Gesundheitsbezogene Lebensqualität nach Behandlung von Plattenepithelkarzinomen des Oropharynx

 

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Zusammenfassung

Hintergrund: Bei bösartigen Erkrankungen gewinnen neben dem Überleben als primärem Zielkriterium auch sekundäre Therapieziele wie die gesundheitsbezogene Lebensqualität zunehmend an Bedeutung. In der durchgeführten Studie erfolgte die Analyse der gesundheitsbezogenen Lebensqualität bei Patienten mit Oropharynxkarzinomen nach kurativer Behandlung in Abhängigkeit von der Therapiemodalität.

Material und Methoden: Die Krankenakten von 256 Patienten wurden retrospektiv ausgewertet. Die Einschlusskriterien für diese Studie erfüllten hiervon 98 Patienten, von denen 82 bereit waren, an der Studie teilzunehmen. Dieses Kollektiv wurde entsprechend der Therapiemodalität in 2 Gruppen aufgeteilt: primäre Radiochemotherapie vs. operative Erstbehandlung mit adjuvanter Bestrahlung. Die Erhebung der Lebensqualität erfolgte mithilfe von 2 validierten Fragebögen (EORTC QLQ-C30 und EORTC QLQ-H&N35).

Ergebnisse: Die Patienten unseres Kollektivs zeigten in den meisten Skalen schlechtere Ergebnisse als die Allgemeinbevölkerung. Vor allem die Itemskala „Mattigkeit“ zeigte hier eine starke Veränderung, ebenso die Einzelsymptomfragen „Atemprobleme“ und „Finanzielle Schwierigkeiten“. Der Vergleich der Lebensqualität in Abhängigkeit der Therapiemodalität zeigte nur in einzelnen Skalen „Körperliches und Kognitives Befinden“ des EORTC QLQ-C30 einen signifikanten Unterschied.

Schlussfolgerungen: Insgesamt wird die Lebensqualität von den befragten Patienten unabhängig von der Therapiemodalität als überwiegend zufrieden stellend bewertet. In den Skalen „Körperliches und Kognitives Befinden“ zeigen Patienten nach primärer kombinierter Radiochemotherapie ein signifikant besseres Ergebnis, obwohl das Tumorstadium in dieser Patientengruppe deutlich weiter fortgeschritten war.

Abstract

Background: Oropharyngeal cancer is a diagnosis which means a change in life and even after successful treatment a tremendous reduction in the quality of life. Aim of this study is to analyse the health-related quality of life in patients with oropharyngeal cancer dependent on different treatment options.

Methods and Patients: Charts of 256 patients treated for oropharyngeal cancer between 1997 and 2007 were analysed in a retrospective study. Inclusion criteria for this study has been fulfilled by 98 patients, 82 of these completed the study. Therefore, standardised questionnaires (EORTC QLQ-C30 und EORTC QLQ-H&N35) have been used and 2 groups were compared: patients with primary radiochemotherapy (pRCT) vs. patients treated by an operation and adjuvant radiation.

Results: Most of the health-related quality of life domains in our patients were significantly reduced compared to the general population. There have been just very few significant differences in the quality of life domains in between the 2 groups.

Conclusions: Health-related quality of life after treatment of oropharyngeal cancer is significantly compromised for these patients compared to the general population, but there have been no obvious differences depending on the compared treatment options. Only regarding the items “physical and cognitive functioning” patients after primary radiochemotherapy showed significantly better results and thus a better quality of life, despite the fact, that this group has a significantly advanced cancer stadium.

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