Prospective, longitudinal quality-of-life study of patients with head and neck cancer: A feasibility study including the EORTC QLQ-C30
Prospective, longitudinal quality-of-life study of patients with head and neck cancer: A feasibility study including the EORTC QLQ-C30
复制标题
DOI：
10.1016/s0194-5998(97)70246-8
复制
发表时间：
1997-06-01
影响因子：
3.4
通讯作者：
Westin, T
中科院分区：
文献类型：
--
作者：
Hammerlid, E;Bjordal, K;Westin, T
尽管头颈部癌症的治疗取得了现代进步，但生存率未能提高。考虑到所涉及的不同治疗方式，生活质量被认为是临床试验中使用的额外终点标准。建立了一个北欧方案来测量头颈部癌症患者在治疗前、治疗中和治疗后的生活质量。在研究之前，用该方案进行了一项初步研究。这项试验性研究的主要目的是要了解这些癌症患者是否会重复回答生活质量问卷（六次），以及所选的候选人是否愿意参加-核心问卷（欧洲癌症研究和治疗组织核心生活质量问卷（EORTC QLQ-C30）），一种肿瘤特异性问卷，和心理困扰测量（医院焦虑和抑郁量表（HAD））-是敏感的功能和症状的变化，在研究年内，本文中提出的结果都是指试点研究。48名连续患者同意参加这项研究。最常见的肿瘤位置是口腔（17）和喉（12）。几乎所有的患者都接受了联合治疗：48例患者中有45例接受了放疗，48例患者中有18例接受了化疗，48例患者中有17例接受了手术治疗。48名患者中有4名没有回答任何问卷，因此被排除在研究之外。其余44名患者中，3名在研究年期间死亡，另外6名因各种原因退出研究。在1年随访时存活的41例患者中，有35例（85%）回答了所有6份问卷，因此完成了研究。在整个研究期间使用了邮寄问卷。所有问卷均被良好接受，并发现对研究年期间的变化敏感。最大的变异性被发现的症状和功能，特别是与头颈癌。症状为吞咽困难、声音嘶哑、口腔疼痛、口干和味觉问题，它们都表现出相同的模式，在治疗期间和治疗结束后症状增加。HAD量表揭示了高水平的心理困扰，21%的可能病例在诊断时精神病发病率。总之，研究设计和问卷调查对于即将进行的瑞典和挪威头颈癌患者的前瞻性生活质量评估是可行的。
Despite modern advances in the treatment of head and neck cancer, the survival rate fails to improve. Considering the different treatment modalities involved, quality of life has been thought of as an additional end point criterion for use in clinical trials. A Nordic protocol to measure the quality of life of head and neck cancer patients before, during, and after treatment was established, Before the study a pilot study was done with this protocol. The main purpose of this pilot study was to find out whether this cancer population would answer quality-of-life questionnaires repeatedly (six times) over a 1-year period and whether the chosen questionnaires-a core questionnaire (European Organisation for Research and Treatment of Cancer Core Qualify of Life Questionnaire (EORTC QLQ-C30)), a tumor-specific questionnaire, and a psychological distress measure (Hospital Anxiety and Depression scale (HAD))-were sensitive for changes to functions and symptoms during the study year, The results presented in this article all refer to the pilot study. Forty-eight consecutive patients agreed to participate in the study The most common tumor locations were the oral cavity (17) and the larynx (12). Almost all patients received combined treatment: 45 of 48 radiation therapy 18 of 48 chemotherapy, and 17 of 48 surgery After the primary treatment, 40 patients had complete tumor remission. Four of the 48 patients did not answer any questionnaires and were therefore excluded from the study Of the remaining 44 patients, 3 died during the study year, and another 6 withdrew for various reasons. Thirty-five (85%) of the 41 patients alive at the 1-year follow-up answered all six questionnaires and thus completed the study Mailed questionnaires were used throughout the study All questionnaires were well accepted and found to be sensitive to changes during the study year. The greatest variability was found for symptoms and functions related specifically to head and neck cancer. The symptoms were swallowing difficulties, hoarse voice, sore mouth, dry mouth, and problems with taste, They all showed the same pattern, with an increase of symptoms during and just after finishing the treatment. The HAD scale revealed a high level of psychological distress, with 21% probable cases of psychiatric morbidity at diagnosis. In conclusion, it was shown that the study design and questionnaires were feasible for the forthcoming prospective qualify-of-life assessment of Swedish and Norwegian head and neck cancer patients.