Funk G F, Karnell L H, Dawson C J, Means M E, Colwill M L, Gliklich R E, Alford E L, Stewart M G
Department of Otolaryngology-Head and Neck Surgery, University of Iowa College of Medicine, Iowa City 52242, USA.
Head Neck. 1997 Dec;19(8):675-83. doi: 10.1002/(sici)1097-0347(199712)19:8<675::aid-hed5>3.0.co;2-2.
It is a common perception that the overall health of patients with head and neck cancer (HNC) is likely to be poor compared with the general population. This project was undertaken to investigate the pre- and post-treatment, global health status of HNC patients in comparison with age-matched, U.S. population norms using a self-administered general health status survey.
Between July 1, 1993, and May 1, 1996, 180 patients underwent pretreatment and 6 month follow-up evaluation with the standard version of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). The SF-36 scale scores, means, standard deviations, and 95% confidence intervals were calculated for each SF-36 scale as well as for physical-health-component summary scores (PCS) and mental-health-component summary scores (MCS). Comparisons of these scores were made to U.S. population normative data. Pretreatment and 6-month follow-up SF-36 scores were compared.
In the 45-54-year age group, all 8 SF-36 scale scores, the PCS, and MCS scores were significantly worse for the HNC patients in comparison with age-matched norms (p < .05). In the 55-64-year age group, the HNC patients were worse in 5 of the 8 SF-36 scale scores and the MCS score in comparison with age-matched norms (p < .05). In the 65-74-year age group, the HNC patients scored significantly worse in the mental health scale. In the comparison of pretreatment and 6-month follow-up scores, the HNC patients had significant decreases in the physical functioning scale (p = .003) and the PCS score (p = .047). The HNC patients showed significant improvement in the mental health scale (p = .049) and improvement in the bodily-pain scale, which approached significance (p = .053) at 6-month follow-up. The HNC patients showed a marked decrease in general health status with increasing stage of HNC.
This work provides objective support for the perception that many HNC patients are initially seen for treatment with baseline health status functioning significantly below their age-matched contemporaries in the general population. An educated evaluation of global health outcomes following treatment in the HNC patient population must begin with an accurate pretreatment assessment of these parameters. Self-reported health-status assessment (HSA) is a useful means of evaluating global health status in this patient population.
人们普遍认为，与普通人群相比，头颈癌（HNC）患者的整体健康状况可能较差。本项目旨在通过一项自我管理的一般健康状况调查，研究HNC患者治疗前后的全球健康状况，并与年龄匹配的美国人群规范进行比较。
在1993年7月1日至1996年5月1日期间，180例患者接受了医学结果研究36项简短健康调查（SF-36）标准版本的治疗前和6个月随访评估。计算每个SF-36量表以及身体健康成分汇总得分（PCS）和心理健康成分汇总得分（MCS）的SF-36量表得分、均值、标准差和95%置信区间。将这些得分与美国人群规范数据进行比较。比较治疗前和6个月随访时的SF-36得分。
在45-54岁年龄组中，与年龄匹配的规范相比，HNC患者的所有8个SF-36量表得分、PCS和MCS得分均显著更差（p < 0.05）。在55-64岁年龄组中，与年龄匹配的规范相比，HNC患者在8个SF-36量表得分中的5个以及MCS得分更差（p < 0.05）。在65-74岁年龄组中，HNC患者在心理健康量表上的得分显著更差。在治疗前和6个月随访得分的比较中，HNC患者在身体功能量表（p = 0.003）和PCS得分（p = 0.047）上有显著下降。HNC患者在心理健康量表上有显著改善（p = 0.049），在身体疼痛量表上有改善，在6个月随访时接近显著水平（p = 0.053）。随着HNC分期的增加，HNC患者的总体健康状况显著下降。
这项工作为以下观点提供了客观支持，即许多HNC患者最初接受治疗时的基线健康状况功能明显低于其在普通人群中年龄匹配的同龄人。对头颈癌患者群体治疗后的全球健康结果进行有依据的评估，必须从对这些参数进行准确的治疗前评估开始。自我报告的健康状况评估（HSA）是评估该患者群体全球健康状况的一种有用方法。
