Alapati Rahul, Wagoner Sarah F, Lawrence Amelia, Bon Nieves Antonio, Desai Atharva, Shnayder Yelizaveta, Hamill Chelsea, Kakarala Kiran, Neupane Prakash, Gan Gregory, Sykes Kevin J, Bur Andrés M
Department of Otolaryngology-Head and Neck Surgery, University of Kansas, Kansas City, Kansas, U.S.A.
School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri, U.S.A.
Laryngoscope. 2024 Aug;134(8):3645-3655. doi: 10.1002/lary.31382. Epub 2024 Mar 4.
To determine differences in post-treatment QoL across treatment settings in patients receiving adjuvant radiation therapy for head and neck squamous cell carcinoma (HNSCC).
This was a prospective observational cohort study of patients with HNSCC initially evaluated in a head and neck surgical oncologic and reconstructive clinic at an academic medical center (AMC). Participants were enrolled prior to treatment in a prospective registry collecting demographic, social, and clinical data. Physical and social-emotional QoL (phys-QoL and soc-QoL, respectively) was measured using the University of Washington-QoL questionnaire at pre-treatment and post-treatment visits.
A cohort of 177 patients, primarily male and White with an average age of 61.2 ± 11.2 years, met inclusion criteria. Most patients presented with oral cavity tumors (n = 132, 74.6%), had non-HPV-mediated disease (n = 97, 61.8%), and were classified as Stage IVa (n = 72, 42.8%). After controlling for covariates, patients treated at community medical centers (CMCs) reported a 7.15-point lower phys-QoL compared with those treated at AMCs (95% CI: -13.96 to -0.35, p = 0.040) up to 12 months post-treatment. Additionally, patients who were treated at CMCs had a 5.77-point (-11.86-0.31, p = 0.063) lower soc-QoL score compared with those treated at an AMC, which was not statistically significant.
This study revealed that HNSCC patients treated with radiation at AMCs reported significantly greater phys-QoL in their first-year post-treatment compared to those treated at CMCs, but soc-QoL did not differ significantly. Further observational studies are needed to explore potential factors, including treatment planning and cancer resource engagement, behind disparities between AMCs and CMCs.
3 Laryngoscope, 134:3645-3655, 2024.
确定接受头颈部鳞状细胞癌（HNSCC）辅助放疗的患者在不同治疗环境下治疗后生活质量（QoL）的差异。
这是一项对HNSCC患者进行的前瞻性观察队列研究，这些患者最初在一家学术医疗中心（AMC）的头颈外科肿瘤与重建诊所接受评估。参与者在治疗前被纳入一个前瞻性登记系统，该系统收集人口统计学、社会和临床数据。在治疗前和治疗后访视时，使用华盛顿大学生活质量问卷测量身体和社会情感生活质量（分别为phys-QoL和soc-QoL）。
一组177例患者符合纳入标准，主要为男性和白人，平均年龄61.2±11.2岁。大多数患者表现为口腔肿瘤（n = 132，74.6%），患有非HPV介导的疾病（n = 97，61.8%），并被分类为IVa期（n = 72，42.8%）。在控制协变量后，在社区医疗中心（CMC）接受治疗的患者在治疗后长达12个月的时间里，其phys-QoL比在AMC接受治疗的患者低7.15分（95%CI：-13.96至-0.35，p = 0.040）。此外，在CMC接受治疗的患者的soc-QoL得分比在AMC接受治疗的患者低5.77分（-11.86至0.31，p = 0.063），差异无统计学意义。
本研究表明，与在CMC接受放疗的HNSCC患者相比，在AMC接受放疗的患者在治疗后第一年的phys-QoL显著更高，但soc-QoL无显著差异。需要进一步的观察性研究来探索AMC和CMC之间差异背后的潜在因素，包括治疗计划和癌症资源利用情况。
3《喉镜》，134:3645 - 3655，2024年。
