Chen Changlian, Cao Jiayan, Wang Yueyang, Han Xuya, Zhang Yaju, Zhuang Shumei
Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.
Basic Nursing Teaching and Research Office, School of Nursing, Tianjin Medical University, Tianjin, China.
Thyroid. 2023 Apr;33(4):474-483. doi: 10.1089/thy.2022.0490. Epub 2023 Mar 17.
The incidence of differentiated thyroid cancer in Mainland China has increased rapidly in recent years, yet the number of studies focusing on health-related quality of life (HR-QOL) is still limited. Additionally, some of the quality-of-life (QOL) issues specific to thyroid cancer have not been adequately described. The aims of this study were to assess the generic and disease-specific HR-QOL of differentiated thyroid cancer survivors and to identify the associated factors. A cross-sectional survey including 373 patients was conducted in Mainland China. Participants completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the Thyroid Cancer-Specific Quality of Life Questionnaire (THYCA-QOL), and a questionnaire on patient demographics and clinical characteristics. The QLQ-C30 global mean score was 73.12 (standard deviation [SD] = 11.95), while the THYCA-QOL summary mean score was 34.50 (SD = 12.68). The two QLQ-C30 functional subscales with the lowest scores were the social functioning and role functioning subscales. The five symptom subscales of the THYCA-QOL with the highest scores were the subscales regarding less interest in sex, problems with scar, psychological problems, voice problems, and sympathetic problems. Factors associated with worse global QOL on the QLQ-C30 included a shorter time since completing primary treatment (≤6 months), a history of lateral neck dissection, and a lower current thyrotropin (TSH) level (≤0.5 mIU/L). Higher cumulative activities of radioiodine (RAI; >100 mCi), gender (women), postoperative hypoparathyroidism, and a history of lateral neck dissection were associated with worse thyroid cancer-specific QOL. In contrast, higher monthly household income (>5000￥) and a history of minimally invasive thyroid surgery were associated with better thyroid cancer-specific QOL. Thyroid cancer patients experience multiple health-related problems and disease-specific symptoms after completing primary treatment. Patients with a duration ≤6 months from the completion of primary treatment, those with a history of lateral neck dissection, and a current TSH level ≤0.5 mIU/L may be more likely to have impaired generic QOL. More thyroid cancer-specific symptoms may be associated with higher cumulative activities of RAI, gender (women), postoperative hypoparathyroidism, a history of lateral neck dissection, lower monthly household income, and conventional surgery.
近年来，中国大陆分化型甲状腺癌的发病率迅速上升，但关注健康相关生活质量（HR-QOL）的研究数量仍然有限。此外，一些甲状腺癌特有的生活质量（QOL）问题尚未得到充分描述。本研究的目的是评估分化型甲状腺癌幸存者的一般和疾病特异性HR-QOL，并确定相关因素。在中国内地进行了一项横断面调查，包括373名患者。参与者完成了欧洲癌症研究与治疗组织生活质量问卷（EORTC QLQ-C30）、甲状腺癌特异性生活质量问卷（THYCA-QOL）以及一份关于患者人口统计学和临床特征的问卷。QLQ-C30全球平均得分为73.12（标准差[SD]=11.95），而THYCA-QOL总结平均得分为34.50（SD=12.68）。QLQ-C30得分最低的两个功能子量表是社会功能和角色功能子量表。THYCA-QOL得分最高的五个症状子量表是关于对性兴趣降低、疤痕问题、心理问题、声音问题和交感神经问题的子量表。与QLQ-C30上较差的总体QOL相关的因素包括完成初次治疗后的时间较短（≤6个月）、侧颈清扫史以及当前促甲状腺激素（TSH）水平较低（≤0.5 mIU/L）。放射性碘（RAI）的累积活度较高（>100 mCi）、性别（女性）、术后甲状旁腺功能减退以及侧颈清扫史与较差的甲状腺癌特异性QOL相关。相比之下，较高的月家庭收入（>5000元）和微创甲状腺手术史与较好的甲状腺癌特异性QOL相关。甲状腺癌患者在完成初次治疗后会经历多种与健康相关的问题和疾病特异性症状。初次治疗完成后持续时间≤6个月的患者、有侧颈清扫史的患者以及当前TSH水平≤0.5 mIU/L的患者可能更有可能出现一般QOL受损。更多的甲状腺癌特异性症状可能与RAI的累积活度较高、性别（女性）、术后甲状旁腺功能减退、侧颈清扫史、较低的月家庭收入以及传统手术有关。
