97例口腔癌患者术前生存质量的初步评价

目的:描述口腔癌患者术前的生存质量(quality of life,QOL)状况;分析社会人口学特点、临床特点对术前QOL的影响.方法:采用36条目简明健康状况调查问卷(SF-36)中文版和华盛顿大学生存质量问卷(UW-QOL)第4版,对97例口腔鳞癌患者术前的QOL进行测量.将97例患者分别按社会人口学特点和临床特点分组.组间差异采用SPSS12.0软件包进行Mann-Whitney U检验.将癌症患者SF-36的得分与普通人群参考值进行独立样本t检验.结果:①与普通人群配伍组比较,高龄患者有着相似的QOL值,而低龄患者则在躯体角色、身体疼痛和情感角色等领域表现出较低的QOL值;②T分期是影响术前QOL的最重要因素;③社会人口学特点如性别、年龄和共病等对QOL的影响主要体现在活力、躯体功能、躯体角色、情绪等反映身体状况和心理状况的指标上,而与口腔相关的特异性问题(口干除外)基本无关.而临床特点如肿瘤分期和部位对QOL的影响则不仅表现在与口腔相关的多项特异性问题上,如咀嚼、吞咽、发音、味觉等,还与身体疼痛、躯体角色、情感角色等反映身体状况和心理状况的指标密切相关.结论:与普通人群参考值进行比较.能更精确地反映口腔癌患者的QOL信息;临床特点对术前QOL的影响大于社会人口学特点;将普适性测量与头颈特异性量表结合,能更全面地评价口腔癌患者的QOL.联合使用UW-QOL和SF-36能较好地达到这一目的.

Preliminary evaluation of quality of life in 97 patients with oral cancer before surgery

PURPOSE： To describe the quality of life（QOL） in patients with oral cancer preoperatively, and to analyze the impact of soeiodemo-graphic variables and clinical features on their QOL scores. METHODS： SF-36（Chinese version） and UW-QOL （version 4.0） were used to examine QOL of 97 consecutive patients with oral squamous cell carcinoma. These patients were divided into different groups according to sociodemographie variables（age, sex, education, comorbidity） and clinical features（tumor location, tumor stage or TNM stage）. The differences between groups were analyzed by Mann-Whitney U test with SPSS12.0 software package. Independent-samples t test Was used for comparison between their scores of SF-36 and the normative QOL scores. RESULTS： ①Compared with the age- and sex-matched population-based sample, the older patients generally showed parallel QOL scores, while in patients 〈60 years , there was reduced QOL regarding the domains of RP, BP and RE; ②Tumor stage had the most powerful impact on QOL scores; ③The impact of soeiodemographic variables （e.g. age, sex, eomorbidity） on these QOL scores lied predominantly in parameters（e.g. VT, PF, RP and mood） reflecting the domains of physical complaints and psychological distress ; while the impact of clinical features （e.g. tumor location, tumor stage） on these QOL scores not only lied in specific problems related to oral cavity（e.g. chewing, swallowing, speech and taste）, but also parameters reflecting the domains of physical complaints and psychological distress such as RP, BP and RE. CONCLUSION： A comparison with the normative QOL scores contributed to obtain more precise QOL information of patients with oral cancer. Clinical features appeared to have stronger impact on QOL than sociodemographic variables. Combination of general measures and head and neck-specific measures, for example, combination of SF-36 and UW-QOL, will evaluate QOL of oral cancer patients more comprehensively.