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Iwanaga K, Ishibashi Y, Maki K, Ura A, kotake K, Haba K, Sakata T, Nakagawa T, Arima H. Two-year evolution of quality of life following radiotherapy and/or chemotherapy in patients with head and neck cancer. Asia Pac J Oncol Nurs 2023; 10:100301. [PMID: 37885764 PMCID: PMC10597762 DOI: 10.1016/j.apjon.2023.100301] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/24/2023] [Indexed: 10/28/2023] Open
Abstract
Objective This study aims to elucidate the trajectory of quality of life (QoL) over a two-year period after radiotherapy and/or chemotherapy for head and neck cancer (HNC), addressing the gap in long-term QoL information. Methods Employing a prospective longitudinal observational design, we tracked 58 HNC patients who underwent radiotherapy and/or chemotherapy, analyzing their QoL using Short-Form 36-Item Health Survey version 2 (SF36v2), the European Organization for Research and Treatment of Cancer quality of life (EORTC-QLQ-C30), and the European Organization for Research and Treatment of Cancer quality of life head and neck-35 (EORTC-QLQ-H&N35) questionnaires for two years post-discharge. The data underwent repeated measures analysis of variance. Results Over the two-year follow-up, 10 patients (17.2%) succumbed, and 8 (13.8%) dropped out. SF36v2 physical and role-social component summary scores declined during treatment, requiring 1-2 years for recovery. The mental component summary score remained stable. EORTC-QLQ-30 revealed global health status recovery within one year post-discharge. EORTC-QLQ-H&N35 items like "swallowing," "senses problems," "trouble with social eating," "dry mouth," "sticky saliva," "coughing," and "felt ill" worsened pre-discharge. "Trouble with social contact" improved within a year, while "pain," "swallowing," "senses problems," "trouble with social eating," and "coughing" improved within two years. "Dry mouth" and "sticky saliva" persisted throughout the two-year follow-up, common symptoms of HNC and treatment side effects. Conclusions Recovery of specific QoL aspects in HNC patients treated with radiotherapy and/or chemotherapy may require up to two years. Prolonged monitoring and management of oral symptoms could enhance QoL. Future research should extend follow-up beyond two years for comprehensive interventions enhancing patient QoL.
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Affiliation(s)
- Kazuyo Iwanaga
- School of Nursing, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Yoko Ishibashi
- Department of Nursing, Fukuoka International University of Health and Welfare, Fukuoka, Japan
| | - Kaori Maki
- School of Nursing, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Ayako Ura
- School of Nursing, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Kumiko kotake
- Faculty of Nursing, Nara Medical University, Nara, Japan
| | - Kaori Haba
- Faculty of Nursing, Nara Medical University, Nara, Japan
| | - Toshifumi Sakata
- Department of Otorhinolaryngology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Takashi Nakagawa
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Fukuoka, Japan
| | - Hisatomi Arima
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
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Billa O, Bonnetain F, Chamois J, Ligey A, Ganansia V, Renard S, Maillard S, Quivrin M, Vulquin N, Truntzer P, Noel G, Maingon P, Dabakuyo-Yonli TS. Predictive value of health-related quality of life on radiotherapy-related toxicities in patients with head and neck cancer. Support Care Cancer 2023; 31:268. [PMID: 37058164 DOI: 10.1007/s00520-023-07736-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 04/05/2023] [Indexed: 04/15/2023]
Abstract
PURPOSE Little is known about whether baseline health-related quality of life (HRQoL) scores also could predict occurrence radiotherapy-related toxicities, which we aim to assess in this study. METHODS This study analyzed data from 200 patients enrolled in randomized study investigating the utility of HRQoL. HRQOL was assessed at baseline and during follow up using QLQ-C30 questionnaire and major toxicity was considered as adverse event ≥ 3 according to NCI-CTCAE classification. Cox regressions adjusting for clinical and sociodemographic data were used to assess prognostic significance of HRQOL scores. RESULTS In multivariable analyses adjusted on clinical and sociodemographic data, every 10-point improvement in physical (HR = 0.74), role (HR = 0.87) and social (HR = 0.88) functioning was associated with 24%, 13% and 12% lower hazard of occurrence of major toxicity respectively while every 10 point-increase in dyspnea (HR = and loss appetite was associated with 15% and 16% increased hazard of major toxicity. CONCLUSION Certain baseline HRQoL scores were found to be significantly associated with the occurrence of major toxicity.
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Affiliation(s)
- Oumar Billa
- Epidemiology and Quality of Life Unit, Georges-François Leclerc Cancer Centre-UNICANCER, 21000, Dijon, France.
- Lipids, Nutrition, Cancer Research Center, U1231 INSERM, 21000, Dijon, France.
- Epidemiology and Quality of Life Unit, Lipids, Nutrition, Cancer Research Center, U1231 INSERM, Georges-François Leclerc Cancer Centre-UNICANCER, 1 rue Professeur Marion BP 77980, 21079, Dijon Cedex, France.
| | - Franck Bonnetain
- Methodology and Quality of Life in Oncology Unit, Inserm UMR 1098, University Hospital of Besancon, Besancon, France
| | - Jérôme Chamois
- Centre Hospitalier Saint Gregoire, 35760, Saint-Grégoire, France
| | - Angeline Ligey
- Centre Hospitalier Fleriat, 01012, Bourg-en-Bresse, France
| | | | - Sophie Renard
- Institut de Cancérologie de Lorraine, 54519, Vandœuvre-lès-Nancy, France
| | | | - Magali Quivrin
- Radiotherapy Department, Georges-François Leclerc Cancer Centre-UNICANCER, 1 Rue Professeur Marion, 21000, Dijon, France
| | - Noémie Vulquin
- Radiotherapy Department, Georges-François Leclerc Cancer Centre-UNICANCER, 1 Rue Professeur Marion, 21000, Dijon, France
| | - Pierre Truntzer
- Paul Strauss Cancer Centre-Unicancer, 67000, Strasbourg, France
| | - Georges Noel
- Paul Strauss Cancer Centre-Unicancer, 67000, Strasbourg, France
- Institut de Cancerologie Strasbourg Europe, ICANS.eu, 67000, Strasbourg, France
| | - Philippe Maingon
- Radiotherapy Department, Georges-François Leclerc Cancer Centre-UNICANCER, 1 Rue Professeur Marion, 21000, Dijon, France
- Radiotherapy Unit, Hôpital de la Pitié-Salpêtrière-APHP, 75013, Paris, France
| | - Tienhan Sandrine Dabakuyo-Yonli
- Epidemiology and Quality of Life Unit, Georges-François Leclerc Cancer Centre-UNICANCER, 21000, Dijon, France
- Lipids, Nutrition, Cancer Research Center, U1231 INSERM, 21000, Dijon, France
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Viganò A, De Felice F, Iacovelli NA, Alterio D, Ingargiola R, Casbarra A, Facchinetti N, Oneta O, Bacigalupo A, Tornari E, Ursino S, Paiar F, Caspiani O, Di Rito A, Musio D, Bossi P, Steca P, Jereczek-Fossa BA, Caso L, Palena N, Greco A, Orlandi E. Quality of life changes over time and predictors in a large head and neck patients' cohort: secondary analysis from an Italian multi-center longitudinal, prospective, observational study-a study of the Italian Association of Radiotherapy and Clinical Oncology (AIRO) head and neck working group. Support Care Cancer 2023; 31:220. [PMID: 36930353 PMCID: PMC10023607 DOI: 10.1007/s00520-023-07661-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 02/24/2023] [Indexed: 03/18/2023]
Abstract
PURPOSE The present study examined the longitudinal trajectories, through hierarchical modeling, of quality of life among patients with head and neck cancer, specifically symptoms burden, during radiotherapy, and in the follow-up period (1, 3, 6, and 12 months after completion of radiotherapy), through the M.D. Anderson Symptom Inventory Head and Neck questionnaire, formed by three factors. Furthermore, analyses were conducted controlling for socio-demographic as well as clinical characteristics. METHODS Multi-level mixed-effects linear regression was used to estimate the association between quality of life and time, age, gender, household, educational level, employment status, ECOG performance status, human papilloma virus (HPV) status, surgery, chemotherapy, alcohol intake, and smoking. RESULTS Among the 166 participants, time resulted to be a predictor of all the three questionnaire factors, namely, general and specific related symptoms and interference with daily life. Moreover, regarding symptom interference with daily activities factor, HPV-positive status played a significant role. Considering only HPV-negative patients, only time predicted patients' quality of life. Differently, among HPV-positive patients, other variables, such as gender, educational level, alcohol use, surgery, age at diagnosis, employment status, and ECOG status, resulted significant. CONCLUSION It was evident that quality of life of patients with head and neck cancer declined during RT, whereas it slowly improved after ending treatment. Our results clarified the role of some socio-demographic and clinical variables, for instance, HPV, which would allow to develop treatments tailored to each patient.
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Affiliation(s)
- Anna Viganò
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Francesca De Felice
- Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy.
| | | | - Daniela Alterio
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Rossana Ingargiola
- Radiotherapy 2 Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori Di Milano, Milan, Italy
| | - Alessia Casbarra
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Nadia Facchinetti
- Radiotherapy 2 Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori Di Milano, Milan, Italy
| | - Olga Oneta
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | | | - Elena Tornari
- Radiation Oncology Policlinico San Martino IRCCS, Genoa, Italy
| | - Stefano Ursino
- Department of Radiation Oncology, S. Chiara University Hospital, Pisa, Italy
| | - Fabiola Paiar
- Department of Radiation Oncology, S. Chiara University Hospital, Pisa, Italy
| | - Orietta Caspiani
- Radiation Oncology Department, Ospedale "S. Giovanni Calibita" Fatebenefratelli, Rome, Italy
| | | | - Daniela Musio
- Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy
| | - Paolo Bossi
- Medical Oncology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia, ASST-Spedali Civili, Brescia, Italy
| | - Patrizia Steca
- Department of Psychology, University of Milan "Bicocca", Milan, Italy
| | - Barbara Alicja Jereczek-Fossa
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Letizia Caso
- Department of Human Sciences, Libera Università Maria SS. Assunta University, Rome, Italy
| | - Nicola Palena
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Andrea Greco
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Ester Orlandi
- Radiotherapy 2 Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori Di Milano, Milan, Italy
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Wiriyakijja P, Niklander S, Santos-Silva AR, Shorrer MK, Simms ML, Villa A, Sankar V, Kerr AR, Riordain RN, Jensen SB, Delli K. World Workshop on Oral Medicine VIII: Development of a Core Outcome Set for Dry Mouth: A Systematic Review of Outcome Domains for Xerostomia. Oral Surg Oral Med Oral Pathol Oral Radiol 2023:S2212-4403(23)00068-8. [PMID: 37198047 DOI: 10.1016/j.oooo.2023.01.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/11/2022] [Accepted: 01/25/2023] [Indexed: 03/08/2023]
Abstract
OBJECTIVE The purpose of this study was to identify all outcome domains used in clinical studies of xerostomia, that is, subjective sensation of dry mouth. This study is part of the extended project "World Workshop on Oral Medicine Outcomes Initiative for the Direction of Research" to develop a core outcome set for dry mouth. STUDY DESIGN A systematic review was performed on MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials databases. All clinical and observational studies that assessed xerostomia in human participants from 2001 to 2021 were included. Information on outcome domains was extracted and mapped to the Core Outcome Measures in Effectiveness Trials taxonomy. Corresponding outcome measures were summarized. RESULTS From a total of 34,922 records retrieved, 688 articles involving 122,151 persons with xerostomia were included. There were 16 unique outcome domains and 166 outcome measures extracted. None of these domains or measures were consistently used across all the studies. The severity of xerostomia and physical functioning were the 2 most frequently assessed domains. CONCLUSION There is considerable heterogeneity in outcome domains and measures reported in clinical studies of xerostomia. This highlights the need for harmonization of dry mouth assessment to enhance comparability across studies and facilitate the synthesis of robust evidence for managing patients with xerostomia.
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McDowell L, Rischin D, Gough K, Henson C. Health-Related Quality of Life, Psychosocial Distress and Unmet Needs in Older Patients With Head and Neck Cancer. Front Oncol 2022; 12:834068. [PMID: 35242716 PMCID: PMC8885992 DOI: 10.3389/fonc.2022.834068] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 01/24/2022] [Indexed: 01/22/2023] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) is the most common cancer involving the mucosal surfaces of the head and neck and is associated with a number of etiological factors, including cigarette smoking, alcohol and betel nut consumption and exposure to high-risk human papillomavirus. The risk of HNSCC increases with age, peaking in the seventh and eighth decade, but this varies by anatomical and histological subtype. While several advancements have been made in the treatment of head and neck cancer (HNC) in recent decades, undertaking curative treatment still subjects the majority of HNSCC patients to substantial treatment-related toxicity requiring patients to tolerate a gamut of physical, psychological, and emotional demands on their reserves. In conjunction with other patient-related factors, clinicians involved in treating patients with HNSCC may incorporate advancing chronological age into their decision-making process when determining treatment recommendations. While advancing chronological age may be associated with increased concerns regarding physical treatment tolerability, clinicians may also be concerned about heightened vulnerability in various health and wellbeing outcomes. The available literature, however, does not provide evidence of this vulnerability in patients with advancing age, and, in many instances, older patients self-report greater resilience compared to their younger counterparts. While this data is reassuring it is limited by selection bias and heterogeneity in trial and study design and the absence of a consistent definition of the elderly patient with HNSCC. This narrative review article also includes a review of the measures used to assess HRQL, psychosocial outcomes and unmet needs in elderly or older patients with HNSCC.
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Affiliation(s)
- Lachlan McDowell
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Danny Rischin
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia.,Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Karla Gough
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Department of Nursing, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Carlton, VIC, Australia
| | - Christina Henson
- Department of Radiation Oncology, Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, United States
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6
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Aggarwal P, Hutcheson KA, Garden AS, Mott FE, Lu C, Goepfert RP, Fuller CD, Lai SY, Gunn GB, Chambers MS, Sturgis EM, Hanna EY, Shete S. Determinants of patient-reported xerostomia among long-term oropharyngeal cancer survivors. Cancer 2021; 127:4470-4480. [PMID: 34358341 DOI: 10.1002/cncr.33849] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 06/03/2021] [Accepted: 06/05/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND This study was conducted to identify clinicodemographic risk factors for xerostomia among long-term oropharyngeal cancer (OPC) survivors. METHODS This cross-sectional study included 906 disease-free, adult OPC survivors with a median survival duration at the time of survey of 6 years (range, 1-16 years); self-reported xerostomia scores were available for 877 participants. Study participants had completed curative treatment between January 2000 and December 2013 and responded to a survey administered from September 2015 to July 2016. The primary outcome variable was cancer patient-reported xerostomia measured with the MD Anderson Symptom Inventory Head and Neck Cancer Module. Clinicodemographic risk factors for moderate to severe xerostomia were identified via multivariable logistic regression. RESULTS Moderate to severe xerostomia was reported by 343 of the respondents (39.1%). Female sex (odds ratio [OR], 1.82; 95% CI, 1.22-2.71; P = .003; Bayesian false-discovery probability [BFDP] = 0.568), high school or lower education (OR, 1.73; 95% CI, 1.19-2.52; P = .004; BFDP = 0.636), and current cigarette smoking at the time of survey (OR, 2.56; 95% CI, 1.19-5.47; P = .016; BFDP = 0.800) were risk factors for moderate to severe xerostomia, and bilateral intensity-modulated radiotherapy (IMRT) combined with proton therapy and ipsilateral IMRT were protective. CONCLUSIONS In this large xerostomia study, modern radiotherapy was a protective factor, and continued cigarette smoking at the time of survey, female sex, and high school or lower education were identified as other contributing risk factors associated with moderate to severe xerostomia. Importantly, these findings need to be confirmed in prospective studies. These results can inform future research and targeted patient-centered interventions to monitor and manage radiation therapy-associated xerostomia and preserve quality of life among patients with OPC.
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Affiliation(s)
- Puja Aggarwal
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Katherine A Hutcheson
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Adam S Garden
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Frank E Mott
- Department of Thoracic Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Charles Lu
- Department of Thoracic Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ryan P Goepfert
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Clifton D Fuller
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Stephen Y Lai
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - G Brandon Gunn
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mark S Chambers
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Erich M Sturgis
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas
| | - Ehab Y Hanna
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sanjay Shete
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas
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7
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Charalambous M, Papakyriacou C, Tsitsi T, Katodritis N, Vomvas D, Charalambous A. The evaluation of the reliability and validity properties of the Greek version of the xerostomia questionnaire (ΧQ). Eur J Oncol Nurs 2021; 52:101971. [PMID: 34022580 DOI: 10.1016/j.ejon.2021.101971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 04/18/2021] [Accepted: 04/20/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Xerostomia is one of the multidimensional effects of cancer therapy that can impact on patients' quality of life. This study aims to evaluate the reliability and validity properties of the xerostomia questionnaire. METHODS The data were retrieved from a randomized, interventional and longitudinal follow-up study of 72 head and neck cancer patients on active oral radiotherapy. Data were retrieved by the Xerostomia Questionnaire, the EORTC-QLQ C30 and EORT QLQ HN35. Data analyzes included intrinsic credibility of affinity Cronbach alpha factor, which is related to validity and cross-sectional validity. RESULTS The Cronbach's alpha index of the Greek version of the questionnaire was high. Explicitly, the total scale of the questionnaire had an α = 0.97, and the individual dimensions - Degree of dryness and the quality of life had an alpha of 0.97 and 0.98 respectively. The xerostomia dimension of the questionnaire has a high positive correlation with QLQ C30 overall (r = 0.61, p < 0.001), and with the HN35 xerostomia dimension (r = 0.63, p < 0.001) which demonstrate its' concurrent validity. The dimensions of the xerostomia questionnaire were highly correlated with the EORTC-QLQ C30 dimensions which supports its' predictive validity. The level of xerostomia and the quality of life varied according to the level of pain of the patients (p < 0.001) that support the cross-sectional validity of the questionnaire. CONCLUSION The Greek version of the xerostomia questionnaire is a reliable and valid tool for use in head and neck cancer patients on active oral radiotherapy.
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Affiliation(s)
| | | | | | | | | | - Andreas Charalambous
- Cyprus University of Technology, Limassol, Cyprus and University of Turku, Turku, Finland
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8
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Kaya C, Chan F, Tansey T, Bezyak J, Aksoy S, Altundag K. Evaluating the World Health Organization’s International Classification of Functioning, Disability and Health Framework as a Participation Model for Cancer Survivors in Turkey. REHABILITATION COUNSELING BULLETIN 2018. [DOI: 10.1177/0034355218792900] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Improvements in diagnosis and treatment options for cancer now allow cancer survivors to live longer, and as a result, services are necessary to help individuals live an active and meaningful life in the community. The purpose of this study was to evaluate the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) framework as a participation model for cancer survivors in Turkey. Results from simultaneous regression analyses indicated educational attainment, fatigue, perceived stress, role functioning, social functioning, core self-evaluations, independent self-construal, social support, and autonomy support were significantly associated with participation. Specific interventions including health education, psychological workshops, support groups, and assistive technology may improve cancer survivors’ motivation and desire to actively engage in community activities. Higher levels of participation were also found when cancer survivors were involved in the treatment decision-making process, and felt cared for and understood by their treatment providers.
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Affiliation(s)
| | - Fong Chan
- University of Wisconsin–Madison, USA
| | | | - Jill Bezyak
- University of Northern Colorado, Greeley, USA
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9
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Nutritional status in patients with head and neck cancer undergoing radiotherapy: a longitudinal study. Support Care Cancer 2018; 27:239-247. [PMID: 29938330 DOI: 10.1007/s00520-018-4319-6] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 06/13/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Patients with head and neck cancers are susceptible to malnutrition during radiotherapy. This study aimed to determine the changes in the nutritional status and its determinants in patients with head and neck cancer during radiotherapy. METHODS This prospective observational study was performed in an outpatient Radiation Oncology clinic with a sample of 54 patients. An interview form (including anthropometric and laboratory parameters), the Patient-Generated Subjective Global Assessment to assess nutritional status, quality of life scales, and toxicity criteria were used for data collection at the baseline, the end of radiotherapy and 1 and 3 months after radiotherapy. RESULTS While the majority of the patients (90%) were well nourished at baseline, most of the patients (74%) were malnourished at the end of radiotherapy (p < 0.001). During radiotherapy, patients developed malnutrition, reflected in a decrease in food intake, approximately 5% loss of body weight, a reduction in mid-arm upper circumference and mid-arm muscle mass, and reduced serum protein and albumin levels. The nutritional status was worse in oropharyngeal cancers (p = 0.021), advanced stage (p = 0.004), use of concomitant chemotherapy (p = 0.041), and worse toxicity (p < 0.001). Furthermore, the nutritional status was strongly associated with the quality of life. CONCLUSIONS This study demonstrated negative impact of radiotherapy on the nutritional status of patients with head and neck cancer. The study also showed the association of the nutritional status and the quality of life. The nutritional status should be assessed during different periods in the trajectory of treatment due to its significant contribution to the quality of life.
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10
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Obturators versus flaps after maxillary oncological ablation: A systematic review and best evidence synthesis. Oral Oncol 2018; 82:152-161. [PMID: 29909890 DOI: 10.1016/j.oraloncology.2018.05.019] [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] [Received: 04/10/2018] [Revised: 05/02/2018] [Accepted: 05/25/2018] [Indexed: 02/05/2023]
Abstract
Maxillary defects can be resolved by prosthetic obturation, autologous tissue reconstruction, or a combination of both. However, there is still controversy in the selection of the optimal approach. Therefore, the aim of this study was to systematically review evidences comparing the performance of obturators and flaps in patients after maxillary oncological ablation. Both electronic and manual searching approaches were conducted to identify eligible evidence. Two reviewers independently assessed the risk of bias. In addition, the same reviewers independently extracted the data. Meta-analyses were performed using Revman 5.3, and best evidence synthesis was performed. Sixteen studies were included and a total of 528 participants were analyzed. All studies were assessed at low quality. Results of this meta-analysis showed weak evidence in the difference between obturators and flaps on the outcome regarding word intelligibility (P = 0.004) and masticatory efficiency (P = 0.002). However, no differences were detected regarding speech intelligibility and nasalance. All studies were compiled into the best evidence synthesis. The sum of 31 evidences was considered. Twelve evidences were evaluated at a moderate level, such as speech, mastication, pain, salivation, taste sensations, and mouth opening. Except the outcomes of word intelligibility, masticatory efficiency, and mouth pain, other moderate evidences showed no difference between obturators and flaps. In conclusion, both obturators and flaps might be effective in patients' rehabilitation functions after maxillary ablation. However, some advantages were observed when using surgical reconstruction over prosthetic rehabilitation. Additional high-quality studies are needed to provide more solid evidence before applying these results into clinical practice.
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Berger K, Schopohl D, Bollig A, Strobach D, Rieger C, Rublee D, Ostermann H. Burden of Oral Mucositis: A Systematic Review and Implications for Future Research. Oncol Res Treat 2018; 41:399-405. [PMID: 29734184 DOI: 10.1159/000487085] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 01/22/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Surprisingly little is known about the burden of oral mucositis (OM). We provide a systematic review of studies on the burden of OM (incidence, economic impact, health-related quality of life (HRQoL)). METHODS Systematic literature searches were made in BIOSIS, EMBASE, and MEDLINE. Inclusion criteria were studies on OM in hematology/oncology patients of ≥ 18 years, journal articles, English language, and published between 2000 and 2016; OM treatment studies were excluded. Quality assessment was performed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS We screened 4,996 hits, and identified 68 studies of which 13 were without transparency on OM grading. The evidence level of 65 studies was rated 'low' or 'very low' in 58.5%, 'moderate' in 20% and 'high' in 21.5%. Mean value of incidence (7 studies) was 83.5% for all grades of OM with hematopoietic stem cell transplantation. OM incidence for all grades in head and neck cancer patients was 59.4-100%. Considering the economic impact, 16 studies showed highly variable numbers. HRQoL was measured in 16 studies using 13 different instruments. Statistically significant changes in HRQoL scores were demonstrated. CONCLUSION OM is common, burdensome, costly and imposes major reductions in HRQoL. However, from a quality standpoint, the level of current evidence in OM is disappointing. The field needs continued attention to address methodological challenges.
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Astrup GL, Rustøen T, Hofsø K, Gran JM, Bjordal K. Symptom burden and patient characteristics: Association with quality of life in patients with head and neck cancer undergoing radiotherapy. Head Neck 2017; 39:2114-2126. [PMID: 28766791 DOI: 10.1002/hed.24875] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 05/09/2017] [Accepted: 05/30/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Patients with head and neck cancer (HNC) experience diminished quality of life (QOL) during and after treatment. This study examined which characteristics were associated with QOL over time. METHODS One hundred thirty-three patients with HNC from a study of 534 oncology patients rated physical and mental QOL using the Short Form-12 5 times from the initiation of radiotherapy (RT) through the following 6 months. Linear mixed model analyses examined changes over time and associated characteristics. RESULTS The QOL deteriorated during RT and gradually improved after completion. Less social support was negatively associated with both physical and mental QOL. Older age, more comorbidities, more psychological symptoms, and concomitant chemotherapy (CTX) were negatively associated with physical QOL. Male sex, less physical symptoms, surgery before RT, and concomitant chemotherapy were positively associated with mental QOL. CONCLUSION Clinicians can use knowledge on time course and associated characteristics to identify and inform patients at higher risk for diminished QOL.
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Affiliation(s)
- Guro Lindviksmoen Astrup
- Department of Oncology, Division of Cancer Medicine, Oslo University Hospital, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway
| | - Tone Rustøen
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Norway.,Institute of Health and Society, Faculty of Medicine, University of Oslo, Norway
| | - Kristin Hofsø
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Norway.,Lovisenberg Diaconal University College, Oslo, Norway
| | - Jon Michael Gran
- Oslo Centre for Biostatistics and Epidemiology, Faculty of Medicine, University of Oslo and Oslo University Hospital, Norway
| | - Kristin Bjordal
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway.,Research Support Services, Oslo University Hospital, Norway
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Galitis E, Droukas V, Tzakis M, Psarras V, Galiti D, Kyrodimos E, Trichas M, Psyrri A, Papadogeorgakis N, Kouri M, Belli E, Kouloulias V. Trismus and reduced quality of life in patients with oral squamous cell carcinoma, who received post-operative radiotherapy alone or combined with chemotherapy. FORUM OF CLINICAL ONCOLOGY 2017. [DOI: 10.1515/fco-2015-0023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Abstract
Background
Patients, who receive radiotherapy (RT) for head and neck cancer, develop chronic functional abnormalities and survive with reduced quality of life.
Purpose
We aimed to study patients with oral cancer, who received post-operative radiotherapy or chemoradiotherapy.
Patients
Ten patients (mean age 63.8 years) were included.
Methods
Oral mucositis, pain and xerostomia, maximum mouth opening (MMO) and functional abnormalities before and after RT were recorded. The 35 mm MMO or less was accepted as trismus. Patients completed the EORTC QLQ C-30 and Head/Neck35 questionnaires.
Results
Mean RT dose was 64.3 Gray. Six patients received chemoradiotherapy. Severe mucositis, pain and xerostomia were recorded in 6 and 5 patients respectively. MMO was reduced in all patients. The mean MMO (34 mm) reached the level of trismus. The total number of symptoms increased from 3.1 to 6.3 in C-30 and from 3.1 to 8.8 per patient in the H/N35. Severe fatigue, pain, limitations at work, weakness, sad feelings, family problems, sleeping problems, anorexia, financial difficulties, tense/irritable, constipation, nausea, vomiting and depression were most often reported with C-30. Most patients reported low to moderate quality of life. Severe oral, jaw and neck pain, swallowing problems, taste alterations, sticky saliva, dry mouth, coarseness, dental problems, feeling sick and reduced interest in life/sex were the most common symptoms reported with N/H35.
Conclusions
The observed trismus, 2- to 3-fold increase of symptoms and poorer quality of life highlighted the need for support of oral cancer patients, who receive postoperative radiotherapy or chemoradiotherapy.
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Affiliation(s)
- Evangelos Galitis
- Clinic of Orofacial Pain, Dental School , National and Kapodistrian University of Athens , Athens Greece
| | - Vyron Droukas
- Clinic of Orofacial Pain, Dental School , National and Kapodistrian University of Athens , Athens Greece
| | - Michail Tzakis
- Clinic of Orofacial Pain, Dental School , National and Kapodistrian University of Athens , Athens Greece
| | - Vassileios Psarras
- Clinic of Orofacial Pain, Dental School , National and Kapodistrian University of Athens , Athens Greece
| | - Dimitra Galiti
- Clinic of Oral Diagnosis and Radiology, Dental School , National and Kapodistrian University of Athens , Athens Greece
| | - Eythymios Kyrodimos
- ENT Clinic, Head & Neck Oncology Unit, Ippokrateion Hospital, Medical School , National and Kapodistrian University of Athens , Athens Greece
| | - Miltiadis Trichas
- Department of Radiotherapy , Iaso General Hospital , Athens , Greece
| | - Amanda Psyrri
- Oncology Department , ‘Attikon’ University Hospital, Medical School , National and Kapodistrian University of Athens , Athens Greece
| | - Nikolaos Papadogeorgakis
- Oral & Maxillofacial Surgery Clinic, Evangelismos Hospital, Dental School , National and Kapodistrian University of Athens , Athens Greece
| | - Maria Kouri
- Clinic of Hospital Dentistry, Dental School , National and Kapodistrian University of Athens , Athens Greece
| | | | - Vasileios Kouloulias
- Department of Radiotherapy , ‘Attikon’ University Hospital, Medical School , National and Kapodistrian University of Athens , Athens Greece
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Validity and reliability of the Greek version of the xerostomia questionnaire in head and neck cancer patients. Support Care Cancer 2016; 25:847-853. [DOI: 10.1007/s00520-016-3471-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 10/26/2016] [Indexed: 11/25/2022]
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15
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Krüger M, Pabst AM, Al-Nawas B, Horke S, Moergel M. Paraoxonase-2 (PON2) protects oral squamous cell cancer cells against irradiation-induced apoptosis. J Cancer Res Clin Oncol 2015; 141:1757-66. [DOI: 10.1007/s00432-015-1941-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Accepted: 02/16/2015] [Indexed: 12/14/2022]
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16
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Nightingale CL, Lagorio L, Carnaby G. A prospective pilot study of psychosocial functioning in head and neck cancer patient-caregiver dyads. J Psychosoc Oncol 2014; 32:477-92. [PMID: 24988320 DOI: 10.1080/07347332.2014.936649] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study explored the psychosocial functioning of 10 head and neck cancer patient-caregiver dyads over the radiation/chemoradiation (radiation or combined chemoradiation) treatment period, including the interdependence in patient-caregiver quality of life (QOL). Dyads were recruited prior to or at the initiation of radiation/chemoradiation treatment. Patient QOL decreased across the treatment trajectory, and many caregiver QOL subscales decreased during the middle of treatment. Caregiver burden increased over the treatment trajectory with levels remaining relatively low. Patients and caregivers demonstrated interdependence in QOL toward the middle and conclusion of treatment. Patients demonstrated more depression than caregivers at all time points. Results suggest that both members of the dyad should be targeted for psychosocial interventions during radiation/chemoradiation treatment period.
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Affiliation(s)
- Chandylen L Nightingale
- a Department of Behavioral Science and Community Health, College of Public Health and Health Professions , University of Florida , Gainesville , FL , USA
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17
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Pellegrino F, Groff E, Bastiani L, Fattori B, Sotti G. Assessment of radiation-induced xerostomia: validation of the Italian version of the xerostomia questionnaire in head and neck cancer patients. Support Care Cancer 2014; 23:925-32. [DOI: 10.1007/s00520-014-2438-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 09/09/2014] [Indexed: 11/29/2022]
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18
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Validation of the “Quality of Life in Life-Threatening Illness—Family Carer Version” (QOLLTI-F) in German-speaking carers of advanced cancer patients. Support Care Cancer 2014; 22:2783-91. [DOI: 10.1007/s00520-014-2272-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 04/28/2014] [Indexed: 01/26/2023]
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19
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Epstein JB, Güneri P, Barasch A. Appropriate and necessary oral care for people with cancer: guidance to obtain the right oral and dental care at the right time. Support Care Cancer 2014; 22:1981-8. [PMID: 24676676 DOI: 10.1007/s00520-014-2228-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 03/21/2014] [Indexed: 02/07/2023]
Abstract
PURPOSE The identification of experienced and knowledgeable dental specialists to provide appropriate oral care for cancer patients, as well as the integration of this care within general oncology management, may be a challenge. This paper discusses the general and additional requirements for dental care providers to support the cancer patient and provide prevention and/or treatment for oral complications of cancer therapy. METHODS We performed a literature review of specific issues regarding the oral cavity and adjacent structures in the cancer patient, including detection and early diagnosis of oral malignancy. We incorporated the systemic effects of cancer and its therapy that affect oral disease and treatment. We present a summary of how to seek expert dental care for cancer patients and for referral from the dental and medical community. RESULTS Due to the complexity conferred by the disease and its treatment, cancer patients require educated, experienced dentists for treatment and/or prevention of oral-related morbidity. Correct diagnosis and evidence-based prophylactic and therapeutic oral care can significantly improve patient quality of life and reduce morbidity and healthcare costs. CONCLUSIONS The knowledge and expertise of dental professionals regarding prevention/treatment of complications and secondary malignant lesions in cancer patients are critical. Integration of oral care with the oncology care and in survivors requires effective communication between dental and medical providers beginning ideally at diagnosis. These clinicians may be identified at the cancer center, nearby hospital dental programs, and, less commonly, in the community.
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Affiliation(s)
- Joel B Epstein
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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