下咽鳞状细胞癌根治术后患者随访分析及生活质量调查

Follow-up analysis and quality of life investigation in patients after hypopharyngeal squamous cell carcinoma radical operation

目的分析下咽鳞状细胞癌根治术后患者的生存情况及生活质量。方法回顾性分析首都医科大学附属北京同仁医院耳鼻咽喉头颈外科2011年1月至2015年6月住院下咽鳞状细胞癌患者194例临床资料。使用欧洲癌症研究与治疗组织针对头颈肿瘤患者的生命质量测定量表(EORTC-QLQ-H&N35)对患者生活质量进行评估。使用Kaplan-Meier方法分析患者术后3年生存情况。结果 194例患者中,接受不保留喉功能切除术69例(35. 6%),保留喉功能切除术125例(64. 4%)。不保留喉功能患者术后3年病死率为50. 7%(35/69),保留喉功能患者术后3年病死率为23. 2%(29/125),保留喉功能组生存情况优于不保留喉功能组(χ~2=15. 520,P <0. 001)。EORTC-QLQ-H&N35评估患者生活质量可见,术后3、12个月时,患者吞咽功能、语言功能、饮食情况、社会接触得分较术前变化差异均有统计学意义(均P <0. 05),术后3个月时患者生活质量最差。结论下咽鳞状细胞癌术后患者3年生存率较低,患者生活质量较术前明显降低,今后关注生存率的同时更应提高患者生活质量。

Objective To investigate the survival condition and quality of life in patients with hypopharyngeal squamous cell carcinoma after radical resection.Methods Clinical data of 194 cases of hypopharyngeal squamous cell carcinoma who had surgical treatment at Beijing Tongren Hospital,Capital Medical University from January2011 to June 2015 were retrospectively analyzed.Quality of life was assessed by the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire(EORTC-QLQ-H&N35).Kaplan-Meier method was used to analyze the survival data during 3-year follow-up.Results Among the 194 patients,69 patients(35.6%)underwent laryngectomy without laryngeal function preservation and the 3-year death rate was50.7%(35/69);125 patients(64.4%)underwent laryngectomy with laryngeal function preservation and the3-year death rate was 23.2%(29/125).Patients with laryngeal function preservation showed a high survival(χ~2=15.520,P<0.001).At 3 and 12 months after operation,EORTC-QLQ-H&N35 scores of swallowing function,language function,dietary status and social contact were worse than those before operation(P<0.05)and it showed the worst quality of life at 3 months.Conclusion The 3-year survival condition of patients with hypopharyngeal squamous cell carcinoma resection is poor;quality of life decreases significantly after operation.