Iwanaga Kazuyo, Ishibashi Yoko, Maki Kaori, Ura Ayako, Kotake Kumiko, Haba Kaori, Sakata Toshifumi, Nakagawa Takashi, Arima Hisatomi
School of Nursing, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
Asia Pac J Oncol Nurs. 2023 Aug 30;10(11):100301. doi: 10.1016/j.apjon.2023.100301. eCollection 2023 Nov.
This study aims to elucidate the trajectory of quality of life (QoL) over a two-year period after radiotherapy and/or chemotherapy for head and neck cancer (HNC), addressing the gap in long-term QoL information.
Employing a prospective longitudinal observational design, we tracked 58 HNC patients who underwent radiotherapy and/or chemotherapy, analyzing their QoL using Short-Form 36-Item Health Survey version 2 (SF36v2), the European Organization for Research and Treatment of Cancer quality of life (EORTC-QLQ-C30), and the European Organization for Research and Treatment of Cancer quality of life head and neck-35 (EORTC-QLQ-H&N35) questionnaires for two years post-discharge. The data underwent repeated measures analysis of variance.
Over the two-year follow-up, 10 patients (17.2%) succumbed, and 8 (13.8%) dropped out. SF36v2 physical and role-social component summary scores declined during treatment, requiring 1-2 years for recovery. The mental component summary score remained stable. EORTC-QLQ-30 revealed global health status recovery within one year post-discharge. EORTC-QLQ-H&N35 items like "swallowing," "senses problems," "trouble with social eating," "dry mouth," "sticky saliva," "coughing," and "felt ill" worsened pre-discharge. "Trouble with social contact" improved within a year, while "pain," "swallowing," "senses problems," "trouble with social eating," and "coughing" improved within two years. "Dry mouth" and "sticky saliva" persisted throughout the two-year follow-up, common symptoms of HNC and treatment side effects.
Recovery of specific QoL aspects in HNC patients treated with radiotherapy and/or chemotherapy may require up to two years. Prolonged monitoring and management of oral symptoms could enhance QoL. Future research should extend follow-up beyond two years for comprehensive interventions enhancing patient QoL.
本研究旨在阐明头颈部癌(HNC)患者放疗和/或化疗后两年内的生活质量(QoL)轨迹,填补长期QoL信息方面的空白。
采用前瞻性纵向观察设计,我们跟踪了58例接受放疗和/或化疗的HNC患者,在出院后两年内使用简明健康状况调查简表第2版(SF36v2)、欧洲癌症研究与治疗组织生活质量问卷(EORTC-QLQ-C30)以及欧洲癌症研究与治疗组织头颈部生活质量问卷-35(EORTC-QLQ-H&N35)对他们的QoL进行分析。数据进行重复测量方差分析。
在两年的随访中,10例患者(17.2%)死亡,8例(13.8%)退出研究。SF36v2身体和角色-社会成分总结得分在治疗期间下降,需要1至2年才能恢复。心理成分总结得分保持稳定。EORTC-QLQ-30显示出院后一年内总体健康状况恢复。EORTC-QLQ-H&N35中的项目,如“吞咽”“感觉问题”“社交进食困难”“口干”“唾液黏稠”“咳嗽”和“感觉不适”在出院前恶化。“社交接触困难”在一年内改善,而“疼痛”“吞咽”“感觉问题”“社交进食困难”和“咳嗽”在两年内改善。“口干”和“唾液黏稠”在两年的随访中持续存在,是HNC和治疗副作用的常见症状。
接受放疗和/或化疗的HNC患者特定QoL方面的恢复可能需要长达两年时间。对口干症状进行长期监测和管理可提高QoL。未来的研究应将随访时间延长至两年以上,以进行全面干预,提高患者QoL。