Feasibility and impact of a dedicated multidisciplinary rehabilitation program on health-related quality of life in advanced head and neck cancer patients
Feasibility and impact of a dedicated multidisciplinary rehabilitation program on health-related quality of life in advanced head and neck cancer patients
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DOI：
10.1007/s00405-015-3648-z
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发表时间：
2016-06-01
影响因子：
2.6
通讯作者：
Hilgers, Frans J. M.
中科院分区：
文献类型：
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作者：
Passchier, Ellen;Stuiver, Martijn M.;Hilgers, Frans J. M.
在一项观察性前瞻性研究中，评估了头颈癌（HNC）患者专用多学科康复计划（HNR）的可行性和结局。采用EORTC C30和H&N-35生活质量问卷对52例连续患者在HNR前后进行HRQoL评估。将HNC患者的初始HRQoL评分与EORTC参考评分进行比较，并将HNR后的HRQoL评分与一般健康人群的HRQoL评分进行比较。在HNR前后用遇险温度计（DT）评估遇险情况。在平均持续时间为7个月的HNR完成时，总体HRQoL显著改善（p < 0.001）。角色、情感和社会功能量表以及大多数EORTC C30和H&N35症状量表项目显示出统计学显著性（p < 0.01）和临床相关改善。HNR前的平均痛苦评分高于5分的临界值，表明需要转诊至康复中心。完成HNR后，痛苦显著降低至3.0（p < 0.001）。HRQoL治疗前比EORTC参考HNC人群差，而在HNR项目完成时，HRQoL与一般人群参考水平相当。我们的结论是，一个专门的多学科HNR计划是可行的，并建议它有一个积极的影响HRQoL。多学科方法可能比单学科干预更有价值。然而，由于研究的观察性质，我们的结果应谨慎判断。
In an observational prospective study, feasibility and outcomes of a dedicated multidisciplinary rehabilitation program (HNR) for head and neck cancer (HNC) patients were evaluated. HRQoL was assessed before and after HNR with EORTC C30 and H&N-35 QoL questionnaires in 52 consecutive patients. Initial HRQoL scores were compared with EORTC reference scores for HNC patients and post-HNR with those available for the general healthy population. Distress was assessed before and after HNR with the distress thermometer (DT). At completion of HNR with a mean duration of 7 months, overall HRQoL was significantly improved (p < 0.001). Role, Emotional, and Social function scales and most EORTC C30 and H&N35 symptom scale items showed a statistically significant (p < 0.01) and clinically relevant improvement. Mean distress score before HNR was above the cutoff value of 5, suggesting the need for referral to rehabilitation. After completing HNR, distress decreased significantly to 3.0 (p < 0.001). HRQoL pretreatment was poorer than that of the EORTC reference HNC population, whereas at the completion of the HNR program, the HRQoL was comparable to that of the general population reference level. We conclude that a dedicated multidisciplinary HNR program is feasible and suggest that it has a positive impact on HRQoL. The multidisciplinary approach may have added value over mono-disciplinary interventions. However, our results should be judged cautiously due to the observational nature of the study.