KISEP Head and Neck Korean J Otolaryngol 2001;44:973-81 ํ๋์์น๋ฃํ์ถ์์งํ๊ฐ ๋จ์ฑ์ผ ์ก๋ฌ์ ์๋ณํ ์ต๋ํ ์์ง์ Quality of Life after Treatment of Laryngeal Carcinoma Sung Il Nam, MD, Dal Won Song, MD, Byung Hoon Ahn, MD, Dong Ha Choi, MD and Jin Sik Sohn, MD Department of Otolaryngology, School of Medicine, Keimyung University, Taegu, Korea ABSTRACT Background and Objectives:Head and neck cancer strikes at some of the most basic human functions, including verbal communication, social interaction, eating and breathing. Traditionally, the success of cancer treatment has been assessed by objective measures such as disease-free intervals, cure rates, and complication rates. Recently, however, there has been an increased awareness of the need to evaluate treatment effects on the individual s quality of life (QOL). The purpose of this study is to assess quality of life following various types of treatment for laryngeal carcinoma. Material and Methods:We assessed a quality-of-life after treatment of laryngeal carcinoma patients using WHOQOL-BREF questionnaires which was employed by the WHOQOL-group. Fifty-seven patients with laryngeal carcinoma were contacted with the completion of the survey:radiotherapy only (n=24), conservative laryngectomy (n=16) and total layngectomy (n=17). Results:This study demonstrates that there was no significant difference in QOL in physical health, social relationship and environment between the radiotherapy-only-group and the operation-group (conservative & total laryngectomy). However, the radiotherapy-only group had significantly better (p<.05) QOL on the psychological health domain, especially regarding body image and negative feelings than those of the operation group. Conclusion:The negative feeling, the body image change and the poor ability of communication have a negative impact on QOL in the operation group, especially in the total laryngectomee. Providing positive psychosocial adjustment training and voice rehabilitation programs for those who underwent total laryngectomy would be a great help in enhancing their quality of life. Korean J Otolaryngol 2001;44:973-81 KEY WORDS:Quality of life Larynx Carcinoma WHOQOL-BREF. 973
974 Table 1. General characteristics of laryngeal cancer patients Characteristics Total laryngectomy Conservative surgery erapy Radioth- Overall Mean age, Yr 65.8 66.8 65.1 No. of patients 17 16 24 57 Level of education High school 15 10 15 40 High school 2 4 6 12 High school 2 3 5 Living arrangement living alone 1 4 3 8 Economic statusmonthly income won 200 2 2 150200 0 100150 2 2 4 50100 5 6 9 20 50 12 8 11 31 Table 2. WHOQOL-BREF domains of QOL Domain Facets incorporated within domains I. Physical health Pain and discomfort item 11 Sleep and rest item 23 Energy and fatigue item 18 Mobility item 33 Activities of daily living item 24 Dependence on medication item 12 Work capacity item 25 II. Psychological Positive feeling item 13 Thinking, learning, memory item 15 Self-esteem item 26 Body image and appearance item 19 Negative feelings item 34 Spirituality/religion item 14 III. Social relation- Personal relationships item 27 ships Social support item 29 Sexual activity item 28 IV. Environment Freedom, physical safety item 16 Home environment item 30 Financial resources item 20 Health and social care item 31 Information item 21 Recreation leisure activity item 22 Physical environment item 17 Transport item 32 Korean J Otolaryngol 2001;44:973-81
Fig. 1. Comparison of health related quality of life for patients with laryngeal cancer vs. control group. Domain 1 Indicates physical health, Domain 2Psychological health, Domain 3Social relationship, Domain 4Environment p0.05. Fig. 3. Comparison of health related quality of life for operation group total laryngectomy and conservationlaryngectomy vs. radiation therapy. Domain 1Indicates physical health, Domain 2Psychological health, Domain 3Social relationship, Domain 4Environment p0.05. Fig. 2. Comparison of health related quality of life for total laryngectomy vs. conservation surgery vs. radiation therapy. Domain 1Indicates physical health, Domain 2Psychological health, Domain 3Social relationship, Domain 4Environment p0.05. Fig. 4. Comparison of health related quality of life for total laryngectomy vs. conservative laryngectomy and radiation therapy. Domain 1Indicates physical health, Domain 2 Psychological health, Domain 3Social relationship, Domain 4Environment p0.05. 975
Table 3. Problems of swallowing For swallowing 976 Total Conservation Radiation laryngectomy surgery therapy Generally possible 17 15 23 Difficult 1 1 Greatly difficult Fig. 5. Comparison of voice and quality of life for total laryngectomy vs. conservative laryngectomy vs. radiation therapy. Korean J Otolaryngol 2001;44:973-81
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