Succo G, Bramardi F, Airoldi M, Gabriele P, Riva F, Moletto M, Rosso S, Caiazzo A, Sartoris A
I Clinica ORL, Dipartimento di Fisiopatologia Clinica, Università di Torino.
Acta Otorhinolaryngol Ital. 1997 Feb;17(1):32-44.
Today laryngeal cancer can be cured by means of a variety of treatments (nearly 60% of the patients in an unselected population are still alive after 5 years). Despite the low incidence, this form of cancer can present a significant social problem because the form of treatment can have an impact on the esthetic, functional and emotional aspects affecting the quality of life (QOL). In the present study 690 laryngeal cancer patients treated with 6 different forms of therapy (total laryngectomy, partial laryngectomy, cordectomy, radiotherapy alone, total laryngectomy plus post-operative radiotherapy, partial laryngectomy plus post-operative radiotherapy) were asked to fill out a specific EORTC CORE QOL Questionnaire (EORTC QLQ C-30) as well as a specific head and neck questionnaire. Six multi-item function scales, 3 symptom scales and 6 individual items assessing both symptoms and economic consequences of the disease were evaluated. A total of 517 patients (74.92%) filled out the questionnaire. For each form of therapy the patients were divided by age (under and over 65 years of age). The results indicate that the quality of life is better in those patients who underwent a single form of treatment (i.e. radiotherapy alone, partial laryngectomy, total laryngectomy) than in those who underwent combination treatments (i.e. surgery plus radiotherapy). Moreover, the results were better in the older patients. Quite often laryngeal cancer patients are subject to psychosocial problems although this did not show up in the present study where the patients tended to consider surgery as a liberation. The social-cultural level of the patient has a significant effect on the quality of life as it proved better in those social classes were physical strength is of prime importance as opposed to those dominated by social parameters such as socialization, communication and aesthetics.
如今,喉癌可以通过多种治疗方法治愈(在未经挑选的人群中,近60%的患者在5年后仍然存活)。尽管发病率较低,但这种癌症形式可能会带来重大的社会问题,因为治疗方式会对影响生活质量(QOL)的美学、功能和情感方面产生影响。在本研究中,690名接受6种不同治疗方式(全喉切除术、部分喉切除术、声带切除术、单纯放疗、全喉切除术加术后放疗、部分喉切除术加术后放疗)的喉癌患者被要求填写一份特定的欧洲癌症研究与治疗组织核心生活质量问卷(EORTC QLQ C - 30)以及一份特定的头颈问卷。对六个多项目功能量表、三个症状量表和六个评估疾病症状及经济后果的单项进行了评估。共有517名患者(74.92%)填写了问卷。对于每种治疗方式,患者按年龄(65岁以下和65岁以上)进行了划分。结果表明,接受单一治疗方式(即单纯放疗、部分喉切除术、全喉切除术)的患者的生活质量优于接受联合治疗(即手术加放疗)的患者。此外,老年患者的结果更好。喉癌患者经常会面临心理社会问题,尽管在本研究中未体现出来,在该研究中患者倾向于将手术视为一种解脱。患者的社会文化水平对生活质量有显著影响,事实证明,在体力至关重要的社会阶层中,患者的生活质量优于那些受社交、沟通和美学等社会参数主导的阶层。