Avaliação da qualidade de vida de pacientes com câncer de cabeça e pescoço

Abstract

Head and neck cancer is the sixth most common cancer in the world and is considered one of the most affected in the quality of life of the affected. The present study aimed to evaluate the health-related quality of life of patients diagnosed with head and neck cancer. The cross- sectional study was carried out at the Hospital of the Paraíba Care Foundation and at the Hospital Napoleão Laureano, both located in the state of Paraíba. The sample consisted of 130 patients diagnosed with malignant head and neck neoplasms, 102 (78.5%) receiving antineoplastic treatment and 28 (21.5%) before starting. For data collection, the Medical Outcomes Study 36 - Item - Short Form (SF36) and the Oral Health Impact Profile - short form (OHIP 14) were used. The analysis was done on an individual basis, considering only oral health, with all patients (n = 130) and in a unified form, considering oral health and general health in a single score, only with patients who were receiving antineoplastic treatment (N = 102). The statistical tests applied were the following: Mann-Whitney, Kruskal- Wallis, Kolmogorov-Smirnov, Levene, Canonical discriminant analysis, Wilks' F and Lambda tests, and Decision Tree Analysis using the Chi-squared Automatic Interaction Detector. The majority of patients were between 60 and 69 years of age (n = 36, 27.7%) and were male (n = 91, 70.0%). The most prevalent type of cancer was squamous cell carcinoma (66.2%) followed by metastatic carcinoma (14.3%) and non-Hodgkin's lymphoma (6.5%), with advanced lesions (72.1%). Located in the oral cavity (23.8%) or larynx (23.8%), followed by the pharynx. The OHIP-14 presented good internal consistency in the sample studied (Cronbach's Alpha = 0.861), with the mean total score being 19.52 ± 11.79. Hierarchically, the three most affected domains were: physical pain (3.70 ± 2.44), physical disability (3.26 ± 2.62) and functional limitation (3.24 ± 2.45). Non-white individuals (PR = 1.30, 95% CI = 1.07-1.58, p = 0.009), widows (PR = 1.36, 95% CI = 1.13-1.64, p = 0.001), Diagnosed with squamous cell carcinoma (RP = 1.28, 95% CI = 1.05-1.58, p = 0.017) and who reported pain in the TMJ (RP = 1.31, 95% CI = 1, 08-160, p = 0.007) were more likely to exhibit higher scores on OHIP-14. When assessing quality of life related to oral health and general health, a single score showed an association between the clinical staging of the lesion (p = 0.035), sex (p = 0.028) and treatment modality (p = 0.032). Self-reported, nonwhite, widowed individuals diagnosed with squamous cell carcinoma and who reported pain in TMJ were more likely to exhibit greater impact of oral health on quality of life. In addition, patients diagnosed with advanced lesions who were female, as well as those who underwent chemotherapy and / or radiotherapy, were more likely to exhibit worse overall and oral quality of life when assessed on a single score. It can be concluded that patients with head and neck cancer have an impact on the quality of life due to the impairment of their oral health and, consequently, general health.