Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Otolaryngol Head Neck Surg. 2023 Feb;168(2):196-202. doi: 10.1177/01945998221087712.
In the setting of similar outcomes, quality of life (QOL) measures can be utilized to compare treatment modalities in head and neck squamous cell carcinoma (HNSCC). We evaluate QOL and symptoms in patients treated for primary, second primary, and recurrent HNSCC.
Retrospective cohort study.
Head and neck cancer survivorship clinic.
We identified patients seen between 2016 and 2019. QOL and symptoms were assessed with the University of Washington Quality of Life (UW-QOL) questionnaire, 10-item Eating Assessment Tool, 8-item Patient Health Questionnaire, 7-item Generalized Anxiety Disorder, and Neck Disability Index. Regression analysis was utilized to explore associations and compare QOL outcomes.
Our cohort comprised 662 patients: 546 with primary HNSCC, 34 with second primary HNSCC, and 82 with recurrent HNSCC. Multimodality therapy was associated with lower UW-QOL Physical Subscale (UW-QOL-PS) vs single modality: chemoradiation therapy (-12.17 [95% CI, -16.57 to -7.78]) and surgery + postadjuvant treatment (-12.11 [-16.06 to -8.16]). Multimodality therapy was also associated with lower UW-QOL Social-Emotional Subscale (UW-QOL-SS): chemoradiation therapy (-6.70 [-11.41 to -1.99]) and surgery + postadjuvant treatment (-7.41 [-11.63 to -3.19]). Recurrence (-14.42 [-18.80 to -10.04]) and second primary (-11.15 [-17.71 to -4.59]) demonstrated lower UW-QOL-PS vs primary. Radiation for recurrence or second primary had worse UW-QOL-PS (-10.43 [-19.27 to -1.59]) and UW-QOL-SS (-10.58 [-18.76 to -1.54]) and higher Eating Assessment Tool (6.08 [1.39-10.77]) than surgery alone. Surgery + postadjuvant treatment showed worse UW-QOL-PS (-12.65 [-23.76 to -1.54]) and UW-QOL-SS (-12.20 [-22.38 to -2.03]).
Multimodality therapy, particularly with recurrent and second primary HNSCC, is more likely to contribute to diminished QOL and symptoms. This important consideration should play a role in framing informed discussions with patients regarding treatment.
在结局相似的情况下，生活质量（QOL）指标可用于比较头颈部鳞状细胞癌（HNSCC）的治疗方式。我们评估了原发性、第二原发性和复发性 HNSCC 患者的 QOL 和症状。
回顾性队列研究。
头颈部癌症生存者诊所。
我们鉴定了 2016 年至 2019 年就诊的患者。使用华盛顿大学生活质量（UW-QOL）问卷、10 项进食评估工具、8 项患者健康问卷、7 项广泛性焦虑症和颈部残疾指数评估 QOL 和症状。回归分析用于探讨相关性并比较 QOL 结果。
我们的队列包括 662 名患者：546 名原发性 HNSCC 患者，34 名第二原发性 HNSCC 患者，82 名复发性 HNSCC 患者。与单一疗法相比，多模式疗法与较低的 UW-QOL 生理量表（UW-QOL-PS）相关：放化疗（-12.17 [95%CI，-16.57 至-7.78]）和手术+辅助治疗（-12.11 [-16.06 至-8.16]）。多模式疗法也与较低的 UW-QOL 社会-情感量表（UW-QOL-SS）相关：放化疗（-6.70 [11.41 至-1.99]）和手术+辅助治疗（-7.41 [-11.63 至-3.19]）。复发（-14.42 [-18.80 至-10.04]）和第二原发性（-11.15 [-17.71 至-4.59]）的 UW-QOL-PS 低于原发性。与单独手术相比，复发或第二原发性的放疗具有更差的 UW-QOL-PS（-10.43 [-19.27 至-1.59]）和 UW-QOL-SS（-10.58 [-18.76 至-1.54]）和更高的进食评估工具（6.08 [1.39-10.77]）。手术+辅助治疗显示出更差的 UW-QOL-PS（-12.65 [-23.76 至-1.54]）和 UW-QOL-SS（-12.20 [-22.38 至-2.03]）。
多模式疗法，特别是针对复发性和第二原发性 HNSCC 的疗法，更有可能导致 QOL 和症状下降。在与患者进行有关治疗的知情讨论时，这一重要考虑因素应发挥作用。
