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Abstract：
BACKGROUND: Few studies have examined health related Quality of Life (HR-QoL) during the treatment of head and neck cancer (HNC) with even fewer focusing on the impact of oral mucositis (OM) on HR-QoL. Studies performed during treatment of HNC makes it possible to follow fluctuations in HR-QoL, OM and other treatment related side effects. The aim was to prospectively analyze HR-QoL, changes in clinical variables and the impact of OM on HR-QoL during HNC treatment.
METHODS: Patients were recruited before commencing curative cancer treatment and were given professional oral care weekly during oncologic treatment. HR-QoL was reported before, during (week 2, 4 and 6) and three months after treatment using the EORTC Quality of Life questionnaires C30 and H&N35 and the stimulated whole salivary secretion rate was determined at the same time-points. OM (erythema and ulceration) was registered using the Oral Mucositis Assessment Scale (OMAS), at baseline, weekly during treatment and post treatment. Differences in HR-QoL between different timepoints were analyzed. To analyze the impact of OM on HR-QoL the patients were categorized into two groups: no/mild OM (OMAS ulceration score 0-1) or severe OM (OMAS ulceration score ≥ 2) and HR-QoL was compared between the two OM groups at three timepoints during treatment.
RESULTS: Fifty-seven patients (43 men, 14 women), with a mean age of 58 years were included. Patients reported progressively impaired HR-QoL, with peak issues noted at weeks 4 and 6, particularly in social eating, senses, appetite loss, sticky saliva, and decreasing salivary secretion rates were determined. Patients with severe OM reported worse HR-QoL compared to those with no/mild OM. Persistent problems 3 months post treatment were appetite loss, dry mouth, senses (smell and taste) and problems with social eating.
CONCLUSIONS: Patients experienced exacerbated symptoms and problems weeks 4 and 6 of oncological treatment, especially among those with severe OM, stressing the importance of clinically monitoring the patients to reduce and alleviate their symptoms. Persistent problems three months post treatment are likely associated with the reduced salivary secretion rate indicating that patients should be monitored also after completed oncological treatment.
METHODS: Patients were recruited before commencing curative cancer treatment and were given professional oral care weekly during oncologic treatment. HR-QoL was reported before, during (week 2, 4 and 6) and three months after treatment using the EORTC Quality of Life questionnaires C30 and H&N35 and the stimulated whole salivary secretion rate was determined at the same time-points. OM (erythema and ulceration) was registered using the Oral Mucositis Assessment Scale (OMAS), at baseline, weekly during treatment and post treatment. Differences in HR-QoL between different timepoints were analyzed. To analyze the impact of OM on HR-QoL the patients were categorized into two groups: no/mild OM (OMAS ulceration score 0-1) or severe OM (OMAS ulceration score ≥ 2) and HR-QoL was compared between the two OM groups at three timepoints during treatment.
RESULTS: Fifty-seven patients (43 men, 14 women), with a mean age of 58 years were included. Patients reported progressively impaired HR-QoL, with peak issues noted at weeks 4 and 6, particularly in social eating, senses, appetite loss, sticky saliva, and decreasing salivary secretion rates were determined. Patients with severe OM reported worse HR-QoL compared to those with no/mild OM. Persistent problems 3 months post treatment were appetite loss, dry mouth, senses (smell and taste) and problems with social eating.
CONCLUSIONS: Patients experienced exacerbated symptoms and problems weeks 4 and 6 of oncological treatment, especially among those with severe OM, stressing the importance of clinically monitoring the patients to reduce and alleviate their symptoms. Persistent problems three months post treatment are likely associated with the reduced salivary secretion rate indicating that patients should be monitored also after completed oncological treatment.
摘要：
背景：很少有研究在头颈癌（HNC）治疗期间检查与健康相关的生活质量（HR-QoL），而更少关注口腔黏膜炎（OM）对HR-QoL的影响。在HNC治疗期间进行的研究可以跟踪HR-QoL的波动，OM等治疗相关副作用。目的是前瞻性分析HR-QoL，HNC治疗期间临床变量的变化以及OM对HR-QoL的影响。
方法：患者在开始治愈性癌症治疗之前被招募，并在肿瘤治疗期间每周给予专业口腔护理。以前报告过HR-QoL，在治疗后（第2、4和6周）和3个月内，使用EORTC生活质量问卷C30和H＆N35，并在同一时间点确定刺激的整个唾液分泌率。使用口腔粘膜炎评估量表（OMAS）记录OM（红斑和溃疡），在基线，治疗期间和治疗后每周一次。分析不同时间点之间HR-QoL的差异。为了分析OM对HR-QoL的影响，将患者分为两组：无/轻度OM（OMAS溃疡评分0-1）或重度OM（OMAS溃疡评分≥2），并在治疗期间的三个时间点比较两组之间的HR-QoL。
结果：57名患者（43名男性，14名妇女），包括平均年龄58岁。患者报告HR-QoL逐渐受损，在第4周和第6周注意到高峰问题，特别是在社交饮食方面，感官,食欲减退,粘稠的唾液,并测定了唾液分泌率的降低。与没有/轻度OM的患者相比，重度OM患者的HR-QoL较差。治疗后3个月的持续问题是食欲不振，口干,感官(嗅觉和味觉)和社交饮食的问题。
结论：患者在肿瘤治疗的第4周和第6周出现症状和问题加剧，尤其是那些严重的OM，强调临床监测患者以减轻和缓解症状的重要性。治疗后三个月的持续问题可能与唾液分泌率降低有关，表明在完成肿瘤治疗后也应对患者进行监测。
方法：患者在开始治愈性癌症治疗之前被招募，并在肿瘤治疗期间每周给予专业口腔护理。以前报告过HR-QoL，在治疗后（第2、4和6周）和3个月内，使用EORTC生活质量问卷C30和H＆N35，并在同一时间点确定刺激的整个唾液分泌率。使用口腔粘膜炎评估量表（OMAS）记录OM（红斑和溃疡），在基线，治疗期间和治疗后每周一次。分析不同时间点之间HR-QoL的差异。为了分析OM对HR-QoL的影响，将患者分为两组：无/轻度OM（OMAS溃疡评分0-1）或重度OM（OMAS溃疡评分≥2），并在治疗期间的三个时间点比较两组之间的HR-QoL。
结果：57名患者（43名男性，14名妇女），包括平均年龄58岁。患者报告HR-QoL逐渐受损，在第4周和第6周注意到高峰问题，特别是在社交饮食方面，感官,食欲减退,粘稠的唾液,并测定了唾液分泌率的降低。与没有/轻度OM的患者相比，重度OM患者的HR-QoL较差。治疗后3个月的持续问题是食欲不振，口干,感官(嗅觉和味觉)和社交饮食的问题。
结论：患者在肿瘤治疗的第4周和第6周出现症状和问题加剧，尤其是那些严重的OM，强调临床监测患者以减轻和缓解症状的重要性。治疗后三个月的持续问题可能与唾液分泌率降低有关，表明在完成肿瘤治疗后也应对患者进行监测。
