216例口腔鳞癌患者术后心理困扰影响因素及放疗前、后生存质量评价

Factors associated with psychological distress after surgery and quality of life before and after radiotherapy in 216 patients with oral squamous cell carcinoma

目的:调查口腔鳞癌患者术后心理困扰程度的影响因素及放疗对生存质量的影响。方法:对216例口腔鳞癌术后患者采用单因素分析和回归分析,评价心理困扰与社会经济和治疗因素的关系。采用中文版欧洲癌症研究与治疗组织的生存质量核心量表及头颈癌特异模块问卷,通过配对t检验对受试者放疗前及放疗后3个月的生存质量进行评估。采用SPSS 22.0软件包对数据进行统计学处理。结果:年龄、AJCC分期、下唇正中切口是心理困扰的主要影响因素。在放疗前和放疗后,大多数功能领域和特定项目评分存在显著差异。结论:临床医师应针对不同年龄、不同分期患者,选择个体化治疗方案和程序,对心理困扰高风险人群作针对性筛查和额外心理、社会支持。放疗可改善及加重患者的特殊症状,应采取针对性预防措施。

PURPOSE:To investigate the degree of psychological distress of patients with oral squamous cell carcinoma after operation and its influencing factors,and the impact of radiotherapy on their quality of life.METHODS:Univariate analysis and regression analysis were used to evaluate the relationship between psychological distress and socio-economic and therapeutic factors.The quality of life of the subjects before and after radiotherapy was evaluated by paired t-test using the Chinese version of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30/Head and Neck 35.SPSS 22.0 software package was used to deal with the data.RESULTS:Age,AJCC stage and median incision of lower lip were the main factors affecting psychological distress.In addition,there were significant differences in scores of most functional areas and specific items before and after radiotherapy.CONCLUSIONS:Clinicians should select individualized treatment programs and procedures for patients of different ages and stages,and screen high-risk groups for psychological distress and provide additional psychological and social support.In addition,radiotherapy can improve or aggravate some special symptoms of patients.Clinicians should take targeted preventive measures.