头颈部肿瘤患者主观自我评价有效性及其与患者生存率的相关性

The efficiency of head and neck cancer patients-self report quality of life and its relationship with survival rates

目的：探讨头颈部肿瘤患者主观评价对病情和预后预测的有效性。方法收集新诊断的头颈部鳞癌患者79例，患者主观评价采用Swal－QOL表和EuroQOL－5D－3L问卷调查表，临床客观评价疾病程度通过成人疾病评估表－27评价，体力状态通过肿瘤合作组织标准评估。结果患者平均随访时间为29个月（4～65个月），随访期间19例患者死亡，主要死亡原因为肿瘤进展（63．2％）。73．4％患者体质量下降0％～5％，60例患者（75．9％）ACE－27等级介于0～1之间，47例患者（59．5％）ECOG评分介于0～1之间。 T分期、体质量减轻比例、性别与多个患者主观评价指标（日常获得能力、疼痛或不舒服、吞咽困难）相关，差异均有统计学意义（OR＝1．9～7．7，均P＜0．05）。结论头颈部肿瘤患者自我主观评价与临床客观指标相关性较高，并能很好预测肿瘤严重程度及病程；吞咽困难是评测肿瘤患者病死率最有效的指标。

Objective To investigate the effectiveness of head and neck cancer patient subjective assessment of forecast of the disease and prognosis .Methods 79 patients with head and neck squamous cell carcinoma were col-lected for newly diagnosed cases .Swal-QOL scale and EuroQOL-5D-3L questionnaire was used to detect subjec-tive evaluation .Clinical adult disease assessment scale -27 evaluation was used to detect objective assessment of the extent of the disease .The tumor organization standard was used to evaluate physical state .Results The average follow-up time was 29 months（4~65 months）,19 patients died during the follow -up period,the main causes of death were tumor progression（63.2%）.0%~5%decreased body mass of 73.4%patients,60 patients（75.9%） between ACE-27 grade was between 0~1,47 patients（59.5%） ECOG score between 0~1.T staging,loss of body mass ra-tio,sex with multiple patient subjective evaluation index （ daily gain ability , pain or discomfort and dysphagia ） , the differences were statistically significant （ OR=1.9~7.7,P〈0.05）.Conclusion The correlation is higher in pa-tients with head and neck cancer subjective evaluation and clinical indexes ,which can well predict the severity and duration of tumor .Dysphagia is the most effective index for evaluating tumor mortality rate .