Westgaard Kristine Løken, Amdal Cecilie Delphin, Taylor Katherine J, Falk Ragnhild Sørum, Bjordal Kristin, Singer Susanne, Hammerlid Eva, Krüger Max, Stromberger Carmen, Guntinas-Lichius Orlando, Duprez Fréderic, Stempler Noa, Yarom Noam, Papadopoulou Erofili, Herlofson Bente Brokstad
Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, Postbox 1109 Blindern, N-0317, Oslo, Norway.
Department of Otorhinolaryngology, Division for Head, Neck, and Reconstructive Surgery, Unit of Oral and Maxillofacial Surgery, Oslo University Hospital, Oslo, Norway.
Support Care Cancer. 2025 Sep 20;33(10):868. doi: 10.1007/s00520-025-09930-8.
Our aim was to investigate oral health-related quality of life (OHRQoL) and toxicities in long-term head and neck cancer (HNC) survivors diagnosed ≥five years earlier.
HNC survivors treated between 2007 and 2013 participated in an international cross-sectional study. They completed the European Organization for Research and Treatment of Cancer (EORTC) core quality of life questionnaire (EORTC QLQ-C30) and the oral health module (EORTC QLQ-OH15) and attended a hospital examination. Clinicians scored toxicities using the Common Terminology Criteria for Adverse Events version 5.0. OHRQoL was analyzed based on four types of treatment: surgery, radiotherapy, chemoradiotherapy without surgery and surgery with postoperative (chemo) radiotherapy. Survivors were divided into three groups according to the EORTC QLQ-OH15 oral health-QoL scale score; the lowest (defined as poor OHRQoL), middle and highest tertile.
Eleven sites in six countries enrolled 404 HNC survivors. The median time since diagnosis was 8.4 years, the mean age was 66 years and 67% were male. A total of 116 (29%) of the survivors reported poor OHRQoL. They were more often females and survivors with advanced disease. The survivors with poor OHRQoL also had more toxicity: dysphagia, trismus, osteonecrosis of the jaw, oral pain and dry mouth. There were no clinically significant differences in OHRQoL between the four treatment groups.
Our study showed that the survivors who reported poor OHRQoL also had a high level of late toxicity. This highlight the need for improved follow-up of the oral health of HNC survivors many years after initial treatment, especially for women and those who were treated for advanced disease.
我们的目的是调查早在五年前被诊断出的长期头颈癌（HNC）幸存者的口腔健康相关生活质量（OHRQoL）和毒性反应。
2007年至2013年间接受治疗的HNC幸存者参与了一项国际横断面研究。他们完成了欧洲癌症研究与治疗组织（EORTC）核心生活质量问卷（EORTC QLQ-C30）和口腔健康模块（EORTC QLQ-OH15），并接受了医院检查。临床医生使用《不良事件通用术语标准》第5.0版对毒性反应进行评分。基于四种治疗方式分析OHRQoL：手术、放疗、非手术的放化疗以及术后（化疗）放疗的手术。根据EORTC QLQ-OH15口腔健康生活质量量表评分，将幸存者分为三组；最低（定义为OHRQoL差）、中间和最高三分位数。
六个国家的11个地点招募了404名HNC幸存者。自诊断以来的中位时间为8.4年，平均年龄为66岁，67%为男性。共有116名（29%）幸存者报告OHRQoL差。他们更常为女性以及患有晚期疾病的幸存者。OHRQoL差的幸存者也有更多的毒性反应：吞咽困难、牙关紧闭、颌骨坏死、口腔疼痛和口干。四个治疗组之间的OHRQoL在临床上没有显著差异。
我们的研究表明，报告OHRQoL差的幸存者也有高水平的晚期毒性反应。这凸显了在初始治疗多年后改善HNC幸存者口腔健康随访的必要性，特别是对于女性和那些接受晚期疾病治疗的患者。
