Yousef Andrew, Nichol Ariadne, Luu Bao, Montesa Carie, Ramsey Celia, Verpukhovskiy Philipp, Blumenfeld Liza, Linnemeyer-Risser Kristen, Guo Theresa
Department of Otolaryngology-Head and Neck Surgery, University of California, San Diego, California, USA.
Otolaryngol Head Neck Surg. 2025 Jan;172(1):167-175. doi: 10.1002/ohn.985. Epub 2024 Oct 1.
To characterize the concerns of head and neck cancer (HNC) patients and discern changes in quality-of-life (QoL) during long-term follow-up.
Retrospective review.
Survivorship clinic at a tertiary academic center.
A retrospective review was conducted on HNC patients seen in our survivorship clinic between 1/2020 and 1/2024 using the University of Washington Quality of Life (UW-QOL) Questionnaire.
Three hundred and forty-two patients were seen for 914 encounters. Patients were divided into 4 groups: pretreatment (n = 326), 0 to 12 months posttreatment (n = 247), 1 to 3 years posttreatment (n = 248), and more than 3 years posttreatment (n = 64). The average follow-up after treatment was 459 days (range: 0-5.2 years). Multivariable analysis revealed significant improvements in overall QoL, health-related QoL, social-emotional composite scores, activity, anxiety, appearance, chewing, mood, pain, speech, and recreation at more than 1-year posttreatment compared to less than 1-year posttreatment. However, declines were noted in saliva and taste scores. No differences in scores were observed between patients 1 to 3 years posttreatment and those >3 years posttreatment. At all timepoints before and after treatment, top concerns were pain, activity, and swallowing. Patients with oral cancer followed for more than 1-year posttreatment had worse scores in appearance, chewing, pain, and speech compared to those with oropharyngeal cancer.
Understanding the evolving concerns of HNC patients is imperative for enhancing care. Most QoL domains improve at 1-year posttreatment except for saliva, taste, swallowing, and shoulder function. QoL scores stabilize after 1-year post-treatment. Pain, activity, and swallowing remain the top concerns at all time points.
描述头颈癌（HNC）患者的担忧，并了解长期随访期间生活质量（QoL）的变化。
回顾性研究。
一所三级学术中心的幸存者诊所。
使用华盛顿大学生活质量（UW-QOL）问卷，对2020年1月至2024年1月期间在我们幸存者诊所就诊的HNC患者进行回顾性研究。
共诊治342例患者，进行了914次随访。患者分为4组：治疗前（n = 326）、治疗后0至12个月（n = 247）、治疗后1至3年（n = 248）和治疗后3年以上（n = 64）。治疗后的平均随访时间为459天（范围：0至5.2年）。多变量分析显示，与治疗后不到1年相比，治疗后1年以上患者的总体生活质量、健康相关生活质量、社会情感综合评分、活动、焦虑、外貌、咀嚼、情绪、疼痛、言语和娱乐方面有显著改善。然而，唾液和味觉评分有所下降。治疗后1至3年的患者与治疗后>3年的患者评分无差异。在治疗前后的所有时间点，最主要的担忧是疼痛、活动和吞咽。与口咽癌患者相比，治疗后随访超过1年的口腔癌患者在外观、咀嚼、疼痛和言语方面的评分更差。
了解HNC患者不断变化的担忧对于加强护理至关重要。除唾液、味觉、吞咽和肩部功能外，大多数生活质量领域在治疗后1年有所改善。治疗后1年生活质量评分稳定。疼痛、活动和吞咽在所有时间点仍然是最主要的担忧。
