Εκτίμηση της ποιότητας ζωής σε ασθενείς με καρκίνο του φάρυγγα και του λάρυγγα
Creators: name: Ναλμπαντιάν-Ζαρούχη, Μαίρη Θ.
Publisher: name: Aristotle University of Thessaloniki
Year: 2008
Subjects: EORTC QLQ C30
H&amp;N 35

description: Σκοπός της παρούσας μελέτης είναι η εκτίμηση τηα ποιότητας ζωής ασθενών με καρκίνο του φάρυγγα και του λάρυγγα, οι οποίοι έχουν ολοκληρώσει τη θεραπεία τους και είναι ελεύθεροι νόσου. Μέθοδος. Τα ερωτηματολόγια που επιλέχθηκαν ήταν του Ευρωπαϊκού Οργανισμού για την Ερευνα και Θεραπεία του Καρκίνου(EORTC). Το γενικό ερωτηματολόγιο EORTC QLQ C30, και το ειδικό ερωτηματολόγιο που απευθύνεται σε ασθενείς με καρκίνο της κεφαλής και του τραχήλου EORTC QLQ H&amp;N35 το οποίο μεταφράσθηκε στα ελληνικά και σταθμίστηκε. Υλικό. Στην έρευνα έλαβαν μέρος 163 ασθενείς με καρκίνο του λάρυγγα και του φάρυγγα. Αποτελέσματα. Οι ασθενείς παρουσίασαν καλή λειτουργική κατάσταση, η οποία εκφράσθηκε από υψηλό μέσο όρο της βαθμολογίας στους λειτουργικούς τομείς που κυμάνθηκε από 72,5 έως 88,6. Στους τομείς των συμπτωμάτων, η βαθμολογία ήταν χαμηλή, γεγονός που αντιστοιχεί σε μικρό βαθμό προβλημάτων. Το μεγαλύτερο μέσο όρο συγκέντρωσαν η δύσπνοια (23,8) και η αϋπνία (22,3) τα προβλήματα της ομιλίας (40,6), σεξουαλικότητας (35,78) και ξηροστομίας (31,8). Συμπεράσματα. Τα αποτελέσματα της έρευνας για την ποιότητα ζωής των ασθενών με καρκίνο του φάρυγγα και του λάρυγγα ήταν ικανοποιητικά και συγκρίσιμα με αυτά που αναφέρονται στην διεθνή βιβλιογραφία. Ο παράγοντας που επηρέασε την συνολική ποιότητα ζωής σημαντικά στη πολυπαραγοντική ανάλυση ήταν το στάδιο της νόσου
description: Background. Quality of life (QOL) has become an important issue in head andneck cancer. Explanation of factors predicting QOL after treatment has important implications for patient management. Objective: This study was conducted to evaluate long term quality of life and functional outcome in disease-free patients with carcinomas of the larynx and pharynx. Methods. QOL was measured using the European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire (EORTC QLQC30/H&amp;N35). The H&amp;N35 module was formally translated and validated in Greek. Patients: Questionnaires were given to 163 disease-free patients with cancer of larynx or pharynx. 131 patients had cancer of the larynx, 24 patients cancer of the nasopharynx and 8 patients had cancer of the oropharynx or hypopharynx. There were 143 males and 20 females. Age ranged from 18 to 82 years (mean 62,57). The compliance rate was high, and the questionnaires were well accepted by the Patients Results: According to TNM stage, disease was diagnosed at the I stage in 36 (22,2%) patients, at the II stage in 22 (13%), at the III stage in 64 (39,8%) and at the IV stage in 41 (25%) patients. The patients were treated with surgery 88 (54,1%), or radiotherapy 38(23,3%), or chemo-radiotherapy 36(22,6%). Recurrences occurred in 21 patients. The mean follow up was 40,8 months (range 2-158). The scores were heavily skewed toward having few symptoms and high level of function. The mean scores in all functional scales were high, ranged from 72,5-88,6, which represents good function. The mean score for Global Quality of life was 75,23. The most disturbing symptoms were dyspnoea (23,8) and insomnia (22,3) (EORTC C 30) and speech problems(40,6), less sexuality (35,78) and xerostomia (31,8) (H&amp;N 35). Patients of 40 years or younger reported more complaints and worse functioning. There was hardly any influence of gender. Women with laryngeal cancer scored better in global quality of life and had fewer problems with speech and social contact. Education level had no influence in QOL results. The patients who lived in small towns scored significantly better than those who lived in villages and cities in emotional functioning, social contact and speech scales. Time since treatment was found to have significant positive influence on social functioning, financial problems, sexuality, social eating and feeling ill scales. The other functional scales and global quality of life hadn't significant improvement with time. Dyspnoea, insomnia, cough, problems with teeth, opening of the mouth, xerostomia, and sticky saliva were persistent or worsening. Patients with laryngeal cancer had more speech problems and cough. Patients withnasopharyngeal cancer had the worst scores in most of QOL scales. Stage and treatment had a significant influence in particular on the scales and items of the H&amp;N35. Patients with higher stages and patients receiving combination treatment had worse scores. Advanced stage had significant negative influence on eleven scales, including global quality of life. Patients, who had recurrences (although successfully treated), showed a significant deterioration in physical functioning, social functioning, sense problems,speech, cough and social contact. Patients who were treated with radiotherapy showed the best scores and patients treated with chemo-radiotherapy showed the worst scores in most of the scales. Larygectomized patients scored significantly worse in seven scales and single items (social functioning, sense problems, speech, social contact, sexuality, feeling ill and cough). They scored better in six scales and single items (pain, swallowing,xerostomia, sticky saliva, problems with teeth and opening mouth). The mean score for speech problems was 72,2, which represents a high degree of problem.Tracheoesophageal speakers scored significantly better than esophageal speakers. Conclusions: The results of this study seem to be compatible with the literature. Disease stage predicted global quality of life as was proved using linear regression analysis. This influence is related to the morbidity caused by therapy, as advanced stage justifies more intense tumor treatment. Early diagnosis of head and neck cancer is very important. It is the best way to ensure good results for both survival and quality of life