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Health-related quality of life of parotid carcinoma patients—a comparative study with parotid adenoma patients and assessment of the influence of demographic, treatment, and pathological factors. Int J Oral Maxillofac Surg 2019; 48:163-172. [DOI: 10.1016/j.ijom.2018.07.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 05/29/2018] [Accepted: 07/26/2018] [Indexed: 11/23/2022]
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Abstract
Oral cancer is the fifth most common form of cancer in Taiwan in terms of incidence and death rate and results in at least 2700 deaths each year.
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Baxi SS, Cullen G, Xiao H, Atoria CL, Sherman EJ, Ho A, Lee NY, Elkin EB, Pfister DG. Long-term quality of life in older patients with HPV-related oropharyngeal cancer. Head Neck 2018; 40:2321-2328. [PMID: 30421835 DOI: 10.1002/hed.25159] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 12/19/2017] [Accepted: 02/08/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND We explored if age affects quality of life (QOL) in survivors of locally advanced human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (SCC). METHODS In a cross-sectional survey of 185 patients, at least 12 months from radiation, we evaluated generic (EuroQOL-5D questionnaire [EQ-5D]) and head and neck specific (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Head and Neck 35-questions [EORTC-QLQ-H&N35]) QOL questionnaires and compared differences between younger (<65) and older (≥65) patients. RESULTS The median age was 57.0 years (range 25-77 years), and 31 patients (16.8%) were ≥65 years old. There was no significant difference in EQ-5D global QOL scores by age (P = .53). Patients ≥65 years reported more immobility (P < .01), problems with social eating (P < .0001), and coughing (P < .01). Patients ≥65 years were not more likely to ever require a gastrostomy (P = .24) but were more likely to remain gastrostomy-dependent at the time of the survey (P = .02). CONCLUSION Despite similar generic QOL, older survivors may have more mobility problems and issues with social eating compared with younger survivors deserving of further evaluation.
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Affiliation(s)
- Shrujal S Baxi
- Head and Neck Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Medicine, Weil Medical College of Cornell University, New York, New York
| | - Grace Cullen
- Head and Neck Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Han Xiao
- Head and Neck Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Medicine, Weil Medical College of Cornell University, New York, New York
| | - Coral L Atoria
- Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Eric J Sherman
- Head and Neck Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Medicine, Weil Medical College of Cornell University, New York, New York
| | - Alan Ho
- Head and Neck Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Medicine, Weil Medical College of Cornell University, New York, New York
| | - Nancy Y Lee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Elena B Elkin
- Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Public Health, Weill Medical College of Cornell University, New York, New York
| | - David G Pfister
- Head and Neck Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Medicine, Weil Medical College of Cornell University, New York, New York
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Likhterov I, Ru M, Ganz C, Urken ML, Chai R, Okay D, Liu J, Stewart R, Culliney B, Palacios D, Lazarus CL. Objective and subjective hyposalivation after treatment for head and neck cancer: Long-term outcomes. Laryngoscope 2018; 128:2732-2739. [PMID: 30325025 DOI: 10.1002/lary.27224] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2018] [Indexed: 11/07/2022]
Abstract
OBJECTIVES/HYPOTHESIS This study examined saliva weight over time and its association with diet and patient-rated swallowing, dry mouth, sticky saliva, and dysgeusia quality of life in head and neck cancer (HNCA) patients treated with surgery plus adjuvant chemoradiotherapy (CRT), or primary CRT. STUDY DESIGN Prospective cohort study in an outpatient HNCA center setting. METHODS Patients were seen pretreatment, and 1, 3, 6, 12, 24, and 36 + months post-treatment. All had newly diagnosed oral, oropharynx, nasopharynx, larynx/hypopharynx cancer from 2010 to 2016 and were to undergo surgery + CRT or primary CRT. Stimulated saliva weight was assessed with the Saxon test. Diet, eating, dry mouth, and dysgeusia quality of life were assessed and correlated with saliva weight, treatment modality, and tumor site. RESULTS Saliva weight decreased the most within the first 3 months across treatment groups, except for the surgery + CRT group, which continued to decline. Similar trends were seen by tumor site. Performance Status Scale (PSS) Normalcy of Diet and all quality-of-life scores declined following treatment. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck-35 (EORTC QLQ-H&N35); Eating Assessment Tool (EAT-10); M. D. Anderson Dysphagia Inventory (MDADI) Composite, Global, and subdomain scores; and PSS Diet were significantly correlated with saliva weight. CONCLUSIONS Saliva weight worsened post-treatment across groups and tumor site, with improvement by 36 + months. Saliva weight correlated with diet, eating quality of life and perception of dysgeusia across time points. Despite dose-sparing intensity-modulated radiation therapy, newer technologies are needed to preserve saliva production and maintain higher quality of life. LEVEL OF EVIDENCE 2b Laryngoscope, 128:2732-2739, 2018.
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Affiliation(s)
- Ilya Likhterov
- Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York.,Department of Otolaryngology-Head and Neck Surgery
| | - Meng Ru
- Department of Population Health Science and Policy
| | - Cindy Ganz
- Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York.,Department of Otolaryngology-Head and Neck Surgery
| | - Mark L Urken
- Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York.,Department of Otolaryngology-Head and Neck Surgery
| | - Raymond Chai
- Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York.,Department of Otolaryngology-Head and Neck Surgery
| | - Devin Okay
- Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York.,Department of Otolaryngology-Head and Neck Surgery
| | - Jerry Liu
- Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York
| | - Robert Stewart
- Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York
| | - Bruce Culliney
- Department of Radiation Oncology.,Department of Medical Oncology, Mount Sinai Health System, New York, New York, U.S.A
| | - Daisy Palacios
- Department of Radiation Oncology.,Department of Medical Oncology, Mount Sinai Health System, New York, New York, U.S.A
| | - Cathy L Lazarus
- Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York.,Department of Otolaryngology-Head and Neck Surgery
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Degboe A, Knight SL, Halling K, Trigg A, Al-Zubeidi T, Aldhouse N, Kitchen H, Wirth L, Rogers SN. Patients' experience of recurrent/metastatic head and neck squamous cell carcinoma and their perspective on the EORTC QLQ-C30 and QLQ-H&N35 questionnaires: a qualitative study. J Patient Rep Outcomes 2018; 2:33. [PMID: 30148250 PMCID: PMC6092741 DOI: 10.1186/s41687-018-0060-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 07/09/2018] [Indexed: 02/03/2023] Open
Abstract
Background Head and neck squamous cell carcinoma (HNSCC) and its associated treatments may affect all aspects of patients’ health-related quality of life (HRQoL). Although the EORTC QLQ-H&N35 is regularly administered to patients with HNSCC, there is a paucity of studies re-assessing the conceptual relevance of this patient-reported outcome (PRO) measure from a patient perspective. Furthermore, the content validity of the EORTC QLQ-C30 has not been widely documented in patients with recurrent and/or metastatic HNSCC. The objectives of this study were to understand patients’ experiences of recurrent/metastatic HNSCC and its treatments, and to evaluate the conceptual relevance and acceptability of the EORTC QLQ-C30 and QLQ-H&N35 from a patient perspective for use in clinical trials. Methods A literature review and clinician interviews were conducted to inform in-depth semi-structured telephone interviews with US patients who had received treatment for recurrent and/or metastatic HNSCC in the preceding 12 months. Interview transcripts were analysed thematically using ATLAS.ti v7; patient quotes were coded to identify concepts and themes to develop a conceptual model of HNSCC experience. Results Fourteen patients were interviewed (71% male, aged 35–84 years). Patients reported few symptoms pre-diagnosis including neck lump/swelling (n = 7/14, 50%) and/or difficulty swallowing (n = 3/14, 21%). Treatments generally comprised surgery and chemotherapy and/or radiotherapy. A number of side effects from all treatments were reported. Numbness, difficulty speaking and pain were the most reported side effects of surgery (n = 4/8, 50%); weight loss and fatigue were the most reported side effects of chemotherapy and/or radiotherapy (n = 8/13, 61%). All side effects negatively impacted patients’ HRQoL. Patients generally found the QLQ-C30 and QLQ H&N35 content to be understandable and conceptually relevant; excessive mucous production and neuropathic symptoms were among the suggested additions. Conclusions HNSCC and its diverse symptoms and treatments have a negative impact on many aspects of patients’ lives. A number of reported symptoms including difficulty speaking and swallowing, localised pain and fatigue may be important for treatment benefit evaluation in clinical trials from a patient perspective. The QLQ-C30 and QLQ-H&N35 are generally relevant and suitable for use in clinical trials. However, some items could be amended/added to ensure conceptual comprehensiveness of these measures. Electronic supplementary material The online version of this article (10.1186/s41687-018-0060-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | | | | | | | | | | | - Lori Wirth
- 5Massachusetts General Hospital, Boston, MA USA
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Paek MS, Nightingale CL, Tooze JA, Milliron BJ, Weaver KE, Sterba KR. Contextual and stress process factors associated with head and neck cancer caregivers' physical and psychological well-being. Eur J Cancer Care (Engl) 2018; 27:e12833. [PMID: 29461649 PMCID: PMC5867245 DOI: 10.1111/ecc.12833] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2018] [Indexed: 01/09/2023]
Abstract
Head and neck cancer (HNC) caregivers are especially vulnerable to poor outcomes because the HNC patients are at high risk for physical and functional impairments. This study examines contextual and stress process variables potentially associated with HNC caregivers' physical and psychological well-being. Patient-caregiver variables included socio-demographics, primary stressors (caregiving, patient clinical characteristics, HNC-related symptoms/dysfunction), secondary stressors (caregiver employment, childcare responsibilities and sleep duration <7 hr), appraisal, and response (physical activity). General linear models modeled caregiver well-being, along with depression and anxiety. A total of 33 patient-caregiver dyads were included. Most caregivers were female (81.8%) and patient spouses/partners (72.7%). Factors significantly associated with better caregiver physical well-being included caregiver older age, <2 comorbidities, ≥7 hr of sleep, ≥3 days/week physical activity, and patient swallowing and speech dysfunction. Factors significantly associated with better caregiver mental health functioning were less patient social dysfunction and less perceived caregiving burden. Short nighttime sleep, higher caregiver burden, and <3 days/week physical activity were also significantly related to caregivers' depression and anxiety. Results suggested caregiver behaviors and perceived burden, along with patient HNC concerns are linked with caregiver well-being. These behavioral, cognitive, and patient factors should be incorporated into caregiver screening tools or targeted with behavioral interventions to improve caregiver well-being.
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Affiliation(s)
- M-S Paek
- Department of Social Welfare, Konkuk University, Chungju-si, Chungcheongbuk-do, South Korea
| | - C L Nightingale
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - J A Tooze
- Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - B-J Milliron
- Department of Nutrition Sciences, College of Nursing and Health, Drexel University, Philadelphia, PA, USA
| | - K E Weaver
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - K R Sterba
- Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
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Chen YH, Liang WA, Hsu CY, Guo SL, Lien SH, Tseng HJ, Chao YH. Functional outcomes and quality of life after a 6-month early intervention program for oral cancer survivors: a single-arm clinical trial. PeerJ 2018; 6:e4419. [PMID: 29492348 PMCID: PMC5827017 DOI: 10.7717/peerj.4419] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 02/06/2018] [Indexed: 11/25/2022] Open
Abstract
Background Advanced treatment of oral cancer increases survival rates; however, it also increases the risk of developing shoulder dysfunction, dysphagia, oral dysfunction, donor site morbidity and psychological issues. This single-arm preliminary pilot study aims to explore the effects of a six-month early intervention program following reconstructive surgery in oral cancer survivors. Methods A total of 65 participants were analyzed following reconstructive surgery. Outcome measurements were taken during the first visit, and at one, three and six months after reconstructive surgery. Results Scapular muscle strength and shoulder range of motion progressively improved during the 6-month follow-up. The mean Disability of the Arms, Shoulder and Hand (DASH) score showed significant improvement at 1 month (p < .001). Health related QoL showed significant differences between baseline and 6-months post-surgery scores on global health and on most of the function and symptom scales. The predicted return-to-work rate was 80% at one year after the operation. Return-to-work rate differs in different vocational types, with a higher rate of return in the skilled or semi-skilled (87.5%) and self-employed (86.7%). Conclusions We suggest that early integrated intervention program with a follow-up of at least six months following reconstructive surgery may help develop and identify intervention guidelines and goals in the initial six months of treatment following neck dissection in oral cancer survivors.
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Affiliation(s)
- Yueh-Hsia Chen
- Rehabilitation Center, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital Linkou Branch, Taoyuan, Taiwan
| | - Wei-An Liang
- Rehabilitation Center, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital Linkou Branch, Taoyuan, Taiwan
| | - Chung-Yin Hsu
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Siang-Lan Guo
- Rehabilitation Center, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital Linkou Branch, Taoyuan, Taiwan
| | - Shwu-Huei Lien
- Rehabilitation Center, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital Linkou Branch, Taoyuan, Taiwan
| | - Hsiao-Jung Tseng
- Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital Linkou Branch, Taoyuan, Taiwan
| | - Yuan-Hung Chao
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Rehabilitation Center, National Taiwan University Hospital Chu-Tung Branch, Hsinchu County, Taiwan.,Center of Physical Therapy, National Taiwan University Hospital, Taipei, Taiwan
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Clasen D, Keszte J, Dietz A, Oeken J, Meister EF, Guntinas-Lichius O, Pabst F, Büntzel J, Jenzewski EM, Singer S, Meyer A. Quality of life during the first year after partial laryngectomy: Longitudinal study. Head Neck 2018; 40:1185-1195. [PMID: 29417656 DOI: 10.1002/hed.25095] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 10/03/2017] [Accepted: 01/10/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND This prospective study was conducted to assess changes in quality of life (QOL) of patients who undergo a partial laryngectomy. METHODS The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaires Core and Head and Neck (EORTC-QLQ-C30, QLQ-H&N35) were used preprocedure (n = 218), 1 week (n = 159), 3 months (n = 122), and 1 year after partial laryngectomy (n = 88). Changes over time were analyzed with the Wilcoxon signed rank test and the Holm-Bonferroni method, and interpreted regarding clinical relevance. RESULTS Most subscales worsened 1 week postprocedure, but many recovered to baseline level after 1 year. Dyspnea and cognitive functioning deteriorated over time, with worst scores recorded after 1 year. Financial difficulties and fatigue increased after surgery and maintained that level throughout the follow-up period; sticky saliva remained worse than at baseline, despite some improvements over time. CONCLUSION The discovered limitations of QOL should be observed more closely during follow-up treatment, and patients should be informed about these potential effects before partial laryngectomy.
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Affiliation(s)
- Daniel Clasen
- Department of Medical Psychology and Medical Sociology, Division Psychosocial Oncology, University Hospital Leipzig, Leipzig, Germany
| | - Judith Keszte
- Department of Medical Psychology and Medical Sociology, Division Psychosocial Oncology, University Hospital Leipzig, Leipzig, Germany
| | - Andreas Dietz
- Department of Otorhinolaryngology, University Hospital Leipzig, Leipzig, Germany
| | - Jens Oeken
- Department of Otorhinolaryngology, Clinical Center Chemnitz, Chemnitz, Germany
| | - Eberhard F Meister
- Department of Otorhinolaryngology, Clinical Center St. Georg, Leipzig, Germany
| | | | - Friedemann Pabst
- Department of Otorhinolaryngology, Clinical Center Dresden-Friedrichstadt, Dresden, Germany
| | - Jens Büntzel
- Department of Otorhinolaryngology, Clinical Center Südharz Nordhausen, Nordhausen, Germany
| | - Eva-Maria Jenzewski
- Department of Otorhinolaryngology, Clinical Center Carl Thiem Cottbus, Cottbus, Germany
| | - Susanne Singer
- University Medical Centre Mainz, Institute of Medical Biostatistics, Epidemiology, and Informatics (IMBEI), Mainz, Germany
| | - Alexandra Meyer
- Department of Medical Psychology and Medical Sociology, Division Psychosocial Oncology, University Hospital Leipzig, Leipzig, Germany
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Protontherapy of head and neck paragangliomas: A monocentric study. Cancer Radiother 2017; 22:31-37. [PMID: 29269165 DOI: 10.1016/j.canrad.2017.07.049] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Revised: 07/09/2017] [Accepted: 07/19/2017] [Indexed: 12/21/2022]
Abstract
PURPOSE The aim of this study was to assess efficacy and safety of proton beam therapy of paragangliomas of the head and neck, rare benign tumours developed close to crucial structures such as cranial nerves and vascular tissues. PATIENTS AND METHODS Ten patients with a paraganglioma of the head and neck were treated from 2001 to 2014 with image-guided proton therapy. Neurological and ear nose throat symptoms were collected in addition to audiometric testing, before and after the treatment. Acute and late toxicities were assessed according to the Common Terminology Criteria for Adverse Events (CTCAE) v4. RESULTS Median age at diagnosis was 52.6years (range: 18.2-65.8years). Proton therapy was the exclusive treatment in six patients and four patients had a postoperative radiotherapy. Median dose was 50.4Gy relative biological effectiveness (RBE; range: 45.0-67.0Gy). With a median follow-up of 24.6months (range: 6.7-46.2 months), local tumour control rate was 100% (stable, n=10). No upper grade 2 acute toxicity was reported. To the latest news, seven patients had controlled symptoms (improved, n=1, stabilized, n=6). One patient out of seven with initial tinnitus had a decrease in his symptoms, while the six other patients had a sustained stabilization. CONCLUSION Proton beam therapy is an effective and well-tolerated treatment modality of skull base paragangliomas, with documented functional benefit. A longer follow-up is planned in order to assess local control and long-term toxicities.
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Holtmann H, Spalthoff S, Gellrich NC, Handschel J, Lommen J, Kübler NR, Krüskemper G, Rana M, Sander K. Determinants for further wishes for cosmetic and reconstructive interventions in 1652 patients with surgical treated carcinomas of the oral cavity. Maxillofac Plast Reconstr Surg 2017; 39:26. [PMID: 28944220 PMCID: PMC5583133 DOI: 10.1186/s40902-017-0125-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Accepted: 08/01/2017] [Indexed: 11/20/2022] Open
Abstract
Background The impairment of the appearance is a major problem for patients with carcinomas of the oral cavity. These patients want to recover their preoperative facial appearance. Some do not realize that this is not always possible and hence develop a desire for further cosmetic and reconstructive surgery (CRS) which often causes psychological problems. Method The desire of patients for CRS (N = 410; 26%) has been acquired in this DÖSAK rehab study including multiple reasons such as medical, functional, aesthetic and psychosocial aspects. They relate to the parameters of diagnosis, treatment and postoperative rehabilitation. Patients without the wish for CRS (N = 1155; 74%) served as control group. For the surgeons, knowledge of the patient’s views is relevant in the wish for CRS. Nevertheless, it has hardly been investigated for patients postoperatively to complete resection of oral cancer. In this retrospective cross-sectional study, questionnaires with 147 variables were completed during control appointments. Thirty-eight departments of Oral and Maxillofacial Surgery took part, and 1652 German patients at least 6 months after complete cancer resection answered the questions. Additionally, a physician’s questionnaire (N = 1489) was available. Statistical analysis was performed with SPSS vers. 22. Results The patient’s assessment of their appearance and scarring are the most important criteria resulting in wishes for CRS. Furthermore, functional limitations such as eating/swallowing, pain of the facial muscles, numb regions in the operating field, dealing with the social environment, return to work, tumour size and location, removal and reconstruction are closely related. Conclusion The wish for CRS depends on diverse functional psychosocial and psychological parameters. Hence, it has to be issued during conversation to improve rehabilitation. A decision on the medical treatment can be of greater satisfaction if the surgeon knows the patients’ needs and is able to compare them with the medical capabilities. The informed consent between doctor and patient in regard to these findings is necessary.
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Affiliation(s)
- Henrik Holtmann
- Department for Oral and Maxillofacial Surgery, Heinrich Heine University of Düsseldorf, Moorenstr 5, 40225 Düsseldorf, Germany
| | - Simon Spalthoff
- Department of Cranio-Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Street 1, 30625 Hannover, Germany
| | - Nils-Claudius Gellrich
- Department of Cranio-Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Street 1, 30625 Hannover, Germany
| | - Jörg Handschel
- Department for Oral and Maxillofacial Surgery, Heinrich Heine University of Düsseldorf, Moorenstr 5, 40225 Düsseldorf, Germany
| | - Julian Lommen
- Department for Oral and Maxillofacial Surgery, Heinrich Heine University of Düsseldorf, Moorenstr 5, 40225 Düsseldorf, Germany
| | - Norbert R Kübler
- Department for Oral and Maxillofacial Surgery, Heinrich Heine University of Düsseldorf, Moorenstr 5, 40225 Düsseldorf, Germany
| | - Gertrud Krüskemper
- Department of Medical Psychology, Ruhr University of Bochum, Universitätsstr 150, Building MA 0/145, 44780 Bochum, Germany
| | - Majeed Rana
- Department for Oral and Maxillofacial Surgery, Heinrich Heine University of Düsseldorf, Moorenstr 5, 40225 Düsseldorf, Germany
| | - Karoline Sander
- Department for Oral and Maxillofacial Surgery, Heinrich Heine University of Düsseldorf, Moorenstr 5, 40225 Düsseldorf, Germany
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Dewey EH, Roche AM, Lazarus CL, Urken ML. Total lower lip and chin reconstruction with radial forearm free flap: A novel approach. Am J Otolaryngol 2017; 38:618-625. [PMID: 28734457 DOI: 10.1016/j.amjoto.2017.07.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 07/04/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND The management of large chin and lower lip defects is challenging due to this facial subunit's tremendous functional and aesthetic importance. Specific methods for total lower lip and mentum reconstruction are not well chronicled. Aesthetic and functional goals of this reconstruction include restoration of oral competence by maintaining lower lip height, vermilion reestablishment, color-matched skin introduction to the chin, sensation restoration, and ideally restoration of dynamic activity to the lower lip. METHODS Literature review performed. RESULTS Presentation of novel, two-stage technique for lower lip and chin reconstruction with a submental flap and a radial forearm free flap, suspension of the lower lip and chin with a tensor fascia lata graft, and vermilion reconstruction with a buccal mucosal flap. CONCLUSIONS This procedure meets all goals of total lower lip reconstruction with the exception of the introduction of dynamic tissue and represents a novel solution to a challenging reconstructive problem.
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Affiliation(s)
- Eliza H Dewey
- Thyroid, Head and Neck Cancer (THANC) Foundation, 10 Union Square East, Suite 5B, New York, NY, USA 10003.
| | - Ansley M Roche
- Otolaryngology Fellow, Department of Otolaryngology Head and Neck Surgery, Mount Sinai Beth Israel, 10 Union Square East, Suite 5B, New York, NY 10003, USA
| | - Cathy L Lazarus
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, 10 Union Square East, Suite 5B, New York, NY 10003, USA
| | - Mark L Urken
- Department of Otolaryngology Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, 10 Union Square East, Suite 5B, New York, NY 10003, USA
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Psychometric Properties of the Chinese Version of the M.D. Anderson Dysphagia Inventory for Head and Neck Cancer Patients. Cancer Nurs 2017; 40:E9-E16. [PMID: 27244664 DOI: 10.1097/ncc.0000000000000397] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Dysphagia is a common side effect of anticancer treatments in patients with head and neck cancer (HNC) and can worsen patients' quality of life. A well-established measure is essential to evaluate dysphagia in HNC patients. OBJECTIVES The aim of this study is to determine the psychometric properties of the Chinese version of the M.D. Anderson Dysphagia Inventory (MDADI-C) for HNC patients. METHODS A total of 220 subjects were included in the study. Reliability was examined by internal consistency (Cronbach's α) and test-retest reliability (intraclass correlation coefficient). Validity was evaluated with Spearman correlations (r). RESULTS The Cronbach's α and intraclass correlation coefficient of the MDADI-C were .923 and 0.942, respectively. The criterion validity of the MDADI-C was 0.777. The Spearman correlation coefficients of the MDADI-C with the European Organization for Research Into the Treatment of Cancer Quality of Life Questionnaire for Head and Neck Cancer (r = -0.851), Hospital Anxiety and Depression Scale (r = -0.424), radiotherapy dose (r = -0.553), and treatment regimens (r = -0.407) demonstrated good construct validity (all P < .01). CONCLUSIONS The MDADI-C demonstrated good psychometric properties and would be a valuable tool for clinicians to screen dysphagia rapidly and evaluate its impact on the quality of life of HNC patients. IMPLICATIONS FOR PRACTICE The MDADI-C could be used to document and monitor the dysphagia level of HNC patients for clinicians, nurses, and researchers. This validated questionnaire will help nurses and doctors to improve dysphagia management in HNC patients and will allow researchers to compare the study results across different countries.
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Terro W, Crean SJ. Prospective, longitudinal assessment of quality of life in patients with cancer of the head and neck and their primary carers. Br J Oral Maxillofac Surg 2017; 55:613-617. [DOI: 10.1016/j.bjoms.2017.04.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 04/05/2017] [Indexed: 11/25/2022]
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Harrington KJ, Ferris RL, Blumenschein G, Colevas AD, Fayette J, Licitra L, Kasper S, Even C, Vokes EE, Worden F, Saba NF, Kiyota N, Haddad R, Tahara M, Grünwald V, Shaw JW, Monga M, Lynch M, Taylor F, DeRosa M, Morrissey L, Cocks K, Gillison ML, Guigay J. Nivolumab versus standard, single-agent therapy of investigator's choice in recurrent or metastatic squamous cell carcinoma of the head and neck (CheckMate 141): health-related quality-of-life results from a randomised, phase 3 trial. Lancet Oncol 2017; 18:1104-1115. [PMID: 28651929 DOI: 10.1016/s1470-2045(17)30421-7] [Citation(s) in RCA: 273] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 05/05/2017] [Accepted: 05/12/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND Patients with platinum-refractory recurrent or metastatic squamous cell carcinoma of the head and neck have few treatment options and poor prognosis. Nivolumab significantly improved survival of this patient population when compared with standard single-agent therapy of investigator's choice in Checkmate 141; here we report the effect of nivolumab on patient-reported outcomes (PROs). METHODS CheckMate 141 was a randomised, open-label, phase 3 trial in patients with recurrent or metastatic squamous cell carcinoma of the head and neck who progressed within 6 months after platinum-based chemotherapy. Patients were randomly assigned (2:1) to nivolumab 3 mg/kg every 2 weeks (n=240) or investigator's choice (n=121) of methotrexate (40-60 mg/m2 of body surface area), docetaxel (30-40 mg/m2), or cetuximab (250 mg/m2 after a loading dose of 400 mg/m2) until disease progression, intolerable toxicity, or withdrawal of consent. On Jan 26, 2016, the independent data monitoring committee reviewed the data at the planned interim analysis and declared overall survival superiority for nivolumab over investigator's choice therapy (primary endpoint; described previously). The protocol was amended to allow patients in the investigator's choice group to cross over to nivolumab. All patients not on active therapy are being followed for survival. As an exploratory endpoint, PROs were assessed at baseline, week 9, and every 6 weeks thereafter using the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30), the EORTC head and neck cancer-specific module (EORTC QLQ-H&N35), and the three-level European Quality of Life-5 Dimensions (EQ-5D) questionnaire. Differences within and between treatment groups in PROs were analysed by ANCOVA among patients with baseline and at least one other assessment. All randomised patients were included in the time to clinically meaningful deterioration analyses. Median time to clinically meaningful deterioration was analysed by Kaplan-Meier methods. CheckMate 141 was registered with ClinicalTrials.org, number NCT02105636. FINDINGS Patients were enrolled between May 29, 2014, and July 31, 2015, and subsequently 361 patients were randomly assigned to receive nivolumab (n=240) or investigator's choice (n=121). Among them, 129 patients (93 in the nivolumab group and 36 in the investigator's choice group) completed any of the PRO questionnaires at baseline and at least one other assessment. Treatment with nivolumab resulted in adjusted mean changes from baseline to week 15 ranging from -2·1 to 5·4 across functional and symptom domains measured by the EORTC QLQ-C30, with no domains indicating clinically meaningful deterioration. By contrast, eight (53%) of the 15 domains in the investigator's choice group showed clinically meaningful deterioration (10 points or more) at week 15 (change from baseline range, -24·5 to 2·4). Similarly, on the EORTC QLQ-H&N35, clinically meaningful worsening at week 15 was seen in no domains in the nivolumab group and eight (44%) of 18 domains in the investigator's choice group. Patients in the nivolumab group had a clinically meaningful improvement (according to a difference of 7 points or greater) in adjusted mean change from baseline to week 15 on the EQ-5D visual analogue scale, in contrast to a clinically meaningful deterioration in the investigator's choice group (7·3 vs -7·8). Differences between groups were significant and clinically meaningful at weeks 9 and 15 in favour of nivolumab for role functioning, social functioning, fatigue, dyspnoea, and appetite loss on the EORTC QLQ-C30 and pain and sensory problems on the EORTC QLQ-H&N35. Median time to deterioration was significantly longer with nivolumab versus investigator's choice for 13 (37%) of 35 domains assessed across the three questionnaires. INTERPRETATION In this exploratory analysis of CheckMate 141, nivolumab stabilised symptoms and functioning from baseline to weeks 9 and 15, whereas investigator's choice led to clinically meaningful deterioration. Nivolumab delayed time to deterioration of patient-reported quality-of-life outcomes compared with single-agent therapy of investigator's choice in patients with platinum-refractory recurrent or metastatic squamous cell carcinoma of the head and neck. In view of the major unmet need in this population and the importance of maintaining or improving quality of life for patients with recurrent or metastatic squamous cell carcinoma of the head and neck, these data support nivolumab as a new standard-of-care option in this setting. FUNDING Bristol-Myers Squibb.
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Affiliation(s)
- Kevin J Harrington
- Royal Marsden NHS Foundation Trust/The Institute of Cancer Research, London, UK.
| | - Robert L Ferris
- University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
| | - George Blumenschein
- Department of Thoracic/Head and Neck Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | | | | | - Lisa Licitra
- Fondazione IRCCS Istituto Nazionale dei Tumori Milan and University of Milan, Milan, Italy
| | - Stefan Kasper
- West German Cancer Center, University Hospital, Essen, Germany
| | | | | | | | - Nabil F Saba
- Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | | | | | - Makoto Tahara
- National Cancer Center Hospital East, Kashiwa, Japan
| | | | | | | | - Mark Lynch
- Bristol-Myers Squibb, Princeton, NJ, USA
| | | | | | | | - Kim Cocks
- Adelphi Values, Bollington, Cheshire, UK
| | | | - Joël Guigay
- Centre Antoine Lacassagne, FHU OncoAge, Université Côte d'Azur, Nice, France
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Norquist J, Chirovsky D, Munshi T, Tolley C, Panter C, Gater A. Assessing the Comparability of Paper and Electronic Versions of the EORTC QOL Module for Head and Neck Cancer: A Qualitative Study. JMIR Cancer 2017; 3:e7. [PMID: 28500019 PMCID: PMC5446668 DOI: 10.2196/cancer.7202] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 03/16/2017] [Accepted: 03/31/2017] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Patient-reported outcome (PRO) instruments are important tools for monitoring disease activity and response to treatment in clinical trials and clinical practice. In recent years, there have been movements away from traditional pen-and-paper PROs towards electronic administration. When using electronic PROs (ePROs), evidence that respondents complete ePROs in a similar way to their paper counterparts provides assurance that the two modes of administration are comparable or equivalent. The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 item (EORTC QLQ-C30) and associated disease-specific modules are among the most widely used PROs in oncology. Although studies have evaluated the comparability and equivalence of electronic and original paper versions of the EORTC QLQ-C30, no such studies have been conducted to date for the head and neck cancer specific module (EORTC QLQ-H&N35). OBJECTIVE This study aimed to qualitatively assess the comparability of paper and electronic versions of the EORTC QLQ-H&N35. METHODS Ten head and neck cancer patients in the United States underwent structured cognitive debriefing and usability interviews. An open randomized crossover design was used in which participants completed the two modes of administration allocated in a randomized order. Using a "think-aloud" process, participants were asked to speak their thoughts aloud while completing the EORTC QLQ-H&N35. They were thoroughly debriefed on their responses to determine consistency in interpretation and cognitive process when completing the instrument in both paper and electronic format. RESULTS Participants reported that the EORTC QLQ-H&N35 demonstrated excellent qualitative comparability between modes of administration. The proportion of noncomparable responses (ie, where the thought process used by participants for selecting responses appeared to be different) observed in the study was low (11/350 response pairs [35 items x 10 participants]; 3.1%). Evidence of noncomparability was observed for 9 of the 35 items of the EORTC QLQ-H&N35 and in no more than 2 participants per item. In addition, there were no apparent differences in level of comparability between individual participants or between modes of administration. CONCLUSIONS Mode of administration does not affect participants' response to, or interpretation of, items in the EORTC QLQ-H&N35. The findings from this study add to the existing evidence supporting the use of electronic versions of the EORTC instruments when migrated to electronic platforms according to best practice guidelines.
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Affiliation(s)
| | | | - Teja Munshi
- Merck & Co., Inc., Kenilworth, NJ, United States
| | - Chloe Tolley
- Adelphi Values Ltd, Patient-Centered Outcomes, Bollington, Cheshire, United Kingdom
| | - Charlotte Panter
- Adelphi Values Ltd, Patient-Centered Outcomes, Bollington, Cheshire, United Kingdom
| | - Adam Gater
- Adelphi Values Ltd, Patient-Centered Outcomes, Bollington, Cheshire, United Kingdom
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Christopher KM, Osazuwa-Peters N, Dougherty R, Indergaard SA, Popp C, Walker R, Varvares MA. Impact of treatment modality on quality of life of head and neck cancer patients: Findings from an academic medical institution. Am J Otolaryngol 2017; 38:168-173. [PMID: 28081981 DOI: 10.1016/j.amjoto.2016.12.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 12/06/2016] [Accepted: 12/19/2016] [Indexed: 12/14/2022]
Abstract
PURPOSE The objective of this pilot study was to determine how different treatment modalities (surgery, radiation, and chemotherapy) impact quality of life (QOL) in a population of head and neck cancer (HNC) survivors. METHODS Fifty-nine newly diagnosed, biopsy-confirmed HNC patients were recruited between 2007-2012. They completed the EORTC Quality of Life Questionnaire and Head & Neck Module at 5 intervals pre- and post-treatment. Participants were grouped into four categories based on modality: surgery only, surgery/radiation, chemoradiation, or surgery/chemoradiation. Repeated measures ANOVA examined effect of treatment modality on QOL over time. RESULTS Xerostomia symptoms were significantly associated with chemoradiation (F(2.47, 59.27)=3.57, p=0.03), lowest at pretreatment and highest 6 months post-treatment. Time was significantly associated with head and neck pain, F(2.95,67.89)=3.39, p=0.02. CONCLUSIONS HNC survivors exhibit different QOL related symptoms depending on combined treatment modalities, and time post-treatment. It is important to understand QOL differences based upon treatment modalities when developing treatment plans for HNC patients.
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Affiliation(s)
- Kara M Christopher
- Saint Louis University Cancer Center, 3655 Vista Avenue, Saint Louis, MO 63110, USA
| | - Nosayaba Osazuwa-Peters
- Saint Louis University Cancer Center, 3655 Vista Avenue, Saint Louis, MO 63110, USA; Saint Louis University, School of Medicine, Department of Otolaryngology-Head and Neck Surgery, 3635 Vista Avenue, Saint Louis, MO 63110, USA.
| | - Rebecca Dougherty
- Saint Louis University Cancer Center, 3655 Vista Avenue, Saint Louis, MO 63110, USA
| | - Sarah A Indergaard
- Saint Louis University Cancer Center, 3655 Vista Avenue, Saint Louis, MO 63110, USA
| | | | - Ronald Walker
- Saint Louis University, School of Medicine, Department of Otolaryngology-Head and Neck Surgery, 3635 Vista Avenue, Saint Louis, MO 63110, USA
| | - Mark A Varvares
- Saint Louis University Cancer Center, 3655 Vista Avenue, Saint Louis, MO 63110, USA; Saint Louis University, School of Medicine, Department of Otolaryngology-Head and Neck Surgery, 3635 Vista Avenue, Saint Louis, MO 63110, USA
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Hansson E, Carlström E, Olsson LE, Nyman J, Koinberg I. Can a person-centred-care intervention improve health-related quality of life in patients with head and neck cancer? A randomized, controlled study. BMC Nurs 2017; 16:9. [PMID: 28239295 PMCID: PMC5320778 DOI: 10.1186/s12912-017-0206-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 02/16/2017] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The incidence of head and neck cancer is increasing slightly. Head and neck cancer but also it's necessary and often successful treatment may affect general domains of health-related quality of life and provoke a variety of adverse symptoms and side effects, both during and after treatment. The objective of this study was to compare a person-centred care intervention in terms of health-related quality of life, disease-specific symptoms or problems, with traditional care as a control group for patients with head and neck cancer. METHODS In this randomized controlled trial, person-centred-care intervention and traditional care (control) groups comprised 54 and 42 patients, respectively. Outcome measures used were: the EORTC QLQ-C30 and the EORTC QLQ-C35. Both groups answered the questionnaires at baseline and after 4, 10, 18 and 52 weeks from start of treatment. The questionnaires' scores were compared between groups by using independent samples test and non-parametric test for continuous variables. For categorical data, Fisher's exact test was used. Longitudinal data were analysed using generalized linear models for normally distributed repeated measures data. RESULTS At baseline, the intervention and control groups were comparable in terms of medical and sociodemographic variables, clinical characteristics, health-related quality of life and disease-specific symptoms or problems. At all the follow-up points, even during the worst period for the patients, the person-centred-care group consistently reported better scores than the control group. The differences were numerically but not always statistically significant. When testing longitudinal data, statistically significant results were found for head and neck cancer-specific problems, swallowing (p = 0.014), social eating (p = 0.048) and feeling ill (p = 0.021). CONCLUSIONS The results from this study suggest that adopting the person-centred-care concept practiced here could be a way to improve function and wellbeing in patients with head and neck cancer. TRIAL REGISTRATION The study was retrospectively registered in 2016-12-05 in Clinical Trials gov. "Can a Person-centred-care Intervention Improve Health-related Quality of Life in Patients With Head and Neck Cancer" registration number: NCT02982746.
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Affiliation(s)
- Elisabeth Hansson
- The Sahlgrenska Academy-Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), Gothenburg University, Gothenburg, Sweden
| | - Eric Carlström
- The Sahlgrenska Academy-Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), Gothenburg University, Gothenburg, Sweden.,University College of South East Norway, Notodden, Norway
| | - Lars-Eric Olsson
- The Sahlgrenska Academy-Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), Gothenburg University, Gothenburg, Sweden
| | - Jan Nyman
- Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ingalill Koinberg
- The Sahlgrenska Academy-Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), Gothenburg University, Gothenburg, Sweden.,Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden
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Moubayed SP, Osorio M, Buchbinder D, Lazarus C, Urken ML. Soft palate reconstruction using a combination of a turn-in flap and a radial forearm flap. Laryngoscope 2017; 127:1772-1774. [DOI: 10.1002/lary.26462] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 11/08/2016] [Accepted: 11/14/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Sami P. Moubayed
- Thyroid, Head, and Neck Cancer (THANC) Foundation
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Beth Israel; New York New York U.S.A
| | - Marcela Osorio
- Thyroid, Head, and Neck Cancer (THANC) Foundation
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Beth Israel; New York New York U.S.A
| | - Daniel Buchbinder
- Thyroid, Head, and Neck Cancer (THANC) Foundation
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Beth Israel; New York New York U.S.A
| | - Cathy Lazarus
- Thyroid, Head, and Neck Cancer (THANC) Foundation
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Beth Israel; New York New York U.S.A
| | - Mark L. Urken
- Thyroid, Head, and Neck Cancer (THANC) Foundation
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Beth Israel; New York New York U.S.A
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Peltola MK, Lehikoinen JS, Sippola LT, Saarilahti K, Mäkitie AA. A Novel Digital Patient-Reported Outcome Platform for Head and Neck Oncology Patients-A Pilot Study. CLINICAL MEDICINE INSIGHTS. EAR, NOSE AND THROAT 2016; 9:1-6. [PMID: 27721662 PMCID: PMC5040424 DOI: 10.4137/cment.s40219] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 07/31/2016] [Accepted: 08/02/2016] [Indexed: 11/14/2022]
Abstract
INTRODUCTION The patient's role in toxicity reporting is increasingly acknowledged. There is also a need for developing modern communication methods between the patient and the medical personnel. Furthermore, the increasing number of head and neck cancer (HNC) patients is reflected in the volume of treatment follow-up visits, which remains a challenge for the health care. Electronic patient-reported outcome (ePRO) measures may provide a cost-efficient way to organize follow-up for cancer patients. MATERIALS AND METHODS We tested a novel ePRO application called Kaiku®, which enables real-time, online collection of patient-reported outcomes, such as side effects caused by treatment and quality of life. We conducted a pilot study to assess the suitability of Kaiku® for HNC patients at the Department of Oncology, Helsinki University Hospital, Helsinki, Finland. Patients used Kaiku® during and one month after radiotherapy to report treatment-related side effects and quality of life. Two physicians and a nurse performed the practical electronic communication part of the study. RESULTS Five of the nine patients agreed to participate in the study: three of them had local early-stage larynx cancer (T2N0, T1aN0, and T2N0) and the remaining two patients had early-stage base of tongue cancer (T2N0 and T1N2b). The degree of side effects reported by the patients via Kaiku® ranged from mild to life threatening. The number of outcome data points on patients' progress was significantly increased, which resulted in a better follow-up and improved communication between the patient and the care team. CONCLUSIONS Kaiku® seems to be a suitable tool to monitor side effects and quality of life during and after radiotherapy among HNC patients. Kaiku® and similar tools could be useful in organizing a cost-effective follow-up process for HNC patients. We recommend conducting a larger study to further assess the impact of an ePRO solution in routine clinical practice. ePRO solutions may aid in the follow-up for cancer patients.They seem suitable to monitor, for example, side effects and quality of life.These systems ensure fast patient-driven reporting.
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Affiliation(s)
- Maria K. Peltola
- Department of Oncology, Helsinki University Hospital, Helsinki, Finland
| | | | | | - Kauko Saarilahti
- Department of Oncology, Helsinki University Hospital, Helsinki, Finland
| | - Antti A. Mäkitie
- Department of Otolaryngology—Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Flach GB, Verdonck-de Leeuw IM, Witte BI, Klop WMC, van Es RJ, Schepman KP, de Bree R. Patients' perspective on the impact of sentinel node biopsy in oral cancer treatment. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122:279-86. [DOI: 10.1016/j.oooo.2016.03.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 03/09/2016] [Accepted: 03/21/2016] [Indexed: 02/06/2023]
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Bertino G, Sersa G, De Terlizzi F, Occhini A, Plaschke CC, Groselj A, Langdon C, Grau JJ, McCaul JA, Heuveling D, Cemazar M, Strojan P, de Bree R, Leemans CR, Wessel I, Gehl J, Benazzo M. European Research on Electrochemotherapy in Head and Neck Cancer (EURECA) project: Results of the treatment of skin cancer. Eur J Cancer 2016; 63:41-52. [DOI: 10.1016/j.ejca.2016.05.001] [Citation(s) in RCA: 118] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 04/15/2016] [Accepted: 05/02/2016] [Indexed: 10/21/2022]
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Implant supported dental rehabilitation following segmental mandibular reconstruction- quality of life outcomes of a prospective randomized trial. J Craniomaxillofac Surg 2016; 44:800-10. [DOI: 10.1016/j.jcms.2016.04.013] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 03/08/2016] [Accepted: 04/06/2016] [Indexed: 11/24/2022] Open
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Pusic A, Liu JC, Chen CM, Cano S, Davidge K, Klassen A, Branski R, Patel S, Kraus D, Cordeiro PG. A systematic review of patient-reported outcome measures in head and neck cancer surgery. Otolaryngol Head Neck Surg 2016; 136:525-35. [PMID: 17418246 DOI: 10.1016/j.otohns.2006.12.006] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2006] [Accepted: 12/05/2006] [Indexed: 11/22/2022]
Abstract
Objective To identify, summarize, and evaluate patient-reported outcome questionnaires for use in head and neck cancer surgery with the view to making recommendations for future research. Data Sources A systematic review of the English-language literature, with the use of head-and-neck-surgery-specific keywords, was performed in the following databases: Medline, Embase, HAPI, CINAHL, Science/Social Sciences Citation Index, and PsycINFO from 1966 to March 2006. Data Extraction and Study Selection All English-language instruments identified as patient-reported outcome questionnaires that measure quality of life and/or satisfaction that had undergone development and validation in a head and neck cancer surgery population were included. Data Synthesis Twelve patient-reported outcome questionnaires fulfilled our inclusion criteria. Of these, four were developed from expert opinion alone or did not have a published development process and seven questionnaires lacked formal item reduction. Only three questionnaires (EORTC Head and Neck Module, University of Michigan Head and Neck Quality-of-life Questionnaire, and Head and Neck Cancer Inventory) fulfilled guidelines for instrument development and evaluation as outlined by the Medical Outcomes Trust. Conclusions Rigorous instrument development is important for creating valid, reliable, and responsive disease-specific questionnaires. As a direction for future instrument development, an increased focus on qualitative research to ensure patient input may help to better conceptualize and operationalize the variables most relevant to head and neck cancer surgery patients. In addition, the use of alternative methods of psychometric data analysis, such as Rasch, may improve the value of health measurement in clinical practice for individual patients.
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Affiliation(s)
- Andrea Pusic
- Plastic and Reconstructive Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
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Salz T, McCabe MS, Oeffinger KC, Corcoran S, Vickers AJ, Salner AL, Dornelas E, Schnall R, Raghunathan NJ, Fortier E, Baxi SS. A head and neck cancer intervention for use in survivorship clinics: a protocol for a feasibility study. Pilot Feasibility Stud 2016; 2:23. [PMID: 27965842 PMCID: PMC5153865 DOI: 10.1186/s40814-016-0061-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 04/19/2016] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Head and neck cancer survivors commonly experience severe long-term toxicities, late-occurring symptoms, and significant risks of the second primary malignancy and comorbid illnesses. With multiple simultaneous health issues, these complex cancer survivors often do not receive comprehensive health care that addresses their needs. A tool is needed to streamline and standardize comprehensive care for this cohort. METHODS/DESIGN We designed the Head and Neck Survivorship Tool: Assessment and Recommendations (HN-STAR) to address health care challenges for head and neck cancer survivors. HN-STAR is an electronic platform that aims to simplify the provision of personalized care in cancer survivorship clinics. It uses an algorithmic approach to integrate patient-reported outcomes, clinical details, and evidence-based guidelines to standardize comprehensive care provided in routine survivorship visits. It has four integrated components: (1) a simplified treatment summary, which pulls treatment details from a clinical database or can be completed manually using a streamlined form; (2) an online self-assessment for patients to report their own symptoms; (3) an interactive discussion guide presenting all relevant information to the provider during the clinic visit; and (4) a survivorship care plan generated at the end of each visit that reflects decisions made during the visit. By using a modifiable electronic platform, HN-STAR provides a method for incorporating survivorship care plans into clinical practice and for disseminating evidence on symptom management and preventive care. This is a study to assess the feasibility of a future multi-site, randomized clinical trial of HN-STAR. We will enroll head and neck cancer survivors who are followed in one of two nurse practitioner-led survivorship clinics. We will implement HN-STAR for one routine survivorship visits. We will assess (1) usability and feasibility outcomes of HN-STAR from the perspective of key stakeholders and (2) the planned outcomes intended for the larger trial. We will collect usability and feasibility data from online surveys of survivors and their providers. Our findings will inform whether it is feasible to advance HN-STAR to trial. If so, we will adapt HN-STAR and the study design of the trial in response to feedback from survivors and providers. The long-term goal is to determine if such an intervention will lead to improved and simplified comprehensive survivorship care. DISCUSSION This feasibility study will evaluate implementation of HN-STAR into clinical practice in terms of usability, practicality, and clinical flow in two distinct clinical settings. This study will also provide critical baseline data to characterize this vulnerable population. Findings from this study will inform a multicenter randomized trial of HN-STAR, aimed at standardizing and streamlining the delivery of evidence-guided comprehensive care for head and neck cancer survivors. Ultimately, if found effective, the modular structure of HN-STAR could permit its expansion to survivors of other complex cancers. TRIAL REGISTRATION ClinicalTrials.gov, NCT02571673.
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Affiliation(s)
- Talya Salz
- Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10021 USA
| | - Mary S. McCabe
- Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10021 USA
| | - Kevin C. Oeffinger
- Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10021 USA
| | - Stacie Corcoran
- Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10021 USA
| | - Andrew J. Vickers
- Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10021 USA
| | | | - Ellen Dornelas
- Hartford Hospital, 80 Seymour St, Hartford, CT 06102 USA
| | - Rebecca Schnall
- Columbia University School of Nursing, 617 W 168th St, New York, NY 10032 USA
| | | | - Elizabeth Fortier
- Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10021 USA
| | - Shrujal S. Baxi
- Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10021 USA
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Xiong J, Krishnaswamy G, Raynor S, Loh KS, Kwa ALH, Lim CM. Risk of swallowing-related chest infections in patients with nasopharyngeal carcinoma treated with definitive intensity-modulated radiotherapy. Head Neck 2016; 38 Suppl 1:E1660-5. [PMID: 26891064 DOI: 10.1002/hed.24296] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 07/03/2015] [Accepted: 09/12/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Pulmonary complications secondary to dysphagia may be encountered in patients with nasopharyngeal carcinoma (NPC) after definitive intensity-modulated radiotherapy. The purpose of this study was to identify patients with NPC at risk of developing swallowing-related chest infections (SRCIs). METHODS Retrospective chart review was performed on 217 patients with stage I to IVB NPC treated definitively with radiotherapy or chemoradiotherapy. RESULTS Twenty-six patients (12.0%) developed SRCIs; 4 of these patients (15.3%) required intensive care unit (ICU) admission and 9 (34.6%) died of the complication. The median time interval between completions of radiotherapy to the development of SRCIs was 24.5 months. Advanced age, recurrent disease, and concurrent chemoradiotherapy were significantly associated with the development of SRCIs in the multivariable analysis. CONCLUSION SRCI is a common and potentially fatal complication for postirradiated patients with NPC. Advanced age, concurrent chemoradiotherapy, and recurrent cancer were strong risk factors for postirradiated patients with NPC to develop SRCIs. © 2016 Wiley Periodicals, Inc. Head Neck 38: E1660-E1665, 2016.
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Affiliation(s)
| | | | - Sharon Raynor
- Department of Otolaryngology-Head and Neck Surgery, National University Hospital, Singapore
| | - Kwok Seng Loh
- Department of Infectious Disease, Duke-NUS Medical School, Singapore
| | - Andrea Lay Hoon Kwa
- Duke-NUS Graduate Medical School, Singapore
- Department of Infectious Disease, Duke-NUS Medical School, Singapore
| | - Chwee Ming Lim
- Department of Otolaryngology-Head and Neck Surgery, National University Hospital, Singapore
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Björling G, Johansson D, Bergström L, Jalal S, Kohn I, Frostell C, Kalman S. Tolerability and performance of BIP endotracheal tubes with noble metal alloy coating--a randomized clinical evaluation study. BMC Anesthesiol 2015; 15:174. [PMID: 26625869 PMCID: PMC4667467 DOI: 10.1186/s12871-015-0156-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 11/24/2015] [Indexed: 11/12/2022] Open
Abstract
Background Hospital acquired infections worsen the outcome of patients treated in intensive care units and are costly. Coatings with silver or metal alloys may reduce or alter the formation of biofilm on invasive medical devices. An endotracheal tube (ETT) is used to connect the patient to a ventilator and coated tubes have been tested in relation to bacterial colonization and respiratory infection. In the present study, we aimed to evaluate and compare a coated and uncoated ETT for patient symptoms and local tracheal tolerability during short term clinical use. Degree of bacterial colonization was also described. Methods A silver-palladium-gold alloy coating (‘Bactiguard®’Infection Protection, BIP) has been extensively used on urinary tract catheters and lately also on central venous catheters. We performed a randomised, single-blinded, controlled, first in man, post Conformité Européenne (EC) certification and CE marking study, focused on Bactiguard® coated ETTs (BIP ETT). Thirty patients at a tertiary university hospital scheduled for upper abdominal elective surgery with an expected duration of anaesthesia of at least 3 h were randomised; BIP ETT (n = 20) or standard ETT (n = 10). The tolerability was assessed with a modified version of Quality of Life Head and Neck Module, QLQ-H&N35 and by inspection of the tracheal mucosa with a fibre-optic bronchoscope before intubation and at extubation. Adverse Events (AE) and bacterial adherence were also studied. Statistical evaluations were carried out with the Fisher’s Exact Test, the Clopper-Pearson method, as well as a Proportional Odds Model. Results Differences between groups were identified in 2 of 8 patient related symptoms with regard to tolerability by QLQ-H&N35 (cough, p = 0.022 and dry mouth, p = 0.014 in the treatment group.). No mucosal damage was identified with bronchoscopy. A low level of bacterial colonization with normal flora, equal between groups, was seen after short-term of intubation (median 5 h). No serious Adverse Events related to the use of an ETT were observed. The results should be treated with caution due to statistical confounders, a small study size and large inter-individual variability in bacterial adhesion. Conclusions The new device BIP ETT is well tolerated and has good clinical performance during short-term intubation. Studies with larger sample sizes and longer intubation periods (>24 h) in the ICU-setting are needed and can now be planned in order to identify possible differences in clinical outcomes. Trial registration Registered in ClinicalTrials.gov, Registration number: NCT01682486, Date of Registration: August, 30, 2012
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Affiliation(s)
- Gunilla Björling
- The Swedish Red Cross University College, P.O. Box 55676, SE-10215, Stockholm, Sweden. .,Karolinska Institutet, Department of Clinical Sciences, Division of Anaesthesia and Intensive Care, Danderyd Hospital, SE-18288, Stockholm, Sweden.
| | - Dorota Johansson
- Bactiguard AB, Stockholm, Sweden. .,, P.O Box 15, SE-146 21, Tullinge, Sweden.
| | - Linda Bergström
- Bactiguard AB, Stockholm, Sweden. .,, P.O Box 15, SE-146 21, Tullinge, Sweden.
| | - Shah Jalal
- Karolinska Institutet, Division of Clinical Microbiology, Department of Laboratory Medicine, SE-14186, Stockholm, Sweden.
| | - Ivar Kohn
- Department Anesthesia and Intensive Care, Karolinska University Hospital Huddinge, SE-14186, Stockholm, Sweden.
| | - Claes Frostell
- Karolinska Institutet, Department of Clinical Sciences, Division of Anaesthesia and Intensive Care, Danderyd Hospital, SE-18288, Stockholm, Sweden.
| | - Sigridur Kalman
- Department Anesthesia and Intensive Care, Karolinska University Hospital Huddinge, SE-14186, Stockholm, Sweden. .,CLINTEC, Karolinska Institutet, SE-14186, Stockholm, Sweden.
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Konopka-Filippow M, Zabrocka E, Wójtowicz A, Skalij P, Wojtukiewicz MZ, Sierko E. Pain management during radiotherapy and radiochemotherapy in oropharyngeal cancer patients: single-institution experience. Int Dent J 2015; 65:242-8. [DOI: 10.1111/idj.12181] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Cosetti MK, Golfinos JG, Roland JT. Quality of Life (QoL) Assessment in Patients with Neurofibromatosis Type 2 (NF2). Otolaryngol Head Neck Surg 2015; 153:599-605. [PMID: 25779467 DOI: 10.1177/0194599815573002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 01/26/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this study was to develop a multidimensional metric for assessing quality of life (QoL) in patients with neurofibromatosis type 2 (NF2). STUDY DESIGN Electronically distributed questionnaire. SETTING University tertiary care hospital, NF2 support groups. SUBJECTS AND METHODS Structured interviews with NF2 providers and patients identified relevant domains. Items in each domain were extracted from validated QoL modules, then combined with items unique to NF2 and pretested on NF2 providers and patients. The final 61-item questionnaire was administered electronically to patients with NF2 (N = 118). The form assessed overall QoL and 11 additional domains, including hearing, balance, facial function, vision, oral intake, future uncertainty, psychosocial, cognition, sexual activity, pain, and vocal communication. Responses were compared with reference values for the general population, patients with head and neck cancer, and patients with brain cancer. RESULTS Overall, QoL in patients with NF2 was lower than that of the general population (P < .01) and similar to that of patients with cancer. Patients with more facial weakness, hearing loss, and imbalance reported significantly lower QoL. However, domains most predictive of overall QoL were psychosocial, future uncertainty, and pain. Compared with patients with head and neck and brain cancer, patients with NF2 demonstrated significantly higher levels of psychosocial stressors, including disease-related anxiety, personal and financial stress, and lack of social support (P < .01). CONCLUSION Psychosocial stress and pain significantly affect QoL in NF2, indicating that mental health, pain management, and financial counseling could have an important impact on QoL in this population.
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Affiliation(s)
- Maura K Cosetti
- Departments of Otolaryngology-Head & Neck Surgery and Neurosurgery, Louisiana State University, Shreveport, Louisiana, USA
| | - John G Golfinos
- Department of Neurosurgery, New York University, New York, New York, USA
| | - J Thomas Roland
- Department of Neurosurgery, New York University, New York, New York, USA Department of Otolaryngology, New York University, New York, New York, USA
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Lazarus CL, Husaini H, Hu K, Culliney B, Li Z, Urken M, Jacobson A, Persky M, Tran T, Concert C, Palacios D, Metcalfe-Klaw R, Kumar M, Bennett B, Harrison L. Functional Outcomes and Quality of Life After Chemoradiotherapy: Baseline and 3 and 6 Months Post-Treatment. Dysphagia 2014; 29:365-75. [DOI: 10.1007/s00455-014-9519-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2013] [Accepted: 02/07/2014] [Indexed: 10/25/2022]
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Oliveira KG, von Zeidler SV, Podestá JR, Sena A, Souza ED, Lenzi J, Bissoli NS, Gouvea SA. Influence of pain severity on the quality of life in patients with head and neck cancer before antineoplastic therapy. BMC Cancer 2014; 14:39. [PMID: 24460780 PMCID: PMC3904211 DOI: 10.1186/1471-2407-14-39] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 12/20/2013] [Indexed: 12/21/2022] Open
Abstract
Background The aim of this study was to assess the severity of pain and its impact on the quality of life (QoL) in untreated patients with head and neck squamous cell carcinoma (HNSCC). Methods A study group of 127 patients with HNSCC were interviewed before antineoplastic treatment. The severity of pain was measured using the Brief Pain Inventory (BPI) questionnaire, and the QoL was assessed with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30) and the head and neck module (QLQ-H&N35). Results The mean age of the patients was 57.9 years, and there was a predominance of men (87.4%). The most frequent site of the primary tumor was the oral cavity (70.6%), and the majority of the patients had advanced cancers (stages III and IV). QoL in early stage of cancer obtained better scores. Conversely, the patients with advanced stage cancer scored significantly higher on the symptom scales regarding fatigue, pain, appetite loss and financial difficulties, indicating greater difficulties. Regard to the severity of pain, patients with moderate-severe pain revealed a significantly worse score than patients without pain. Conclusions The severity of pain is statistically related to the advanced stages of cancer and directly affects the QoL. An assessment of the quality of life and symptoms before therapy can direct attention to the most important symptoms, and appropriate interventions can then be directed toward improving QoL outcomes and the response to treatment.
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Affiliation(s)
| | | | | | | | | | | | | | - Sonia A Gouvea
- Department of Physiological Sciences, Health Sciences Center, Federal University of Espirito Santo, Vitória, Brazil.
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81
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Pandey KC, Revannasiddaiah S, Pant NK, Nautiyal V, Rastogi M, Gupta MK. Palliative radiotherapy in locally advanced head and neck cancer after failure of induction chemotherapy: comparison of two fractionation schemes. Indian J Palliat Care 2013; 19:139-45. [PMID: 24347903 PMCID: PMC3853391 DOI: 10.4103/0973-1075.121522] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Context: Among patients with locally advanced head and neck squamous cell cancers (LAHNSCC), the prognosis after nonresponse or progression despite induction chemotherapy (IC) is dismal, and further treatment is often palliative in intent. Given that nonresponse to chemotherapy could indicate subsequent radioresistance, we intended to assess the outcomes with two different fractionation schemes. Aims: To compare the outcomes of two fractionation schemes- ’standard’ (consisting 3GyX5 daily fractions for 2 consecutive weeks) versus ‘hybrid’ (6GyX3 fractions on alternate days during the 1st week, followed by 2GyX5 daily fractions in the 2nd week). Settings and Design: Prospective randomized controlled two-arm unblinded trial. Materials and Methods: Patients with locally advanced oropharyngeal, laryngeal, and hypopharyngeal cancers treated with a minimum of two cycles of taxane, platinum, and fluorouracil-based IC were eligible if residual disease volume amounted <30 cm3. Kaplan-Meier survival curves were compared by the log-rank test. Response rates were compared using the unpaired t-test. Quality of life (QOL) was measured via patient reported questionnaires. Results: Of the initially enrolled 51 patients, 45 patients (24 from standard arm, and 21 from the hybrid arm) were eligible for analysis. Despite being underpowered to attain statistical significance, there still seemed to be a trend towards improvement in progression-free (Hazard ratio (HR) for progression: 0.5966; 95% CI 0.3216-1.1066) and overall survival (HR for death: 0.6062; 95% CI 0.2676-1.3734) with the hybrid arm when compared to the standard arm. Benefits were also observed with regards to response rates and QOL. Rate of complications were similar in both arms. Conclusions: In comparison to the routinely used palliative fractionation scheme of 30 Gray (Gy) in 10 fractions (Fr), the use of hybrid fractionation which integrates hypofractionation in the 1st week, followed by conventional fractionation in the 2nd week, could possibly offer better response rates, QOL increments, and potential survival benefits among LAHNSCC patients even after failing to respond to IC.
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Affiliation(s)
- Kailash Chandra Pandey
- Department of Radiotherapy, Swami Rama Cancer Hospital & Research Institute, Government Medical College- Haldwani, Nainital, Uttarakhand, India
| | - Swaroop Revannasiddaiah
- Department of Radiotherapy, Swami Rama Cancer Hospital & Research Institute, Government Medical College- Haldwani, Nainital, Uttarakhand, India
| | - Nirdosh Kumar Pant
- Department of Radiotherapy, Swami Rama Cancer Hospital & Research Institute, Government Medical College- Haldwani, Nainital, Uttarakhand, India
| | - Vipul Nautiyal
- Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Madhup Rastogi
- Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Manoj Kumar Gupta
- Regional Cancer Centre, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
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Strieth S, Dunau C, Michaelis U, Jäger L, Gellrich D, Wollenberg B, Dellian M. Phase I/II clinical study on safety and antivascular effects of paclitaxel encapsulated in cationic liposomes for targeted therapy in advanced head and neck cancer. Head Neck 2013; 36:976-84. [DOI: 10.1002/hed.23397] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Revised: 04/18/2013] [Accepted: 05/23/2013] [Indexed: 01/05/2023] Open
Affiliation(s)
- Sebastian Strieth
- Department of Otorhinolaryngology; Goethe-University; Frankfurt/M. Germany
| | - Christoph Dunau
- Department of Otorhinolaryngology; University of Munich (LMU); Germany
| | | | - Lorenz Jäger
- Department of Clinical Radiology; University of Munich (LMU); Germany
| | - Donata Gellrich
- Department of Otorhinolaryngology; University of Munich (LMU); Germany
| | - Barbara Wollenberg
- Department of Otorhinolaryngology; University of Schleswig-Holstein; Campus Lübeck Germany
| | - Marc Dellian
- Department of Otorhinolaryngology; University of Munich (LMU); Germany
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83
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Ch'ng S, Oates J, Gao K, Foo K, Davies S, Brunner M, Clark JR. Prospective quality of life assessment between treatment groups for oral cavity squamous cell carcinoma. Head Neck 2013; 36:834-40. [DOI: 10.1002/hed.23387] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2012] [Revised: 02/25/2013] [Accepted: 05/15/2013] [Indexed: 11/12/2022] Open
Affiliation(s)
- Sydney Ch'ng
- Sydney Head and Neck Cancer Institute; Royal Prince Alfred Hospital; Sydney New South Wales Australia
| | - Justine Oates
- Sydney Head and Neck Cancer Institute; Royal Prince Alfred Hospital; Sydney New South Wales Australia
| | - Kan Gao
- Sydney Head and Neck Cancer Institute; Royal Prince Alfred Hospital; Sydney New South Wales Australia
| | - Kerwyn Foo
- Sydney Head and Neck Cancer Institute; Royal Prince Alfred Hospital; Sydney New South Wales Australia
| | - Sarah Davies
- Sydney Head and Neck Cancer Institute; Royal Prince Alfred Hospital; Sydney New South Wales Australia
| | - Markus Brunner
- Sydney Head and Neck Cancer Institute; Royal Prince Alfred Hospital; Sydney New South Wales Australia
| | - Jonathan R. Clark
- Sydney Head and Neck Cancer Institute; Royal Prince Alfred Hospital; Sydney New South Wales Australia
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84
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Oates J, Davies S, Roydhouse JK, Fethney J, White K. The effect of cancer stage and treatment modality on quality of life in oropharyngeal cancer. Laryngoscope 2013; 124:151-8. [DOI: 10.1002/lary.24136] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2012] [Revised: 03/11/2013] [Accepted: 03/11/2013] [Indexed: 11/12/2022]
Affiliation(s)
- Justine Oates
- Sydney Head and Neck Cancer Institute, Royal Prince Alfred HospitalCamperdown Australia
- Cancer Nursing Research UnitSydney Nursing School, University of SydneySydney Australia
| | - Sarah Davies
- Sydney Head and Neck Cancer Institute, Royal Prince Alfred HospitalCamperdown Australia
- Cancer Nursing Research UnitSydney Nursing School, University of SydneySydney Australia
| | - Jessica K. Roydhouse
- Sydney Cancer CentreRoyal Prince Alfred Hospital, Missenden RoadCamperdown Australia
- School of Nursing, Edith Cowan UniversityJoondalup Australia
| | - Judith Fethney
- Cancer Nursing Research UnitSydney Nursing School, University of SydneySydney Australia
| | - Kate White
- Sydney Cancer CentreRoyal Prince Alfred Hospital, Missenden RoadCamperdown Australia
- Cancer Nursing Research UnitSydney Nursing School, University of SydneySydney Australia
- School of Nursing, Edith Cowan UniversityJoondalup Australia
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85
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Lazarus CL, Husaini H, Anand SM, Jacobson AS, Mojica JK, Buchbinder D, Urken ML. Tongue Strength as a Predictor of Functional Outcomes and Quality of Life after Tongue Cancer Surgery. Ann Otol Rhinol Laryngol 2013; 122:386-97. [DOI: 10.1177/000348941312200608] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: Surgical resection of oral cancer can result in altered speech, swallowing, and quality of life (QOL). To date, the oral outcome variables of tongue strength, tongue and jaw range of motion, and saliva production have not been extensively assessed. This pilot study was done to assess tongue strength along with other oral outcomes and their relationship to performance status for speech, swallowing, and QOL after partial glossectomy. Our aim was to create a norm for what should be considered a normal tongue strength value in this population. We hypothesized that patients with tongue strength of 30 kPa or greater would perform better on the performance status scale and various QOL measures than do patients with tongue strength of less than 30 kPa. Methods: We used a cross-sectional design in this study. The postoperative assessment included 1) Performance Status Scale and Karnofsky Performance Status Scale; 2) oral outcome variables of tongue strength, jaw range of motion, and saliva production; and 3) patient-rated QOL ratings via Eating Assessment Tool, M. D. Anderson Dysphagia Inventory, EORTC-H&N35, and Speech Handicap Index. Results: Patients with tongue strength of at least 30 kPa performed better on the performance status scales and various QOL measures. The cutoff score of 30 kPa for tongue strength measures revealed a trend in predicting performance on the scales and QOL measures. Conclusions: The oral outcome variables correlated with performance status for speech, swallowing, and QOL. We propose a norm for tongue strength in this population, based on the trend seen in this group of patients, as none previously existed. Future studies are under way that incorporate a larger sample size to further validate this norm. Future studies will also examine oral functional outcome measures in a larger population by including other oral and oropharyngeal sites to help predict speech and swallow performance status and QOL.
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Singer S, Danker H, Guntinas-Lichius O, Oeken J, Pabst F, Schock J, Vogel HJ, Meister EF, Wulke C, Dietz A. Quality of life before and after total laryngectomy: Results of a multicenter prospective cohort study. Head Neck 2013; 36:359-68. [DOI: 10.1002/hed.23305] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2013] [Indexed: 01/23/2023] Open
Affiliation(s)
- Susanne Singer
- University Medical Centre Mainz; Institute of Medical Biostatistics; Epidemiology and Informatics (IMBEI); Mainz Germany
- University of Leipzig; Division of Psychosocial Oncology; Leipzig Germany
| | - Helge Danker
- University of Leipzig; Department of Psychosomatic Medicine and Psychotherapy; Leipzig Germany
| | | | - Jens Oeken
- Hospital Chemnitz; Department of Otorhinolaryngology; Chemnitz Germany
| | - Friedemann Pabst
- Hospital Dresden-Friedrichstadt; Department of Otorhinolaryngology; Dresden Germany
| | - Juliane Schock
- Hospital Martha-Maria; Department of Otorhinolaryngology; Halle-Dölau Germany
| | - Hans-Joachim Vogel
- Hospital Elblandkliniken; Department of Otorhinolaryngology; Riesa Germany
| | - Eberhard F. Meister
- Community Hospital St. Georg; Department of Otorhinolaryngology; Leipzig Germany
| | - Cornelia Wulke
- Community Hospital St. Georg; Department of Otorhinolaryngology; Leipzig Germany
| | - Andreas Dietz
- University of Leipzig; Department of Otorhinolaryngology; Leipzig Germany
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A systematic review of questionnaires to measure the impact of appearance on quality of life for head and neck cancer patients. J Plast Reconstr Aesthet Surg 2013; 66:647-59. [DOI: 10.1016/j.bjps.2013.01.007] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Revised: 01/07/2013] [Accepted: 01/07/2013] [Indexed: 11/23/2022]
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Batth SS, Caudell JJ, Chen AM. Practical considerations in reducing swallowing dysfunction following concurrent chemoradiotherapy with intensity-modulated radiotherapy for head and neck cancer. Head Neck 2013; 36:291-8. [PMID: 23508721 DOI: 10.1002/hed.23246] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2012] [Indexed: 11/10/2022] Open
Abstract
Data have emerged that the addition of concurrent chemotherapy to radiation can lead to swallowing dysfunction that may have an impact on patient quality of life and lead to significant morbidities such as poor nutritional status, enteral feeding tube dependence, and aspiration pneumonia. Although intensity-modulated radiation therapy (IMRT) for head and neck cancer was initially developed to spare the parotid gland to reduce xerostomia, attention has recently focused on its utility to selectively decrease radiation dose to specified anatomic structures responsible for a functional swallow. Recent reports have proposed a variety of dose thresholds or constraints to these swallowing-related structures, which may guide IMRT planning with the aim of reducing dysphagia. This critical review of the current literature assesses the feasibility of IMRT to maintain swallowing function and appraises the various dosimetric parameters that have been proposed to help minimize long-term dysphagia.
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Affiliation(s)
- Sukhjeet S Batth
- Department of Radiation Oncology, University of California, Davis, Comprehensive Cancer Center, Sacramento, California
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Deantonio L, Masini L, Brambilla M, Pia F, Krengli M. Dysphagia after definitive radiotherapy for head and neck cancer. Correlation of dose-volume parameters of the pharyngeal constrictor muscles. Strahlenther Onkol 2013; 189:230-6. [PMID: 23319255 DOI: 10.1007/s00066-012-0288-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Revised: 11/26/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Dysphagia is a complication of head and neck cancer patients undergoing radiotherapy (RT). We analysed frequency and severity of swallowing dysfunction and correlated these findings with dose-volume histograms (DVHs) of the pharyngeal constrictor muscles. METHODS A total of 50 patients treated by radical RT were enrolled. DVHs of constrictor muscles were correlated with acute and late dysphagia and with the items of three quality of life questionnaires. RESULTS Mean dose to superior and middle constrictor muscles (SCM, MCM), partial volume of SCM and MCM receiving a dose ≥ 50 Gy dose to the whole constrictor muscles ≥ 60 Gy and tumour location were associated to late dysphagia at univariate analysis. Mean dose to the MCM was the only statistically significant predictor of late dysphagia at the multivariable analysis. CONCLUSION The study shows a significant relationship between long-term dysphagia and mean doses to SCM, MCM, whole constrictor muscles, and oropharyngeal tumour. This finding suggests a potential advantage in reducing the RT dose to swallowing structures to avoid severe dysphagia.
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Affiliation(s)
- L Deantonio
- Radiotherapy, University Hospital "Maggiore della Carità", via Solaroli, 17, 28100, Novara, Italy
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90
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Singer S, Arraras JI, Chie WC, Fisher SE, Galalae R, Hammerlid E, Nicolatou-Galitis O, Schmalz C, Verdonck-de Leeuw I, Gamper E, Keszte J, Hofmeister D. Performance of the EORTC questionnaire for the assessment of quality of life in head and neck cancer patients EORTC QLQ-H&N35: a methodological review. Qual Life Res 2012. [PMID: 23188134 DOI: 10.1007/s11136-012-0325-1] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The EORTC QLQ-H&N35 (H&N35) is widely used to measure quality of life in head and neck cancer patients. The aims of this study were to obtain insight into a) the languages in which the H&N35 has been used and the psychometric properties in those languages, b) the study designs, and c) its acceptance by patients and investigators. METHODS A systematic literature review was performed searching for all original papers that had used at least one item of the H&N35. Identified papers were read and the information about methodological issues abstracted statistically analysed. RESULTS A total of 136 papers were identified. The H&N35 was administered in 19 different languages in 27 countries. The study design was cross-sectional in the majority of studies (53 %), prospective cohort studies (31 %), phase-II-trials (7 %), phase-III-trials (6 %) and case-control studies (1 %). The scales with the highest percentages of missing values were Sexuality (11.5 %) and Speech (7 %). The median Cronbach's alpha of the multi-item scales ranged from 0.61 (Senses) to 0.93 (Sexuality). Construct validity was rarely investigated. On average, 12 scales (range 0-18) of the instrument were used by the investigators. The scale most often used was swallowing (in 85 % of studies) and least often used was Weight Gain (39 %). CONCLUSION The H&N35 is widely used throughout the world, mainly in observational studies, and has demonstrated robust psychometric features in different languages. However, some methodological problems reported imply that the instrument can be improved in some areas.
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Affiliation(s)
- Susanne Singer
- Institute of Medical Biostatistics, Epidemiology, and Informatics, University of Mainz, Obere Zahlbacher Str. 69, 55131, Mainz, Germany,
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Epstein JB, Thariat J, Bensadoun RJ, Barasch A, Murphy BA, Kolnick L, Popplewell L, Maghami E. Oral complications of cancer and cancer therapy: from cancer treatment to survivorship. CA Cancer J Clin 2012; 62:400-22. [PMID: 22972543 DOI: 10.3322/caac.21157] [Citation(s) in RCA: 272] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Answer questions and earn CME/CNE Oral complications resulting from cancer and cancer therapies cause acute and late toxicities that may be underreported, underrecognized, and undertreated. Recent advances in cancer treatment have led to changes in the incidence, nature, and severity of oral complications. As the number of survivors increases, it is becoming increasingly recognized that the aggressive management of oral toxicities is needed to ensure optimal long-term oral health and general well-being. Advances in care have had an impact on previously recognized oral complications and are leading to newly recognized adverse effects. Here, the authors briefly review advances in cancer therapy, including recent advances in surgery, oral care, radiation therapy, hematopoietic cell transplantation, and medical oncology; describe how these advances affect oral health; and discuss the frequent and/or severe oral health complications associated with cancer and cancer treatment and their effect upon long-term health. Although some of the acute oral toxicities of cancer therapies may be reduced, they remain essentially unavoidable. The significant impact of long-term complications requires increased awareness and recognition to promote prevention and appropriate intervention. It is therefore important for the primary oncologist to be aware of these complications so that appropriate measures can be implemented in a timely manner. Prevention and management is best provided via multidisciplinary health care teams, which must be integrated and communicate effectively in order to provide the best patient care in a coordinated manner at the appropriate time.
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Affiliation(s)
- Joel B Epstein
- Division of Otolaryngology and Head and Neck Surgery, City of Hope, Duarte, CA, USA.
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92
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Gunsoy B, Vuralkan E, Sonbay ND, Simsek G, Tokgoz SA, Akin I. Quality of life following surgical treatment of benign parotid disease. Indian J Otolaryngol Head Neck Surg 2012; 65:105-11. [PMID: 24427625 DOI: 10.1007/s12070-012-0585-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Accepted: 10/18/2012] [Indexed: 11/28/2022] Open
Abstract
To evaluate the quality of life after surgery for benign neoplastic disease of the parotid gland. Forty-nine patients who underwent surgery for benign parotid disease between January 2004 and December 2008 were included in this retrospective study. EORTC QLQ-C30 and EORTC QLQ-H&N35 questionnaires were used to determine the quality of life. The variables of these questionnaires were compared with age, gender, educational status, histopathologic diagnosis and Frey syndrome. A statistically significant correlation was noted between the female gender and post-surgical pain, sleeplessness and the use of non-steroid anti-inflammatory drugs (p < 0.001). There was a significant difference between age and difficulties in moving the mouth (p < 0.001). Frey syndrome related to social functions, economical difficulties, speech defect, reduced sexuality, and nutritional parameters were found to be statistically significant (p < 0.001). Frey syndrome is the most common complication that affects the quality of life in patients who had parotidectomy due to a benign parotid disease. Therefore, all patients should be informed about Frey syndrome before parotidectomy.
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Affiliation(s)
- Behçet Gunsoy
- Department of Otorhinolaryngology, Gaziantep Dr. Ersin Aslan State Hospital, Gaziantep, Turkey
| | - Erkan Vuralkan
- Department of Otorhinolaryngology Clinic, Trabzon Kanuni Research and Training Hospital, Trabzon, Turkey
| | | | - Gokce Simsek
- Department of Otorhinolaryngology Clinic I, Ankara Diskapi Yildirim Beyazit Research and Training Hospital, Ankara, Turkey
| | - Sibel Alicura Tokgoz
- Department of Otorhinolaryngology Clinic I, Ankara Diskapi Yildirim Beyazit Research and Training Hospital, Ankara, Turkey
| | - Istemihan Akin
- Department of Otorhinolaryngology Clinic I, Ankara Diskapi Yildirim Beyazit Research and Training Hospital, Ankara, Turkey
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93
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Carrillo JF, Ortiz-Toledo MA, Salido-Noriega Z, Romero-Ventura NB, Ochoa-Carrillo FJ, Oñate-Ocaña LF. Validation of the Mexican Spanish version of the EORTC QLQ-H&N35 instrument to measure health-related quality of life in patients with head and neck cancers. Ann Surg Oncol 2012; 20:1417-26. [PMID: 23108555 DOI: 10.1245/s10434-012-2712-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2012] [Indexed: 11/18/2022]
Abstract
BACKGROUND Health-related quality of life (HRQL) is an important outcome measurement in oncology. Our aim was to validate the Mexican Spanish version of the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-H&N35 questionnaire to measure HRQL in patients with head and neck cancers. METHODS The QLQ-C30 and QLQ-H&N35 instruments were applied to Mexican patients with head and neck cancer at a cancer referral center. Reliability and validity tests were performed. Test-retest was carried out in selected patients. RESULTS One hundred ninety-three patients were included in this cohort; tumor locations included the following: oral cavity 45 (23.3 %); larynx 35 (18.1 %); thyroid carcinoma invasive to aerodigestive tract 32 (16.6 %); oropharynx 17 (8.8 %); hypopharynx 12 (6.2 %); nasal cavity and paranasal sinuses 11 (5.7 %); salivary glands 11 (5.7 %); nasopharynx 8 (4.1 %); eye and adnexa 7 (3.6 %); cervical metastases of unknown origin 5 (2.6 %); primary sarcoma of the head and neck region 5 (2.6 %); maxillary antrum carcinoma 4 (2.1 %); and retinoblastoma 1 (0.5 %). Questionnaire compliance rates were high, and the instrument was well accepted; the internal consistency tests demonstrated good convergent and divergent validity. Cronbach's α coefficients of 8 of 9 multi-item scales of the QLQ-C30 and 6 of 8 scales of the QLQ-H&N35 instruments were >0.7 (range 0.22-0.89). Scales of the QLQ-C30 and QLQ-H&N35 instruments distinguished among clinically distinct groups of patients; some were highly sensitive to change over time. CONCLUSIONS The Mexican Spanish version of the QLQ-H&N35 questionnaire is reliable and valid for the assessment of HRQL in patients with head and neck cancers and can be used in clinical trials in Mexican communities.
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Affiliation(s)
- José F Carrillo
- Departamento de Tumores de Cabeza y Cuello, Instituto Nacional de Cancerología, Mexico City, Mexico
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94
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Tarsitano A, Pizzigallo A, Ballone E, Marchetti C. Health-related quality of life as a survival predictor for patients with oral cancer: is quality of life associated with long-term overall survival? Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114:756-63. [PMID: 23021925 DOI: 10.1016/j.oooo.2012.06.022] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Revised: 06/22/2012] [Accepted: 06/27/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of the present prospective study was to obtain further insight into health-related quality of life (HR-QoL) as a predictor of survival in a selected cohort of patients with oral cancer. STUDY DESIGN A total of 124 patients were treated with surgery or combined therapy. All of the recruited patients completed the European Organization for Research and Treatment of Cancer questionnaires QLQC30 and H&N35 on 4 occasions. Overall survival was assessed. Univariate and multivariate Cox proportional hazards regression models were conducted. RESULTS High baseline HR-QoL score and high pain symptom score were significantly associated with a better survival (HR 0.86 and 0.92 respectively). Swallowing (HR 0.94), and speech (HR 0.92) high baseline scores were also significantly associated with a better survival in the adjusted analyses. CONCLUSIONS Patients who reported a better HR-QoL at tumor diagnosis had a better survival than patients with a lower HR-QoL baseline score.
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Affiliation(s)
- Achille Tarsitano
- Maxillofacial Surgery Unit, S.Orsola-Malpighi Hospital, Alma Mater Studiorum University of Bologna, Bologna, Italy.
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95
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Does lack of glottic closure affect quality of life as a cause of constipation in laryngectomized patients? Eur Arch Otorhinolaryngol 2012; 270:629-34. [PMID: 23008127 DOI: 10.1007/s00405-012-2176-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2012] [Accepted: 08/20/2012] [Indexed: 11/12/2022]
Abstract
The permanent disappearance of glottic closure eventually causes inadequate defecatory propulsion resulting in functional constipation. The aim of this study is to reveal functional constipation probably induced by lack of glottic closure in laryngectomized patients. The study was conducted in a prospective, tertiary care center. Forty patients who had undergone total laryngectomy (study group) and 30 who had undergone microlaryngoscopic surgery (control group) were evaluated. Based on the European Organisation for Research and Treatment of Cancer, Quality of Life Questionnaires C30, the presence of functional constipation was investigated using the Rome II diagnostic criteria and was confirmed by measurement of colonic transit time using a radiopaque marker test. Functional constipation and colonic transit time were found to be increased and statistically significant in laryngectomized patients (70 %) compared with the control group (26 %) (p < 0.01). Functional constipation is more prevalent among laryngectomized patients. When evaluating quality of life of patients undergoing laryngectomy, colorectal functions must be taken into consideration.
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96
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Huijer HAS, Sagherian K, Tamim H. Validation of the Arabic version of the EORTC quality of life questionnaire among cancer patients in Lebanon. Qual Life Res 2012; 22:1473-81. [PMID: 22961075 DOI: 10.1007/s11136-012-0261-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2012] [Indexed: 11/12/2022]
Abstract
PURPOSE The objective of this article was to evaluate the psychometric properties of the translated Lebanese Arabic version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 in a sample of adult cancer patients in Lebanon. METHODS The EORTC QLQ-C30 was translated into Lebanese Arabic and administered to a convenient sample of 200 adult patients diagnosed with cancer at a tertiary care center in Lebanon between 2009 and 2010. The psychometric indices assessed were reliability, multitrait scaling analysis, construct validity, and confirmatory factor analysis. RESULTS Six out of nine subscales had Cronbach's alpha coefficients above 0.70. Multitrait scaling analysis showed that all item-scale correlation coefficients met the set standards of convergent validity with the exception of item 5 only (95.8 %). In addition, 79.7 % of the item-scale correlation coefficients met the criterion for discriminant validity. In inter-scale correlations, all conceptually related scales had correlation coefficients of ≥ 0.40 with the exception of role functioning and fatigue scales having an undesirable correlation coefficient of -0.76. In known-groups comparison, the instrument differentiated significantly between some of the subscales with respect to education, employment, and age. CFA showed an almost good fit (GFI = 0.87) with respect to our current data set. CONCLUSION The translated Lebanese Arabic version of the EORTC QLQ-C30 is a reliable and valid instrument that can be used to assess the quality of life of Lebanese cancer patients.
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Affiliation(s)
- Huda Abu-Saad Huijer
- Hariri School of Nursing, American University of Beirut, Beirut, P.O. Box 11-0236, Lebanon.
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97
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Singer S, Arraras JI, Baumann I, Boehm A, Chie WC, Galalae R, Langendijk JA, Guntinas-Lichius O, Hammerlid E, Pinto M, Nicolatou-Galitis O, Schmalz C, Sen M, Sherman AC, Spiegel K, Verdonck-de Leeuw I, Yarom N, Zotti P, Hofmeister D. Quality of life in patients with head and neck cancer receiving targeted or multimodal therapy - Update of the EORTC QLQ-H&N35, Phase I. Head Neck 2012; 35:1331-8. [DOI: 10.1002/hed.23127] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2012] [Indexed: 11/12/2022] Open
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98
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Payakachat N, Ounpraseuth S, Suen JY. Late complications and long-term quality of life for survivors (>5 years) with history of head and neck cancer. Head Neck 2012; 35:819-25. [DOI: 10.1002/hed.23035] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2012] [Indexed: 11/12/2022] Open
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99
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Moreno KF, Khabbaz E, Gaitonde K, Meinzen-Derr J, Wilson KM, Patil YJ. Sexuality after treatment of head and neck cancer: findings based on modification of sexual adjustment questionnaire. Laryngoscope 2012; 122:1526-31. [PMID: 22508246 DOI: 10.1002/lary.23347] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Accepted: 03/05/2012] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS Evaluate sexual dysfunction in patients after treatment for head and neck cancer. STUDY DESIGN Single-institution cross-sectional study. METHODS Our modified Sexual Adjustment Questionnaire was administered to 42 patients (mean age, 55.1 years) and included seven questions (total score, 7-35). Based on sexual satisfaction ratings, we categorized three groups as unsatisfied (7-16), satisfied (17-25), and very satisfied (26-35). Clinical information was obtained by reviewing medical records. Bivariate analysis tested associations between sexual satisfaction and patient-related factors (e.g., sex, age, site/cancer stage, treatment, time between treatment and survey, partner, alcohol/tobacco consumption). Pearson correlation was used to analyze two continuous variables, and multivariate logistic regression analysis was used to evaluate the independent impact of each factor. RESULTS All 42 patients rated that head and neck cancer negatively impacted their sexual relationships, including 21 (50%) rating effects as negative or extremely negative. Men reported higher satisfaction scores with sexual function (mean ± standard deviation) than women (19.9 ± 5.0 vs. 16.3 ± 6.5, respectively; P = .06). Respondents with partners reported higher scores than those without partners (19.9 ± 5.3 vs. 14.1 ± 4.4, respectively; P = .01). When the survey was administered (median, 12 months; range, 4-33 months) after the first treatment, mean score was 19; 57% of respondents were sexually satisfied, 31% were unsatisfied, and 12% were very satisfied. Instrument reliability was .82 (Cronbach alpha). CONCLUSIONS Patients who are male and ≤ 60 years have a higher probability of sexual satisfaction during recovery. Our sexual dysfunction questionnaire will be administered in further prospective studies in patients with head and neck cancer.
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Affiliation(s)
- Kattia F Moreno
- Brain Tumor Center at the University of Cincinnati Neuroscience Institute, Cincinnati, Ohio, USA
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100
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Psoter WJ, Aguilar ML, Levy A, Baek LS, Morse DE. A preliminary study on the relationships between global health/quality of life and specific head and neck cancer quality of life domains in Puerto Rico. J Prosthodont 2012; 21:460-71. [PMID: 22469330 DOI: 10.1111/j.1532-849x.2012.00848.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
PURPOSE Health-related quality of life (HRQOL) is an important treatment outcome for head and neck cancer (HNC) patients. By ascertaining the most important HNC HRQOL issues, research and practice can be directed toward enhancing patient QOL. MATERIALS AND METHODS A cross-sectional study of 46 ENT clinic HNC patients in Puerto Rico (PR) was completed. The European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 (general QOL), and the QLQ-H&N35 (HNC QOL) instruments were administered. Correlations and multivariable regressions were separately conducted for QLQ-H&N35 variables on the three QLQ-C30 outcome variables: overall health, overall QOL, and the global health/QOL domain. RESULTS Correlation findings included statistically significant negative correlations between the three QLQ-C30 outcome variables and the QLQ-H&N35 variables pain, swallowing, social eating, social contact, and sexuality. Multivariable linear regression identified statistically significant inverse indicators of the outcomes: (1) "lessening of sexuality" with "overall health" (p= 0.02), (2) "problem with social eating" (p= 0.023), "taking pain killers" (p= 0.025), and "problem with social contact" (p= 0.035) with "overall QOL," and (3) "problems with social eating" (p < 0.009) and "taking pain killers" (p= 0.016) with the "global health/QOL" domain. CONCLUSIONS We conclude that problems with pain, social eating, social interactions, and loss of sexuality are critical indicators of degraded HRQOL in HNC patients living in Puerto Rico. Our results add to the overall knowledge base regarding QOL among HNC patients. The promise of improved QOL for the HNC patient is attainable through additional research in conjunction with advances in clinical treatments and patient management protocols.
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Affiliation(s)
- Walter J Psoter
- Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York, NY 10003, USA.
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