头部和部癌症:关于QoL和吞功能之间的复杂关系的研究
Daniel Strüder1, Johanna Ebert1, Friederike Kalle1
1Department of Otorhinolaryngology, Head and Neck Surgery "Otto Körner", Rostock University Medical Center, D-18057 Rostock, Germany.
Current oncology (Toronto, Ont.)
|December 22, 2023
概括
头支状细胞癌 (HNSCC) 患者的生活质量 (QoL) 评估显示,与客观吞功能的相关性有限. 吞特定的QoL (MDADI) 比通用QoL更好地反映了疾病的严重程度,但两者都需要客观验证.
科学领域:
- 在瘤学瘤学.
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 语音语言病理学 语言病理学
- 生活质量研究 研究 生命质量研究
背景情况:
- 头部和部状细胞癌 (HNSCC) 显著影响患者的生存和功能.
- 治疗后的后续症状,如消化不良是很常见的,影响生活质量 (QoL).
- 现有的QoL测量通常缺乏客观相关性,可能会误导患者的结果.
研究的目的:
- 研究HNSCC患者的主观QOL测量 (EQ-5D-5L,MDADI) 和客观吞功能 (FEES) 之间的关系.
- 为了确定吞特定与通用QoL在反映疾病严重程度和治疗影响方面的实用性.
主要方法:
- 评估HNSCC患者的横截面研究.
- 使用EQ-5D-5L和MD Anderson Dysphagia Inventory (MDADI) 进行主观QOL评估.
- 通过纤维光学内镜吞评估 (FEES) 评估的目标吞功能,包括透吸收量表 (PAS) 和残留物评估.
主要成果:
- 在客观吞指标 (PAS,残留物) 和主观QOL得分 (p=0.21) 之间观察到显著的不一致.
- MDADI得分与瘤阶段,多式疗法和输卵管依赖性相关,与通用QoL不同.
- 观察到的MDADI得分差异小于10分,尽管有统计相关性,但临床意义有限.
结论:
- 单独使用 QoL 问卷对 HNSCC 进行全面评估是不够的,因为它依赖于患者的看法.
- 客观的吞评估对于检测被主观报告遗漏的沉默愿望等障碍至关重要.
- 将主观QOL与客观功能数据相结合,对于整体的患者护理和研究HNSCC生存率至关重要.
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