Quality of Life Implications of Bisphosphonate-Associated Osteonecrosis of the Jaw
Quality of Life Implications of Bisphosphonate-Associated Osteonecrosis of the Jaw
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DOI：
10.1634/theoncologist.2010-0183
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发表时间：
2011-01-01
期刊：
影响因子：
5.8
通讯作者：
Swan, J. Shannon
中科院分区：
文献类型：
--
作者：
Miksad, Rebecca Anne;Lai, Kuan-Chi;Swan, J. Shannon
目的。潜在的衰弱，颌骨骨坏死（ONJ）是一个新出现的并发症的双磷酸盐。然而，其对生活质量（QoL）的影响尚不清楚。我们确定了一个癌症患者队列中onj相关的生活质量下降。患者和方法。34名患有二磷酸盐相关ONJ的癌症患者完成了一项电话调查（2007年10月至2008年5月）。口腔健康影响概况14 （OHIP）回顾性评估了ONJ前后受试者口腔健康相关的生活质量。标准化的ONJ描述是在多学科迭代过程中开发的，并使用三种常用的基于偏好的生活质量测量方法在0（死亡）到1（完全健康）量表上进行评估：视觉模拟量表（VAS）、时间权衡量表（TTO）和eq - 5d结果。ONJ显著（p < 0.001）提高了相加法（3.56 ~ 16.53）和加权法（7.0 ~ 17.5）的OHIP评分（较差的生活质量）。7项个体OHIP项目显著增加（Bonferroni校正p < 0.0035）：疼痛、饮食不适、自我意识、饮食不满意、进餐中断、易怒和生活满意度下降。随着ONJ分期（VAS、TTO和EQ-5D）的恶化，基于偏好的平均生活质量值显著降低（p < 0.001）：无ONJ（0.76、0.86、0.82）、ONJ一期（0.69、0.82、0.78）、ONJ二期（0.51、0.67、0.55）和ONJ三期（0.37、0.61、0.32）。随着ONJ的加重，EQ-5D域评分显著升高（p < 0.001）。疼痛/不适和焦虑/抑郁是导致生活质量下降的主要原因。ONJ显著影响生活质量，随着ONJ的恶化，这种损害会增加。ONJ第2期和第3期的生活质量受损与影响决策的其他治疗副作用相似。双膦酸盐相关的ONJ生活质量是患者、临床医生和决策者的重要考虑因素。肿瘤学家2011；16: 121 - 132
Purpose. Potentially debilitating, osteonecrosis of the jaw (ONJ) is an emerging complication of bisphosphonates. However, its effect on quality of life (QoL) is unknown. We determined the ONJ-related QoL decline in a cancer patient cohort.Patients and Methods. Thirty-four cancer patients with bisphosphonate-associated ONJ completed a telephone survey (October 2007 through May 2008). The Oral Health Impact Profile 14 (OHIP) retrospectively assessed participant oral health-related QoL before and after ONJ. Standardized ONJ descriptions were developed in a multidisciplinary, iterative process and were evaluated with three frequently used preference-based QoL measurement methods on a 0 (death) to 1 (perfect health) scale: Visual Analogue Scale (VAS), Time Trade-Off (TTO), and EQ-5D.Results. ONJ significantly (p < .001) increased OHIP scores (worse QoL) for additive (3.56-16.53) and weighted (7.0-17.5) methods. Seven individual OHIP items significantly increased (Bonferroni correction p < .0035): pain, eating discomfort, self-consciousness, unsatisfactory diet, interrupted meals, irritability, and decreased life satisfaction. Mean preference-based QoL values significantly decreased (p < .001) with worsening ONJ stage (VAS, TTO, and EQ-5D): no ONJ (0.76, 0.86, 0.82), ONJ stage 1 (0.69, 0.82, 0.78), ONJ stage 2 (0.51, 0.67, 0.55), and ONJ stage 3 (0.37, 0.61, 0.32). As ONJ worsened, EQ-5D domain scores significantly increased (p < .001). Pain/discomfort and anxiety/depression contributed most to declining QoL.Conclusions. ONJ significantly affects QoL, a detriment that increases with worsening ONJ. QoL impairments for ONJ stages 2 and 3 are similar to other treatment side effects that influence decision-making. Bisphosphonate-associated ONJ QoL is an important consideration for patients, clinicians, and policy makers. The Oncologist 2011; 16: 121-132