Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, Florida, USA.
Florida Blue Center for Rural Health Research & Policy, College of Medicine, Florida State University, Tallahassee, Florida, USA.
Otolaryngol Head Neck Surg. 2023 Dec;169(6):1506-1512. doi: 10.1002/ohn.416. Epub 2023 Jul 5.
Pain following the completion of treatment is important but has received less attention in the head and neck cancer (HNC) literature. The present study sought to examine the prevalence and predictors of pain measured 12 months postdiagnosis and its impact on HNC-specific health-related quality of life (HRQOL) in 1038 HNC survivors.
Prospective observational study.
Single-institution tertiary care center.
Pain was measured using a single item ranging from 0 to 10 with 0 representing no pain and 10 representing the worst pain possible. Self-reported depressive symptomatology was measured using the Beck Depression Inventory and self-reported problem alcohol use was measured by the Short Michigan Alcoholism Screening Test. HNC-specific HRQOL was measured using the Head and Neck Cancer Inventory (HNCI).
Hierarchical multivariable linear regression analyses indicated that in addition to pain at 3 months postdiagnosis (β = .145, t = 3.18, sr = .019, p = .002), both depressive symptomatology (β = .110, t = 2.49, sr = .011, p = .015) and problem alcohol use (β = .092, t = 2.07, sr = .008, p = .039) were significant predictors of pain at 12 months postdiagnosis. Subgroup analyses suggest that across all 4 HNCI domains, those in the moderate and severe pain groups at 12 months postdiagnosis failed to reach 70 which is indicative of high functioning.
Pain in patients with HNC is a considerable issue at 12 months postdiagnosis, deserving further attention. Behavioral factors such as depression and problem alcohol use may be associated with pain and require systematic screening over time to identify and treat issues that impact optimal long-term recovery from HNC, including disease-specific HRQOL.
治疗完成后的疼痛很重要，但在头颈部癌症（HNC）文献中却较少受到关注。本研究旨在调查 1038 例 HNC 幸存者在诊断后 12 个月时疼痛的发生率和预测因素，以及疼痛对 HNC 特异性健康相关生活质量（HRQOL）的影响。
前瞻性观察性研究。
单机构三级保健中心。
使用 0 到 10 的单个项目来衡量疼痛，其中 0 表示无疼痛，10 表示可能的最剧烈疼痛。使用贝克抑郁量表（Beck Depression Inventory）衡量自我报告的抑郁症状，使用密歇根酒精筛查测试（Short Michigan Alcoholism Screening Test）衡量自我报告的酒精使用问题。使用头颈部癌症量表（Head and Neck Cancer Inventory，HNCI）衡量 HNC 特异性 HRQOL。
分层多元线性回归分析表明，除了诊断后 3 个月的疼痛（β=0.145，t=3.18，sr=0.019，p=0.002）外，抑郁症状（β=0.110，t=2.49，sr=0.011，p=0.015）和酒精使用问题（β=0.092，t=2.07，sr=0.008，p=0.039）也是诊断后 12 个月疼痛的显著预测因素。亚组分析表明，在所有 4 个 HNCI 领域中，在诊断后 12 个月处于中度和重度疼痛组的患者均未能达到 70，这表明他们功能良好。
HNC 患者在诊断后 12 个月时的疼痛是一个相当大的问题，值得进一步关注。行为因素，如抑郁和酒精使用问题，可能与疼痛有关，需要随着时间的推移进行系统筛查，以识别和治疗影响 HNC 患者从疾病中最佳长期康复的问题，包括疾病特异性 HRQOL。
