The relationship between operation type, adjuvant radiation therapy, spinal accessory nerve and quality of life in patients with laryngeal cancer

Yıl 2013, Cilt: 23 Sayı: 3, 153 - 162, 19.08.2013

Burak Karabulut Bora Başaran Hakan Yenice Kadir Serkan Orhan Günter Hafız

Öz

Objectives: In this study, we aimed to investigate the effect of operation type, adjuvant radiation therapy RT , and preserved spinal accessory nerve on the quality of life in patients with laryngeal cancer. Patients and Methods: A total of 191 consecutive patients 185 males, 6 females; mean age 59±10 years; range 42 to 79 years who were operated due to laryngeal cancer were included. The quality of life scores were estimated using the Washington University Quality of Life Questionnaire, version IV. The patients were divided into six groups according to the operation type, the need for postoperative RT and preserved or operated spinal accessory nerve during the neck dissection. Group 1 consisted of patients with total or near total laryngectomy; group 2 consisted of those with partial laryngeal surgery; group 3 consisted of those with postoperative RT; group 4 consisted of those without postoperative RT; group 5 consisted of those with preserved 11th cranial nerve during the neck dissection, and group 6 consisted of those with non-preserved 11th cranial nerve during the neck dissection. The questionnaire scores were compared among the groups. Results: The compact quality of life scores were 77.4±11.3 in group 1, 86.2±7.2 in group 2, 79.1±9.5 in group 3, 83.4±10.6 in group 4, 87.3±9.4 in group 5, and 79.4±10.8 in group 6. There was a statistically significant difference in the compact quality of life scores among the surgery groups, neck dissection groups and RT groups p=0.018, p<0.001, p<0.001, respectively . There was no effect of preserved 11th cranial nerve on daily activity, swallowing, chewing, appearance, recreation, salivation, taste, speech, mood, and anxiety parameters. This nerve was not preserved in 71.9% of the patients who were urged to change their job due to shoulder problems. The difference was statistically significant p<0.001 . Conclusion: According to our study results, we concluded that partial laryngectomy improved the quality of life, rather than total or near-total laryngectomy, while postoperative RT had an adverse effect on the quality of life and preserved spinal accessory nerve during the neck dissection had a positive impact on the quality of life in patients with laryngeal cancer.

Anahtar Kelimeler

Laryngeal cancer, quality of life, radiation therapy, spinal accessory nerve, Washington University Quality of Life Questionnaire

Larenks kanserli hastalarda ameliyat tipi, adjuvan radyoterapi ve spinal aksesuvar sinir ile yaşam kalitesi arasındaki ilişki

Öz

Amaç: Bu çalışmada larenks kanserli hastalarda ameliyat tipi, adjuvan radyoterapi RT ve spinal aksesuvar sinirin korunmasının yaşam kalitesi üzerindeki etkisi araştırıldı.Hastalar ve Yöntemler: Larenks kanseri nedeni ile ameliyat edilen, ardışık toplam 191 hasta çalışmaya dahil edildi. Washington Üniversitesi Yaşam Kalitesi Anketi UW-QOL versiyon IV kullanılarak yaşam kalite skorları hesaplandı. Hastalar ameliyat tipine, ameliyat sonrası RT gereksinimine ve boyun diseksiyonu sırasında spinal aksesuvar sinirin korunmasına veya korunmamasına göre altı gruba ayrıldı. Total ve near-total larenjektomi yapılan hastalar grup 1, parsiyel larenks cerrahisi yapılanlar grup 2, ameliyat sonrası RT uygulananlar grup 3, ameliyat sonrası RT uygulanmayanlar grup 4, boyun diseksiyonu sırasında 11. kraniyal siniri korunanlar grup 5, boyun diseksiyonu sırasında 11. kraniyal siniri korunmayanlar grup 6 olarak sınıflandırıldı. Anket skorları, gruplar arasında kıyaslandı.Bulgular: Kompakt yaşam kalitesi skorları grup 1’de 77.4±11.3, grup 2’de 86.2±7.2, grup 3’te 79.1±9.5, grup 4’te 83.4±10.6, grup 5’te 87.3±9.4 ve grup 6’da 79.4±10.8 idi. Kompakt yaşam kalite skorlarında ameliyat grupları, boyun diseksiyon grupları ve RT grupları arasında istatistiksel olarak anlamlı fark bulundu sırasıyla p=0.018, p

Anahtar Kelimeler

Larenks kanseri, yaşam kalitesi, radyasyon terapisi, spinal aksesuvar sinir, Washington Üniversitesi Yaşam Kalitesi Anketi.