Quality of life and related demographic factors in long-term survivors of childhood non-Hodgkin's lymphoma
HU Yang, WU Liu-Hong, GUAN Hui-Jie, WU Su-Yun, LIU Long-Zhen, CAI Rui-Qing, XU Yan-Jie, ZHANG Yi-Zhuo, SUN Xiao-Fei, ZHU Jia
Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China (Zhu J, Email: zhujia@sysucc.org.cn)
摘要 目的 评估儿童非霍奇金淋巴瘤(non‐Hodgkin lymphoma,NHL)长期生存者的生活质量,探讨其相关人口学因素。 方法 回顾性收集初诊年龄<18岁,在中山大学肿瘤防治中心接受NHL诊治,至随访时长期生存,目前年龄≥18岁者的临床和人口学特征资料。使用健康调查简表(The Medical Outcomes Study 36-Item Short Form Health Survey,SF-36)和欧洲癌症研究与治疗组织生活质量问卷(Quality of Life Questionnaire-Core 30,QLQ-C30)中文版的症状子量表进行调查。以美国普通成年人口(美国常模)及中国香港普通成年人口(中国香港常模)为对照,将NHL长期生存者SF-36量表各维度得分与之进行比较分析;分析NHL长期生存者SF-36量表各维度得分与其人口学特征的相关性。根据QLQ-C30量表得分对NHL长期生存者目前的症状进行评价。 结果 随访资料完整的23例NHL患者纳入研究,病理分型包括弥漫大B细胞淋巴瘤10例,伯基特淋巴瘤4例,T细胞淋巴母细胞瘤5例,B细胞淋巴母细胞瘤3例,自然杀伤/T细胞淋巴瘤1例,均接受过含蒽环类和烷化类药物化疗方案的治疗。目前中位年龄为26.2(16.9~55.8)岁,初诊中位年龄为10.4(2.4~17.6)岁,其中,6例已婚已育,2例患有其他慢性疾病。长期生存者的总体健康状况与美国常模相比,生理职能、一般健康状况、情感职能和精神健康评分差异无统计学意义(P>0.05),其他维度评分优于常模(P<0.05);与中国香港常模相比得出的结果类似。初诊年龄与SF-36量表社会功能、生理职能、一般健康状况呈负相关(P<0.05);目前年龄与生理机能呈正相关,与一般健康状况呈负相关(P<0.05);患者的城乡分布与一般健康状况呈负相关(P<0.05)。此外,儿童NHL长期生存者QLQ-C30症状得分较低,症状多集中在轻度,中重度症状较少。 结论 儿童NHL长期生存者的总体健康状况较好,与一般人群无明显差异;患者的初诊年龄是影响生活质量的主要人口学因素。 引用格式:
Abstract:Objective To evaluate the quality of life and related demographic factors in long-term survivors of childhood non-Hodgkin's lymphoma (NHL). Methods A retrospective analysis was performed on the medical and demographic data of the NHL patients who received treatment in the Sun Yat-sen University Cancer Center and achieved long-term survival at follow-up, with an age of <18 years at initial diagnosis and a present age of ≥18 years. A questionnaire survey was performed using 36-Item Short-Form Health Survey (SF-36) and the symptom subscale of the Chinese version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (QLQ-C30). The health status of long-term survivors of NHL was evaluated by comparing the scores of various dimensions of the SF-36 scale of general adult population in the United States (American norm) and those of the SF-36 scale of general adult population in Hong Kong, China (Hong Kong norm). The correlation between the score of each dimension of the scale and demographic characteristics was evaluated. The symptoms of long-term NHL survivors were evaluated according to the score of QLQ-C30 scale. Results A total of 23 patients with NHL with complete follow-up data were enrolled. The pathological types included diffuse large B-cell lymphoma in 10 patients, Burkitt lymphoma in 4 patients, T-cell lymphoblastoma in 5 patients, B-cell lymphoblastoma in 3 patients, and natural killer/T cell lymphoma in 1 patient. All patients received the chemotherapy regimen containing anthracyclines and alkylating agents. The median present age was 26.2 years (range: 16.9-55.8 years), and the median age at initial diagnosis was 10.4 years (range: 2.4-17.6 years). Among the 23 patients, 6 were married and had children and 2 had chronic diseases. There was no significant difference between the long-term survivors and the US norm in role physical, general health, role-emotional, and mental health (P>0.05), while the long-term survivors had significantly better scores of the other dimensions than the US norm (P<0.05). Similar results were obtained for the comparison between the long-term survivors and the China Hong Kong norm. Age at initial diagnosis was negatively correlated with the scores of social functioning, role physical, and general health in the SF-36 scale (P<0.05), and the present age of patients was positively correlated with the score of physical functioning and was negatively correlated with the score of general health (P<0.05). The urban and rural distribution of patients was related to the general health status (P<0.05). In addition, the long-term survivors of childhood NHL had relatively low scores of the symptom domain of QLQ-C30, and few moderate or severe symptoms were found. Conclusions Long-term survivors of childhood NHL tend to have a good overall health status, with no significant differences compared with the general population. Age at initial diagnosis is the main demographic factor that affects patients' quality of life. Citation:
HU Yang,WU Liu-Hong,GUAN Hui-Jie et al. Quality of life and related demographic factors in long-term survivors of childhood non-Hodgkin's lymphoma[J]. CJCP, 2021, 23(9): 882-888.
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