Zusammenfassung
Hintergrund
Das Vestibularisschwannom (VS) ist eine Erkrankung, die die gesundheitsbezogene Lebensqualität („health-related quality of life“, HR-QOL) negativ beeinflussen kann. Nachdem viele Jahre nur allgemeine Lebensqualitätsmessinstrumente wie der SF-36 zur Messung der gesundheitsbezogenen Lebensqualität zur Verfügung standen, existiert seit einigen Jahren mit dem Penn Acoustic Neuroma Quality Of Life (PANQOL) ein krankheitsspezifisches Messinstrument. Es ist zu erwarten, dass die Anwendung dieses Instruments in der Zukunft wichtige Aspekte der HR-QOL bei VS besser herausarbeiten kann. Eine validierte deutsche Version des Instruments existiert noch nicht.
Die von den Patienten am häufigsten beklagten Symptome im Rahmen der Erkrankung sind Kopfschmerzen und Schwindel.
Ergebnisse und Diskussion
Die bisher vorliegende Literatur zeigt, dass die therapeutischen Verfahren die HR-QOL unterschiedlich beeinflussen. Insbesondere die Strahlentherapie hat bei kleinen und mittelgroßen Tumoren keine ausgeprägten negativen Effekte auf die HR-QOL. Die Bewertung operationsbedingter Einschränkungen gleicht sich aber über den Verlauf einiger Jahre den Bewertungen nach Strahlentherapie an. Für große VS mit einem Durchmesser >3 cm liegen diesbezüglich noch keine richtungweisenden Daten vor. Wünschenswert für die Zukunft wären prospektive Studien mit einer Langzeitnachbeobachtung von 10 Jahren und mehr, um die offenen Fragen zu klären.
Abstract
Background
Vestibular schwannoma (VS) is a disease which might affect health-related quality of life (HR-QOL) in a negative manner. For many years, only generic quality of life instruments such as SF-36 were available to measure HR-QOL. However, some years ago, the Penn Acoustic Neuroma Quality Of Life (PANQOL) tool, a disease-specific instrument, was developed and validated. It is expected that the application of this instrument will be able to better assess relevant aspects of the HR-QOL of VS patients in the future. A validated German version of the instrument does not exist yet. The disease-specific symptoms most frequently named by patients are headache and dizziness.
Results and discussion
The available literature shows that the therapeutic approaches affect HR-QOL differently. In particular, radiation therapy of small and medium-sized tumors has no pronounced negative effects on HR-QOL. However, restrictions after surgery become similar to those after radiotherapy over the course of several years. For large VS with a diameter >3 cm, no guiding data on this aspect are currently available. To clarify the outstanding issues, future prospective studies with long-term follow-up of 10 years and more are desirable.
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I. Baumann und P. K. Plinkert geben an, dass kein Interessenkonflikt besteht.
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Baumann, I., Plinkert, P.K. Lebensqualität von Patienten mit Vestibularisschwannom. HNO 65, 719–723 (2017). https://doi.org/10.1007/s00106-017-0371-7
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DOI: https://doi.org/10.1007/s00106-017-0371-7