PDF(Pubmed)
Abstract：
(1) Background: Head and neck cancer treatment, including advanced techniques like Volumetric Modulated Arc Therapy (VMAT), presents challenges for maintaining patient quality of life (QoL). Thus, thoroughly investigating how radiation therapy (RT) affects patients has been proved essential. Derived by that, this study aims to understand the complex interactions between not only RT and QoL but also symptom severity, and treatment-related toxicities in three distinct time points of patient\'s treatment; (2) Methods: To achieve that, EORTC-QLQ-C30 and EORTC QLQ-H&N35 questionnaires were used in combination with EORTC_RTOG scoring criteria and Spearman\'s rho statistical analysis for 74 patients with cancer undergoing VMAT radiation therapy; (3) Results: The results revealed a significant improvement in the Overall Health Index post-treatment, indicating a temporary decline during therapy followed by subsequent recovery, often surpassing pre-treatment QoL levels. Concurrently a reduction in symptomatology was observed, notably in pain, swallowing difficulties, and dry mouth, aligning with prior research indicating decreased symptom burden post-treatment. However, Spearman\'s correlation coefficient analysis at two distinct time points during therapy uncovered varying degrees of correlation between dosimetric data at Organs at Risk (OARs) and reported symptoms, highlighting potential limitations in using QoL questionnaires as sole indicators of treatment efficacy. Our investigation into the correlation between dosimetric data, toxicity, and symptoms focused on the relationship between radiation doses and oral mucositis levels, a common toxicity in head and neck cancer patients. Significant associations were identified between toxicity levels and dosimetric parameters, particularly with OARs such as the parotid glands, oral cavity, and swallowing muscles, underlining the utility of the EORTC method as a reliable toxicity assessment tool; (4) Conclusions: To summarize, current research attempts to underscore the importance of refining QoL assessments for enhanced patient care. The integration of dosimetric data, symptom severity, and treatment-related toxicities in the QoL outcomes of head and neck cancer patients undergoing VMAT radiation therapy, can lead towards the optimization of treatment strategies and the improvement of patient outcomes in future patient-centered radiation therapy practices.
摘要：
(1)背景:头颈部肿瘤的治疗,包括体积调制电弧疗法(VMAT)等先进技术，为维持患者生活质量(QoL)提出了挑战。因此，彻底调查放射治疗（RT）如何影响患者已被证明是至关重要的。由此衍生，这项研究旨在了解不仅RT和QoL之间的复杂相互作用，还有症状严重程度，以及患者治疗的三个不同时间点的治疗相关毒性；(2)方法：实现这一目标，EORTC-QLQ-C30和EORTCQLQ-H&N35问卷结合EORTC_RTOG评分标准和Spearman的rho统计分析，对74例接受VMAT放射治疗的癌症患者进行了研究；（3）结果：结果显示治疗后整体健康指数明显改善，表明治疗期间暂时下降，随后恢复，经常超过治疗前的QoL水平。同时观察到症状学减少，尤其是在疼痛中，吞咽困难,口干,与先前的研究一致，表明治疗后症状负担降低。然而,治疗期间两个不同时间点的Spearman相关系数分析揭示了危险器官（OAR）的剂量学数据与报告的症状之间的不同程度的相关性。强调使用QoL问卷作为治疗疗效唯一指标的潜在局限性。我们对剂量学数据之间的相关性进行了调查，毒性,症状集中在辐射剂量和口腔粘膜炎水平之间的关系上，头颈部癌症患者常见的毒性。毒性水平和剂量学参数之间存在显著关联，特别是OAR，如腮腺，口腔,吞咽肌肉，强调EORTC方法作为一种可靠的毒性评估工具的实用性；(4)结论：总结，当前的研究试图强调完善QoL评估对增强患者护理的重要性。剂量数据的整合，症状严重程度,以及接受VMAT放射治疗的头颈部癌症患者的QoL结局中与治疗相关的毒性，在未来以患者为中心的放射治疗实践中，可以导致治疗策略的优化和患者预后的改善。
