Dadhich Saket, Shakrawal Neha, Soni Kapil, Pareek Puneet, Patro Sourabha K
Department of Otorhinolaryngology, AIIMS, Jodhpur, India.
Department of Otorhinolaryngology & Head-Neck Surgery, AIIMS, Delhi, India.
Indian J Otolaryngol Head Neck Surg. 2023 Jun;75(2):654-660. doi: 10.1007/s12070-022-03397-3. Epub 2022 Dec 29.
Objective- To acknowledge patient-perceived voice-related and overall quality of life (QOL) in addition to disability index based on the validated voice-related quality of life survey (VRQOL), WHOQOL-BREF, and WHO DAS II questionnaires in T2 and early T3 laryngeal tumors after definitive radiotherapy. Methods- 35 patients of T2(15) and early T3(20) tumors were enrolled, assessed with three questionnaires of VRQOL, WHOQOL-BREF, and WHO DAS II before the start of radiotherapy, then at 12 and 24 weeks after radiotherapy, and the results were analyzed. Results- All 35 (100%) patients had significant vocal deterioration with a raw VRQOL score of more than 25 at the beginning, which significantly improved at 12 weeks post-radiotherapy (p < 0.5). However, VRQOL scores at the 12th and 24th weeks were statistically insignificant. On comparing the WHOQOL-BREF and WHO DAS II, domains of physical health, psychological health, and participation in society showed significant improvement in both the groups after radiotherapy except distress scores in T2 laryngeal cancers, where pre and post-radiotherapy scores were not significantly different suggesting residual distress. Conclusion- The QOL parameters improve significantly with treatment, however, there exists a persistence of residual distress even at 24 weeks after radiotherapy and hence, routine involvement of clinical psychologists should be emphasized in practice to alleviate anxiety, distress, and concerns regarding disease outcome and recurrence. 12 to 24 weeks post-radiotherapy can be an optimum time to gauge the improvement in the patient-related QOL outcome parameters and does not differ much between these durations.
The online version contains supplementary material available at 10.1007/s12070-022-03397-3.
目的——基于经过验证的嗓音相关生活质量调查(VRQOL)、世界卫生组织生活质量简表(WHOQOL - BREF)和世界卫生组织残疾评定量表第二版(WHO DAS II)问卷,了解T2和早期T3喉肿瘤患者在根治性放疗后患者感知的嗓音相关及总体生活质量(QOL)以及残疾指数。方法——纳入35例T2期(15例)和早期T3期(20例)肿瘤患者,在放疗开始前、放疗后12周和24周用VRQOL、WHOQOL - BREF和WHO DAS II这三份问卷进行评估,并对结果进行分析。结果——所有35例(100%)患者最初嗓音均有显著恶化,原始VRQOL评分超过25分,放疗后12周有显著改善(p < 0.5)。然而,第12周和第24周的VRQOL评分在统计学上无显著差异。比较WHOQOL - BREF和WHO DAS II时,除T2喉癌的痛苦评分外,放疗后两组的身体健康、心理健康和社会参与领域均有显著改善,T2喉癌放疗前后评分无显著差异,提示存在残留痛苦。结论——生活质量参数随治疗有显著改善,然而,即使在放疗后24周仍存在残留痛苦,因此,在实践中应强调临床心理学家的常规参与,以减轻患者对疾病结局和复发的焦虑、痛苦及担忧。放疗后12至24周可能是评估患者相关生活质量结局参数改善情况的最佳时间,且在这些时间段之间差异不大。
在线版本包含可在10.1007/s12070 - 022 - 03397 - 3获取的补充材料。