Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy.
Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy.
Support Care Cancer. 2023 Mar 17;31(4):220. doi: 10.1007/s00520-023-07661-2.
The present study examined the longitudinal trajectories, through hierarchical modeling, of quality of life among patients with head and neck cancer, specifically symptoms burden, during radiotherapy, and in the follow-up period (1, 3, 6, and 12 months after completion of radiotherapy), through the M.D. Anderson Symptom Inventory Head and Neck questionnaire, formed by three factors. Furthermore, analyses were conducted controlling for socio-demographic as well as clinical characteristics.
Multi-level mixed-effects linear regression was used to estimate the association between quality of life and time, age, gender, household, educational level, employment status, ECOG performance status, human papilloma virus (HPV) status, surgery, chemotherapy, alcohol intake, and smoking.
Among the 166 participants, time resulted to be a predictor of all the three questionnaire factors, namely, general and specific related symptoms and interference with daily life. Moreover, regarding symptom interference with daily activities factor, HPV-positive status played a significant role. Considering only HPV-negative patients, only time predicted patients' quality of life. Differently, among HPV-positive patients, other variables, such as gender, educational level, alcohol use, surgery, age at diagnosis, employment status, and ECOG status, resulted significant.
It was evident that quality of life of patients with head and neck cancer declined during RT, whereas it slowly improved after ending treatment. Our results clarified the role of some socio-demographic and clinical variables, for instance, HPV, which would allow to develop treatments tailored to each patient.
本研究通过层次建模，检查了头颈部癌症患者的生活质量（特别是在放射治疗期间和放射治疗结束后 1、3、6 和 12 个月的随访期间）的纵向轨迹，通过 MD 安德森症状清单头颈部问卷，该问卷由三个因素组成。此外，还通过社会人口统计学和临床特征对分析进行了控制。
采用多级混合效应线性回归来估计生活质量与时间、年龄、性别、家庭、教育程度、就业状况、ECOG 表现状态、人乳头瘤病毒（HPV）状态、手术、化疗、饮酒和吸烟之间的关联。
在 166 名参与者中，时间是所有三个问卷因素（即一般和特定相关症状以及对日常生活的干扰）的预测因素。此外，对于症状干扰日常生活活动的因素，HPV 阳性状态起着重要作用。考虑仅为 HPV 阴性患者，只有时间预测了患者的生活质量。相比之下，在 HPV 阳性患者中，其他变量，如性别、教育程度、饮酒、手术、诊断时的年龄、就业状况和 ECOG 状况，也具有显著意义。
显然，头颈部癌症患者的生活质量在放射治疗期间下降，而在治疗结束后则缓慢改善。我们的结果阐明了一些社会人口统计学和临床变量（例如 HPV）的作用，这将有助于为每个患者制定量身定制的治疗方案。
