不同治疗方案的比较分析

Oral and general health-related quality of life in oral squamous cell carcinoma patients- comparative analysis of different treatment regims.

作者信息

Gondivkar Shailesh M, Gadbail Amol R, Sarode Sachin C, Hedaoo Amol, Dasgupta Subhrajit, Sharma Balkrishna, Sharma Aparna, Gondivkar Rima S, Yuwanati Monal, Patil Shankargouda, Gaikwad Rahul N

机构信息

Department of Oral Medicine & Radiology, Government Dental College & Hospital, Nagpur, Maharashtra, India.

Department of Dentistry, Indira Gandhi Government Medical College & Hospital, Nagpur, Maharashtra State, India.

出版信息

J Oral Biol Craniofac Res. 2021 Apr-Jun;11(2):125-131. doi: 10.1016/j.jobcr.2021.01.004. Epub 2021 Jan 6.

Abstract

BACKGROUND

Modern aggressive oncological treatment options for oral squamous cell carcinoma (OSCC) are inevitably associated with impaired general health-related quality of life (HRQoL) and oral HRQoL (OHRQoL). However, there is dire need for prospective and concomitant assessment of HRQoL and OHRQoL after different treatment regims. Hence, present study was designed to investigate HRQoL and OHRQoL in patients treated for OSCC using various modalities.

METHODS

135 OSCC patients were grouped according to treatment rendered into Group A: surgery only; Group B: post-surgical radiotherapy (PRT); and Group C: post-surgical chemo-radiation (PCRT). The 12-item Short Form Health Survey (SF-12) and Oral Health Impact Profile-14 (OHIP-14) were intervened to assess HRQoL and OHRQoL respectively at 1-month and 6-months post-treatment.

RESULTS

At 1-month post-treatment, patients who received PCRT showed significantly lower mean values for physical and mental domains of SF-12 and higher mean subscales and overall OHIP-14 (24.57 ​± ​2.62) score than those treated by surgery alone (10.55 ​± ​2.26) and PRT (20.20 ​± ​3.80), with largest differences between PCRT and surgery alone groups (p ​< ​0.001). Social functioning, general health and bodily pain of SF-12 and functional limitations, physical pain and physical disability amongst OHIP-14 domains were greatly affected. Although few physical domains of SF-12 showed significant improvement, mental domains remained a greater problem after 6 months. However, OHRQoL was significantly poor in all the three study groups (p ​< ​0.001).

CONCLUSION

Irrespective of the post-treatment duration, patients who received PCRT had worse HRQoL and OHRQoL. There is a need to identify factors associated with impaired HRQoL and OHRQoL to customize better therapeutic decisions.

摘要

背景

口腔鳞状细胞癌(OSCC)的现代积极肿瘤治疗方案不可避免地会导致总体健康相关生活质量(HRQoL)和口腔健康相关生活质量(OHRQoL)受损。然而,迫切需要对不同治疗方案后的HRQoL和OHRQoL进行前瞻性和同步评估。因此,本研究旨在调查采用各种方式治疗的OSCC患者的HRQoL和OHRQoL。

方法

135例OSCC患者根据治疗方式分为A组:仅手术治疗;B组:术后放疗(PRT);C组:术后放化疗(PCRT)。采用12项简短健康调查问卷(SF-12)和口腔健康影响程度量表-14(OHIP-14)分别在治疗后1个月和6个月评估HRQoL和OHRQoL。

结果

治疗后1个月,接受PCRT的患者SF-12身体和心理领域的平均值显著较低,OHIP-14平均分量表和总分(24.57 ± 2.62)得分高于仅接受手术治疗(10.55 ± 2.26)和PRT(20.20 ± 3.80)的患者,PCRT组与仅手术治疗组之间差异最大(p < 0.001)。SF-12的社会功能、总体健康和身体疼痛以及OHIP-14领域中的功能限制、身体疼痛和身体残疾受到极大影响。虽然SF-12的一些身体领域显示出显著改善,但6个月后心理领域仍然是一个更大的问题。然而,所有三个研究组的OHRQoL均显著较差(p < 0.001)。

结论

无论治疗后的持续时间如何,接受PCRT的患者的HRQoL和OHRQoL较差。需要确定与HRQoL和OHRQoL受损相关的因素,以制定更好的治疗决策。

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