Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Cancer. 2021 Dec 1;127(23):4470-4480. doi: 10.1002/cncr.33849. Epub 2021 Aug 6.
This study was conducted to identify clinicodemographic risk factors for xerostomia among long-term oropharyngeal cancer (OPC) survivors.
This cross-sectional study included 906 disease-free, adult OPC survivors with a median survival duration at the time of survey of 6 years (range, 1-16 years); self-reported xerostomia scores were available for 877 participants. Study participants had completed curative treatment between January 2000 and December 2013 and responded to a survey administered from September 2015 to July 2016. The primary outcome variable was cancer patient-reported xerostomia measured with the MD Anderson Symptom Inventory Head and Neck Cancer Module. Clinicodemographic risk factors for moderate to severe xerostomia were identified via multivariable logistic regression.
Moderate to severe xerostomia was reported by 343 of the respondents (39.1%). Female sex (odds ratio [OR], 1.82; 95% CI, 1.22-2.71; P = .003; Bayesian false-discovery probability [BFDP] = 0.568), high school or lower education (OR, 1.73; 95% CI, 1.19-2.52; P = .004; BFDP = 0.636), and current cigarette smoking at the time of survey (OR, 2.56; 95% CI, 1.19-5.47; P = .016; BFDP = 0.800) were risk factors for moderate to severe xerostomia, and bilateral intensity-modulated radiotherapy (IMRT) combined with proton therapy and ipsilateral IMRT were protective.
In this large xerostomia study, modern radiotherapy was a protective factor, and continued cigarette smoking at the time of survey, female sex, and high school or lower education were identified as other contributing risk factors associated with moderate to severe xerostomia. Importantly, these findings need to be confirmed in prospective studies. These results can inform future research and targeted patient-centered interventions to monitor and manage radiation therapy-associated xerostomia and preserve quality of life among patients with OPC.
本研究旨在确定长期口咽癌（OPC）幸存者口干的临床病理危险因素。
本横断面研究纳入了 906 名无疾病、成年 OPC 幸存者，调查时中位生存时间为 6 年（范围为 1-16 年）；877 名参与者提供了自我报告的口干评分。研究参与者在 2000 年 1 月至 2013 年 12 月期间完成了治愈性治疗，并于 2015 年 9 月至 2016 年 7 月期间对一项调查做出了回应。主要结局变量是癌症患者使用 MD 安德森症状量表头颈部癌症模块报告的口干症。通过多变量逻辑回归确定中重度口干的临床病理危险因素。
343 名受访者（39.1%）报告有中重度口干症。女性（比值比[OR]，1.82；95%置信区间[CI]，1.22-2.71；P =.003；贝叶斯假发现概率[BFDP] = 0.568）、高中或以下学历（OR，1.73；95% CI，1.19-2.52；P =.004；BFDP = 0.636）和调查时当前吸烟（OR，2.56；95% CI，1.19-5.47；P =.016；BFDP = 0.800）是中重度口干的危险因素，双侧调强放疗（IMRT）联合质子治疗和同侧 IMRT 为保护因素。
在这项大型口干症研究中，现代放疗是一种保护因素，而调查时持续吸烟、女性和高中或以下学历被确定为与中重度口干症相关的其他危险因素。重要的是，这些发现需要在前瞻性研究中得到证实。这些结果可以为未来的研究和以患者为中心的干预措施提供信息，以监测和管理与放疗相关的口干症，并保持 OPC 患者的生活质量。
