Heyda Alicja, Księżniak-Baran Dorota, Wygoda Andrzej, Składowski Krzysztof
1st Radiation and Clinical Oncology Department, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, 44-102 Gliwice, Poland.
Cancers (Basel). 2023 Dec 22;16(1):79. doi: 10.3390/cancers16010079.
(1) Background: The goal of this study is to evaluate psychological tolerance and health-related quality of life (QOL) in head and neck (HN) cancer patients treated with definitive accelerated radiotherapy (DART). (2) Methods: 76 recurrence-free patients eligible for the study, who were treated with DART in the CAIR-2 phase III clinical study (median of follow-up = 47 months), completed EORTC QLQ-C30 with the H&N35 module, Hospital Anxiety and Depression Scale (HADS) and Visual-Analog Scales (VAS) of pain in HN and the neck/arm areas. (3) Results: The most dominant symptoms measured with QLQ-C30 were as follows: fatigue (44/100), sleeplessness (39/100), financial problems (38/100) and pain (32/100). Within the H&N35, the highest scores were reported on the subscales of sticky saliva (60/100), mouth dryness (65/100) and increased intake of painkillers (50/100). Pain (VAS) was reported by 87% (HN area) and 78% (shoulder area) of the patients, with a mean score of 3/10. One-third of the patients reported depressive moods (HADS ≥ 15 points) with an average score of 12.5/42 p. The depressed group, who smoked more as compared to the non-depressed group before DART (96% vs. 78%) and required steroids treatment (85% vs. 58%) during DART, also scored significantly worse on 23 of the 35 subscales of QLQ-C30 and H&N35 and experienced more intense pain (VAS). Women and less-advanced patients scored better in several aspects of quality of life. (4) Conclusions: Patients treated with DART struggle with low quality of life and persistent treatment-related symptoms including constant pain. HNC survivors, especially those who are depressed, may require additional psychosocial, rehabilitation and medical intervention programmes.
(1) 背景：本研究的目的是评估接受根治性加速放疗（DART）的头颈（HN）癌患者的心理耐受性和健康相关生活质量（QOL）。(2) 方法：76名符合研究条件的无复发病例，他们在CAIR-2三期临床研究中接受了DART治疗（中位随访时间 = 47个月），完成了带有H&N35模块的欧洲癌症研究与治疗组织生活质量核心问卷（EORTC QLQ-C30）、医院焦虑抑郁量表（HADS）以及头颈和颈/臂区域疼痛的视觉模拟量表（VAS）。(3) 结果：用QLQ-C30测量的最主要症状如下：疲劳（44/100）、失眠（39/100）、经济问题（38/100）和疼痛（32/100）。在H&N35中，唾液黏稠（60/1百）、口干（65/100）和止痛药摄入量增加（50/100）等分量表得分最高。87%（头颈区域）和78%（肩部区域）的患者报告有疼痛（VAS），平均得分为3/10。三分之一的患者报告有抑郁情绪（HADS≥15分），平均得分为12.5/42分。与非抑郁组相比，抑郁组在接受DART治疗前吸烟更多（96%对78%），且在DART治疗期间需要类固醇治疗（85%对58%），在QLQ-C30和H&N35的35个分量表中的23个上得分也显著更低，且经历的疼痛更强烈（VAS）。女性和病情较轻的患者在生活质量的几个方面得分更高。(4) 结论：接受DART治疗患者的生活质量较低，且存在与治疗相关的持续症状，包括持续疼痛。头颈癌幸存者，尤其是那些抑郁的患者，可能需要额外的心理社会、康复和医疗干预项目。
