孟加拉国头颈癌患者在接受癌症导向治疗后的生活质量与症状负担的早期变化：一项前瞻性初步研究的结果。
Early Changes in Quality of Life and Symptom Burden Following Cancer-Directed Treatment Among Head and Neck Cancer Patients in Bangladesh: Findings From a Prospective Pilot Study.
文献信息
| PMID | 42741494 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Md Jahirul Islam |
| 作者单位 | Department of Public Health, Faculty of Health and Life Sciences Daffodil International University, Daffodil Smart City Dhaka Bangladesh. |
| 期刊 | Health science reports |
| SCI 分区 | Q1 |
| IF | 2.6 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景与目的： 在孟加拉国等资源匮乏地区，关于头颈癌（HNC）患者早期生活质量（QoL）结局的证据仍然有限。这项前瞻性初步研究评估了孟加拉国HNC患者在接受癌症导向治疗（CDT）开始后生活质量、功能和症状负担的变化。
方法： 在孟加拉国达卡市的三家公立癌症护理医院连续招募了102名HNC患者，进行了一项前瞻性观察性初步研究。随访时联系到91名患者，其中57名在治疗开始后平均7.4±2.2周完成了生活质量评估。使用欧洲癌症研究与治疗组织生活质量问卷核心30（EORTC-QLQ-C30）评估生活质量。采用线性混合模型分析评估纵向变化并确定与生活质量结局相关的因素。
结果： 在91名随访患者中，16.5%的患者死亡，27.5%未开始CDT，包括25%的幸存者。在最终评估的57名患者中，整体生活质量（GQL）仍然受损且随时间未改变（β=-0.15，p=0.95）。整体功能显著下降（β=-5.87，p=0.03），主要由身体功能和角色功能恶化介导，同时疲劳、恶心/呕吐和失眠显著增加。年龄小于50岁和较好的社会功能与生活质量呈正相关，而喉癌或咽癌、疲劳、疼痛和经济困难等临床状况与较差的生活质量独立相关。
结论： 孟加拉国的HNC患者在接受治疗的早期阶段经历了生活质量恶化、功能下降和症状严重程度增加的广泛负担，此外还有相当大的治疗差距和死亡率。我们的发现强调了解决治疗差距、症状管理和支持性护理的必要性。建议进行更多研究，以支持在资源有限环境中关于HNC早期识别、诊断和治疗的政策影响和实施。
英文摘要
BACKGROUND AND AIMS: Evidence on early quality of life (QoL) outcomes among patients with head and neck cancer (HNC) remains limited in low-resource settings like Bangladesh. This prospective pilot study assessed changes in QoL, functioning, and symptom burden following initiation of cancer-directed treatment (CDT) among patients with HNC in Bangladesh.
METHODS: A prospective observational pilot study was conducted among 102 consecutively recruited patients with HNC from three public cancer care hospitals located in Dhaka City, Bangladesh. Ninety-one patients were reached at follow-up, of whom 57 completed QoL assessment following a mean of 7.4 ± 2.2 weeks of treatment initiation. QoL was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC-QLQ-C30). Linear mixed-model analyses were employed to evaluate longitudinal changes and identify factors associated with QoL outcomes.
RESULTS: Of 91 followed-up patients, 16.5% of patients died, and 27.5% did not start CDT, including 25% of survivors. Global quality of life (GQL) among 57 finally assessed patients remained impaired and unchanged over time (β = -0.15, p = 0.95). Overall functioning declined markedly (β = -5.87, p = 0.03), primarily mediated by deteriorated physical and role functions, along with significantly increased fatigue, nausea/vomiting, and insomnia. Younger than 50 years older and better social functioning were positively associated with QoL, whereas clinical conditions such as laryngeal or pharyngeal cancers, fatigue, pain, and financial difficulties were independently associated with poorer QoL.
CONCLUSION: Patients with HNC in Bangladesh experienced an extensive burden of deteriorated QoL, functioning, and increased symptom severity during the early treatment period, besides considerable treatment gaps and mortality. Our findings underscore the necessity of addressing treatment gaps, symptom management, and supportive care. More studies are recommended to support policy implications and implementation regarding early identification, diagnosis, and treatment of HNC in resource-limited settings.