亚洲分化型甲状腺癌幸存者的健康相关生活质量。
Health-Related Quality of Life in Asian Differentiated Thyroid Cancer Survivors.
机构信息
Department of Clinical Oncology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong.
Department of Surgery, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong.
出版信息
Cancer Control. 2021 Jan-Dec;28:10732748211029726. doi: 10.1177/10732748211029726.
BACKGROUND
Health-related quality of life (HRQoL) is important for differentiated thyroid cancer survivors, but data for Asian survivors is lacking. This study aimed to have an overview of, and identify any disease-or treatment-related factors associated with, HRQoL in Asian differentiated thyroid cancer survivors.
PATIENTS AND METHODS
Thyroid cancer survivors were recruited from the thyroid clinics at Queen Mary Hospital, Hong Kong from February 2016 to December 2016. All adult differentiated thyroid cancer patients with stable disease more than or equal to 1 year received a survey on HRQoL using the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and Thyroid cancer specific quality of life (THYCA-QoL) questionnaire. Clinical information was collected retrospectively from the computerized clinical management system. To identify factors associated with poor HRQoL, univariable and stepwise multivariable regression analysis were performed.
RESULTS
A total of 613 survivors completed the questionnaires (response rate: 82.1%; female: 80.1%; median survivorship: 7.4 years (range: 1.0-48.2 years)). The QLQ-C30 summary score mean was 84.4 (standard deviation (SD): 12.7) while the THYCA-QoL summary score mean was 39.9 (SD: 9.7). The 2 highest symptom subscales were fatigue (mean: 26.4, SD: 20.6) and insomnia (mean: 26.2, SD: 27.6). Factors associated with worse HRQoL included serum thyrotropin (TSH) greater than 1.0 mIU/L, unemployment, and concomitant psychiatric disorders. Concomitant psychiatric illness (n = 40/613, 6.5%) also showed significant association with most of the symptom and functional subscales.
CONCLUSIONS
Fatigue and insomnia were the 2 most common symptoms experienced by our differentiated thyroid cancer survivors. Long-term survivorship care with monitoring serum TSH level, supporting return-to-work and screening for concomitant psychiatric disorders should be offered.
背景
健康相关生活质量（HRQoL）对分化型甲状腺癌幸存者很重要，但亚洲幸存者的数据却很少。本研究旨在全面了解并确定与亚洲分化型甲状腺癌幸存者 HRQoL 相关的任何疾病或治疗相关因素。
患者和方法
2016 年 2 月至 2016 年 12 月，从香港玛丽医院甲状腺科招募甲状腺癌幸存者。所有稳定疾病超过或等于 1 年的成年分化型甲状腺癌患者均使用欧洲癌症研究与治疗组织生活质量问卷（EORTC QLQ-C30）和甲状腺癌特定生活质量问卷（THYCA-QoL）进行 HRQoL 调查。临床信息从计算机化临床管理系统中回顾性收集。为了确定与 HRQoL 不良相关的因素，进行了单变量和逐步多变量回归分析。
结果
共有 613 名幸存者完成了问卷调查（应答率：82.1%；女性：80.1%；中位生存时间：7.4 年（范围：1.0-48.2 年））。QLQ-C30 总评分平均值为 84.4（标准差（SD）：12.7），THYCA-QoL 总评分平均值为 39.9（SD：9.7）。两个最高的症状亚量表是疲劳（平均：26.4，SD：20.6）和失眠（平均：26.2，SD：27.6）。与 HRQoL 较差相关的因素包括血清促甲状腺激素（TSH）大于 1.0 mIU/L、失业和并存的精神疾病。并存的精神疾病（n=40/613，6.5%）也与大多数症状和功能亚量表显著相关。
结论
疲劳和失眠是我们分化型甲状腺癌幸存者最常见的两种症状。应提供长期生存护理，监测血清 TSH 水平，支持重返工作岗位，并筛查并存的精神疾病。
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