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喉全切除术后的健康相关生活质量、吞咽困难、嗓音问题、抑郁和焦虑。

Health-Related Quality of Life, Dysphagia, Voice Problems, Depression, and Anxiety After Total Laryngectomy.

机构信息

Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark.

Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark.

出版信息

Laryngoscope. 2022 May;132(5):980-988. doi: 10.1002/lary.29857. Epub 2021 Sep 7.

Abstract

OBJECTIVES/HYPOTHESIS: The aims were to determine health-related quality of life (HRQoL), including voice problems, dysphagia, depression, and anxiety after total laryngectomy (TL), and investigate the associations between HRQoL and the late effects.

STUDY DESIGN

Cross-sectional study.

METHODS

172 participants having received a TL 1.6 to 18.1 years ago for laryngeal/hypopharyngeal cancer filled in the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire, Core and Head and Neck module (EORTC QLQ-C30, EORTC QLQ-H&N35), Voice-Related Quality of Life questionnaire (V-RQOL), M.D. Anderson Dysphagia Inventory (MDADI), and Hospital Anxiety and Depression Scale (HADS) questionnaires.

RESULTS

Participants scored worse than normative reference populations on all scales/items of the EORTC questionnaires, except one, and almost half of the scales/items showed a clinically relevant difference. Moderate/severe dysphagia was present in 46%, moderate/severe voice problems in 57%, depression in 16%, and anxiety in 20%. Decreasing age, increasing numbers of comorbidities, increasing voice problems, increasing dysphagia, and increasing depression symptoms, were associated with a lowered EORTC QLQ-C30 summary score.

CONCLUSION

A substantial proportion of participants experienced clinically significant late effects and increasing levels of these were associated with a lowered HRQoL.

LEVEL OF EVIDENCE

3 Laryngoscope, 132:980-988, 2022.

摘要

目的/假设:目的是确定喉全切除术后(TL)与健康相关的生活质量(HRQoL),包括嗓音问题、吞咽困难、抑郁和焦虑,并探讨 HRQoL 与晚期效应之间的关系。

研究设计

横断面研究。

方法

172 名接受 TL 治疗的患者(1.6-18.1 年前因喉/下咽癌)填写了欧洲癌症研究与治疗组织生活质量问卷核心和头颈部模块(EORTC QLQ-C30、EORTC QLQ-H&N35)、嗓音相关生活质量问卷(V-RQOL)、MD 安德森吞咽障碍量表(MDADI)和医院焦虑抑郁量表(HADS)问卷。

结果

与 EORTC 问卷的所有量表/项目的参考人群相比,除一项外,所有量表/项目的得分均较差,几乎一半的量表/项目存在临床相关差异。46%的患者存在中度/重度吞咽困难,57%的患者存在中度/重度嗓音问题,16%的患者存在抑郁,20%的患者存在焦虑。年龄下降、合并症增多、嗓音问题加重、吞咽困难加重、抑郁症状加重,与 EORTC QLQ-C30 总评分降低有关。

结论

相当一部分患者经历了有临床意义的晚期效应,这些效应的水平增加与 HRQoL 降低有关。

证据水平

3 级喉镜,132:980-988,2022。

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