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头颈癌继发的垂头综合征:对功能和身体形象量表的影响。

Dropped head syndrome secondary to head and neck cancer: Impact on functıonal and body image scale.

作者信息

Kavak Songül Keskin, Kavak Engin Eren

机构信息

Ankara Dr.Abdurrahman Yurtaslan Training and Research Hospital Department of Physical Therapy and Rehabilitation, Turkey.

Ankara University Medical Faculty, Department of Medical Oncology, Turkey.

出版信息

Heliyon. 2024 Sep 29;10(19):e38614. doi: 10.1016/j.heliyon.2024.e38614. eCollection 2024 Oct 15.

Abstract

OBJECTIVE

The primary aim of our prospective study was to assess the impact of Dropped Head Syndrome (DHS), a rare condition in Head and Neck Cancer (HNC) clinics, on patients' functional status and body image. Our secondary aim is to investigate the relationship between head and neck lymphoedema (HNL) and DHS, which will be examined for the first time in the literature.

METHODS

We conducted a study involving 47 patients, aged between 18 and 75, who had been diagnosed with HNC, and exhibited clinical symptoms of DHS for at least 12 months. The staging of HNL was assessed using the MD Anderson Cancer Center HNL (MDACC HNL) staging system. We also administered The Total Functional Scale (TFS) which was a subscale of EORTC QLQ-C30 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30) and the Body Image Scale (BIS).

RESULTS

In the study, it was observed that the BIS was significantly lower in patient groups aged 50 and over (p = 0.0495), those with a laryngectomy (p = 0.0002), those who had undergone bilateral neck dissection (p = 0.0291), and particularly in patients with stage 2-3 lymphedema (p < 0.0001). Similarly, it was noted that passive cervical extension limitation had a statistically significant impact on both the BIS (p < 0.0001) and the TFS (p < 0.0001). It was also found that BIS (p < 0.0001) and TFS (p < 0.0001) improved in the late postoperative period (12 months ≤) and this improvement was statistically significant.

CONCLUSIONS

In this study, we found statistical relationships between age, laryngectomy, surgery procedures, lymphedema stages, passive cervical extension limitations, total functional score, and BIS. Early diagnosis of DHS allows for supportive care and physiotherapy methods, which can lead to improvement. HNL and DHS should be prevented to improve quality of life and body image and increase survival. Therefore, further research with a much larger patient population is needed.

摘要

目的

我们这项前瞻性研究的主要目的是评估垂头综合征(DHS)这一在头颈癌(HNC)诊所中较为罕见的病症对患者功能状态和身体形象的影响。我们的次要目的是研究头颈部淋巴水肿(HNL)与DHS之间的关系,这在文献中尚属首次研究。

方法

我们开展了一项研究,纳入了47例年龄在18至75岁之间、已被诊断为HNC且出现DHS临床症状至少12个月的患者。使用MD安德森癌症中心HNL(MDACC HNL)分期系统对头颈部淋巴水肿进行分期评估。我们还采用了作为欧洲癌症研究与治疗组织生活质量问卷C30(EORTC QLQ-C30)子量表的总功能量表(TFS)和身体形象量表(BIS)。

结果

在该研究中,观察到50岁及以上患者组(p = 0.0495)、接受喉切除术的患者(p = 0.0002)、接受双侧颈部清扫术的患者(p = 0.0291),尤其是2 - 3期淋巴水肿患者(p < 0.0001)的BIS显著更低。同样,注意到被动颈椎伸展受限对BIS(p < 0.0001)和TFS(p < 0.0001)均有统计学上的显著影响。还发现术后晚期(12个月及以后)BIS(p < 0.0001)和TFS(p < 0.0001)有所改善,且这种改善具有统计学意义。

结论

在本研究中,我们发现年龄、喉切除术、手术方式、淋巴水肿分期、被动颈椎伸展受限、总功能评分和BIS之间存在统计学关系。DHS的早期诊断有助于采取支持性护理和物理治疗方法,从而实现病情改善。应预防HNL和DHS,以提高生活质量和身体形象并延长生存期。因此,需要对更多患者群体进行进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b04/11471155/ee0e6c1be4d3/gr1.jpg

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