Farrugia Mark, Erickson Kayleigh, Wendel Elizabeth, Platek Mary E, Ji Wenyan, Attwood Kristopher, Ma Sung Jun, Gu Fangyi, Singh Anurag K, Ray Andrew D
Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA.
Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA.
Cancers (Basel). 2021 Apr 1;13(7):1638. doi: 10.3390/cancers13071638.
Patient-reported quality of life (QoL) metrics, frailty status, and physical functioning are emerging concepts in head and neck cancer (HNC) with implications on both treatment decision-making and prognosis. The impact of treatment-related functional decline on QoL and frailty has not been well-characterized in HNC and was the focus of this investigation.
Patients who underwent radiation therapy for HNC from 2018 to 2020 were evaluated as a prospective observational cohort. Functional decline, QoL, and the frailty phenotype were measured via the Short Physical Performance Battery (SPPB), European Organization for Research and Treatment of Cancer (EORTC) qlq-C30, and Fried Frailty index, respectively.
A total of 106 HNC patients were included, 75 of which received concurrent chemoradiation therapy (CCRT) and 31 received radiation alone, both with and without surgery. There was a decrease in SPPB overall ( < 0.001) from the beginning to the end of treatment in the CCRT group but not the radiation group ( = 0.43). Change in overall SPPB points following treatment correlated with the decline in physical QoL for both groups ( < 0.05) as well as transition frail status in the CCRT group ( < 0.001) with a trend in the radiation group ( = 0.08).
Change in SPPB correlates with QoL and transition to frailty status in patients undergoing definitive CCRT for HNC with similar trends in those receiving radiation alone. Decline in SPPB could potentially be useful in identification of those who may benefit from rehabilitation in future studies.
患者报告的生活质量（QoL）指标、虚弱状态和身体功能是头颈癌（HNC）中正在兴起的概念，对治疗决策和预后均有影响。治疗相关功能下降对HNC患者QoL和虚弱状态的影响尚未得到充分描述，本研究以此为重点。
对2018年至2020年接受头颈癌放射治疗的患者进行前瞻性观察队列评估。分别通过简短体能表现量表（SPPB）、欧洲癌症研究与治疗组织（EORTC）qlq-C30量表和弗里德虚弱指数来测量功能下降、QoL和虚弱表型。
共纳入106例HNC患者，其中75例接受同步放化疗（CCRT），31例仅接受放疗，部分患者有手术，部分没有手术。CCRT组从治疗开始到结束时SPPB总分总体下降（<0.001），而放疗组未下降（=0.43）。两组治疗后SPPB总分的变化与身体QoL的下降相关（<0.05），CCRT组还与虚弱状态转变相关（<0.001），放疗组有相关趋势（=0.08）。
在接受根治性CCRT的HNC患者中，SPPB变化与QoL及向虚弱状态转变相关，仅接受放疗的患者也有类似趋势。SPPB下降可能有助于在未来研究中识别可能从康复治疗中获益的患者。
