(1) Background: The goal of this study is to evaluate psychological tolerance and health-related quality of life (QOL) in head and neck (HN) cancer patients treated with definitive accelerated radiotherapy (DART). (2) Methods: 76 recurrence-free patients eligible for the study, who were treated with DART in the CAIR-2 phase III clinical study (median of follow-up = 47 months), completed EORTC QLQ-C30 with the H&N35 module, Hospital Anxiety and Depression Scale (HADS) and Visual–Analog Scales (VAS) of pain in HN and the neck/arm areas. (3) Results: The most dominant symptoms measured with QLQ-C30 were as follows: fatigue (44/100), sleeplessness (39/100), financial problems (38/100) and pain (32/100). Within the H&N35, the highest scores were reported on the subscales of sticky saliva (60/100), mouth dryness (65/100) and increased intake of painkillers (50/100). Pain (VAS) was reported by 87% (HN area) and 78% (shoulder area) of the patients, with a mean score of 3/10. One-third of the patients reported depressive moods (HADS ≥ 15 points) with an average score of 12.5/42 p. The depressed group, who smoked more as compared to the non-depressed group before DART (96% vs. 78%) and required steroids treatment (85% vs. 58%) during DART, also scored significantly worse on 23 of the 35 subscales of QLQ-C30 and H&N35 and experienced more intense pain (VAS). Women and less-advanced patients scored better in several aspects of quality of life. (4) Conclusions: Patients treated with DART struggle with low quality of life and persistent treatment-related symptoms including constant pain. HNC survivors, especially those who are depressed, may require additional psychosocial, rehabilitation and medical intervention programmes.
(1) 背景：本研究旨在评估接受根治性加速放疗的头颈癌患者的心理耐受性与健康相关生活质量。(2) 方法：纳入CAIR-2三期临床研究中接受根治性加速放疗且无复发的76例患者（中位随访时间47个月），采用欧洲癌症研究与治疗组织生活质量核心量表联合头颈模块、医院焦虑抑郁量表及头颈部/肩臂区域疼痛视觉模拟评分进行测评。(3) 结果：生活质量核心量表显示最突出的症状为：疲劳（44/100）、失眠（39/100）、经济困难（38/100）和疼痛（32/100）。头颈模块中评分最高的子维度为：黏稠唾液（60/100）、口干（65/100）及止痛药用量增加（50/100）。87%患者报告头颈部疼痛，78%报告肩部疼痛，平均视觉模拟评分为3/10。三分之一的患者存在抑郁情绪（医院焦虑抑郁量表≥15分），平均得分12.5/42分。抑郁组在根治性加速放疗前吸烟比例更高（96% vs 78%），治疗期间需类固醇治疗的比例更高（85% vs 58%），且在生活质量核心量表与头颈模块共35个子维度中的23个维度评分显著更差，疼痛程度更剧烈。女性和早期患者在生活质量多个维度表现更好。(4) 结论：接受根治性加速放疗的患者面临生活质量低下及持续存在的治疗相关症状（包括长期疼痛）。头颈癌幸存者，特别是伴有抑郁症状者，可能需要额外的心理社会支持、康复及医疗干预方案。
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