QUALITY-OF-LIFE IN PATIENTS TREATED FOR HEAD AND NECK-CANCER - A FOLLOW-UP-STUDY 7 TO 11 YEARS AFTER RADIOTHERAPY
QUALITY-OF-LIFE IN PATIENTS TREATED FOR HEAD AND NECK-CANCER - A FOLLOW-UP-STUDY 7 TO 11 YEARS AFTER RADIOTHERAPY
复制标题
DOI：
10.1016/0360-3016(94)90104-x
复制
发表时间：
1994-03-01
影响因子：
7
通讯作者：
MASTEKAASA, A
中科院分区：
文献类型：
--
作者：
BJORDAL, K;KAASA, S;MASTEKAASA, A
用途：比较845例头颈部癌症患者的健康相关生活质量因素，这些患者随机接受常规放射治疗（2戈伊，每周5天）或大分割方案（2.35戈伊，每周4天），对存活的患者进行了7 ~ 11年的随访研究，占原始患者人数的30%。方法和材料：将癌症特异性EORTC核心生活质量问卷（30项版本; EORTC QLQ-CC 30）和19项头颈部癌症特异性问卷邮寄给试验的245例存活患者。EORTC QLQ-C30由6个多项功能量表、3个症状量表和6个单项组成，用于评估疾病的症状和经济后果。204例患者（83%）完成了问卷调查。两组患者（N = 103和N = 101）接受不同的分割方案治疗，在社会人口统计学变量、肿瘤部位、治疗变量（包括不同类型的手术治疗）和继发性原发性癌症方面具有可比性。在常规组的患者有更先进的疾病和更高的复发率相比，患者在hypofractionated group.Results：出乎意料的是，患者在hypofractionated组，报告相似或更好的生活质量相比，患者在常规分割组。两组患者都描述了高水平的症状，如口腔干燥和粘液产生。临床和社会人口统计学变量没有解释变异的社会功能，情绪功能或疲劳，除了手术的类型，这显着影响了病人的情绪function.Conclusion：长期生存的头颈部癌症报告了高水平的疾病和治疗相关的症状。情绪功能受手术方式的影响显著。未来头颈部肿瘤临床试验的策略应继续强调保守的手术方法和协调的辅助治疗，以最大限度地提高局部区域控制和生活质量。功能和情绪的结果是重要的参数，应在未来的临床试验中进行前瞻性评估，在珠和颈癌。
Purpose: To compare health-related quality of life factors in 845 head and neck cancer patients randomized to receive either conventional radiotherapy (2 Gy, 5 days-a-week) or a hypofractionated regimen (2.35 Gy, 4 days-a-week), a follow-up study was carried out 7 to 11 years after treatment in the surviving patients, representing 30% of the original patient number.Methods and Materials: The cancer-specific EORTC Core Quality of Life Questionnaire (30 item version; the EORTC QLQ-CC30) and a 19 item head and neck cancer-specific questionnaire were mailed to the 245 surviving patients of the trial. The EORTC QLQ-C30 is comprised of six multi-item function scales, three symptom scales, and six single items which assess both symptoms and economic consequences of the disease. Two hundred and four patients (83%) completed the questionnaire. The two groups of patients (N = 103 and N = 101) treated by different fractionating schedules, were comparable with regard to sociodemographic variables, tumor site, treatment variables (including different types of surgical treatment), and secondary primary cancers. Patients in the conventional group had more advanced disease and a higher recurrence rate compared to patients in the hypofractionated group.Results: Unexpectedly, patients in the hypofractionated group, reported similar or better quality of life compared to patients in the conventional fractionated group. Patients in both groups described a high level of symptoms, like dryness in the mouth and mucus production. Clinical and sociodemographic variables did not explain variance in social function, emotional function or fatigue, except for the type of surgery performed, which significantly influenced the patients' emotional function.Conclusion: Long-term survivors of head and neck cancer reported a high level of disease and treatment related symptoms. Emotional function was significantly influenced by the type of surgical procedure. Strategies for future trials in head and neck cancer should continue to attempt to stress conservative surgical approaches and coordinated adjuvant therapy to maximize local regional control and quality of life. Functional and emotional outcome are important parameters which should prospectively be evaluated in future clinical trials in bead and neck cancer.