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Xiao W, Chan CW, Wang XS, Xiao J, Ng MS. Psychometric validation of the Chinese version of the M. D. Anderson Symptom Inventory-Head and Neck Module in patients with nasopharyngeal carcinoma. Asia Pac J Oncol Nurs 2021; 9:113-118. [PMID: 35529413 PMCID: PMC9072183 DOI: 10.1016/j.apjon.2021.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/22/2021] [Indexed: 11/25/2022] Open
Abstract
Objective The Chinese version of the M. D. Anderson Symptom Inventory—Head and Neck Module (MDASI-HN-C) has been linguistically validated. However, its psychometric properties have not been established yet. The purpose of the study was to psychometrically validate the MDASI-HN-C in patients with nasopharyngeal carcinoma (NPC). Methods 130 Chinese NPC patients who were undergoing radiotherapy (RT) participated in this cross-sectional study. The content, convergent, and construct validity of the MDASI-HN-C were examined. The reliability of the instrument was tested by examining the internal consistency and test–retest reliability. Results Cronbach's α coefficients ranged from 0.85 to 0.91 for the three subscales of the MDASI-HN-C. The 3-day test–retest reliability was acceptable with intraclass correlation coefficients (ICC) ranged from 0.52 to 0.71. The scale content validity index (S-CVI) was satisfactory (0.97). Subscale scores of the MDASI-HN-C were negatively correlated with the total score of the Chinese version of the Functional Assessment of Cancer Therapy—Head and Neck Scale (FACT-H&N-C) as hypothesized (r = −0.484 to −0.563, all P < 0.01). Exploratory factor analysis (EFA) revealed two factors for the 13 core and another two for the nine HNC-specific items. Only one factor was generated for the six interference items. Conclusions The MDASI-HN-C shows desirable psychometric properties for evaluating symptom burden in NPC patients, which can be used in both clinical and research contexts.
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Xiao W, Chan CWH, Xiao J, Wong CL, Chow KM. Development of A Nurse-Led Educational Intervention Program in Managing the Nutrition Impact Symptom Cluster in Patients with Nasopharyngeal Carcinoma following the Medical Research Council Framework. Asia Pac J Oncol Nurs 2021; 8:653-661. [PMID: 34790849 PMCID: PMC8522592 DOI: 10.4103/apjon.apjon-2141] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 08/04/2021] [Indexed: 12/23/2022] Open
Abstract
Objective: This article aimed to report the experience of developing a complex nurse-led, theory-driven, and evidence-based educational intervention program intended to manage the nutrition impact symptom cluster experienced by patients with nasopharyngeal carcinoma (NPC) during radiotherapy, based on the Medical Research Council (MRC) framework. Methods: The “development” and “feasibility and piloting” phases of the MRC framework were used to guide the intervention development. The development phase included identifying the evidence base through a systematic review, exploring the relevant and guiding theory to enhance the effectiveness of the intervention and conducting a qualitative study to identify the intervention modelling. For the feasibility and piloting phase, we conducted a pilot study to examine the feasibility and estimate the effectiveness of the intervention. Results: The systematic review revealed that nurse-led educational interventions were used commonly for symptom cluster management, with promising effectiveness. The theoretical foundation was provided by the Theory of Unpleasant Symptoms, which indicates that an educational intervention can help patients to manage symptom cluster by influencing psychological, situational, and physiological factors. The qualitative study further provided contents of the intervention based on the perspectives of NPC patients and health professionals. The resulting program involves a nurse-led, family caregiver involvement, educational intervention with two sessions that uses a booklet as a medium. The pilot study found that conducting the educational intervention program was feasible and it also had some favorable effects on managing the nutrition impact symptom cluster in NPC patients. Conclusions: The MRC framework provided a strong structure with which to develop a complex intervention for nutrition impact symptom cluster management through a theory-driven and evidence-based approach. The evaluation of the intervention, the delivery process and the mediation mechanism of change using a rigorous randomized controlled trial design is recommended.
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Affiliation(s)
- Wenli Xiao
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Carmen W H Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Jinnan Xiao
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Cho Lee Wong
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Ka Ming Chow
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
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McDowell L, Corry J, Ringash J, Rischin D. Quality of Life, Toxicity and Unmet Needs in Nasopharyngeal Cancer Survivors. Front Oncol 2020; 10:930. [PMID: 32596155 PMCID: PMC7303258 DOI: 10.3389/fonc.2020.00930] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 05/12/2020] [Indexed: 12/19/2022] Open
Abstract
Concerted research efforts over the last three decades have resulted in improved survival and outcomes for patients diagnosed with nasopharyngeal carcinoma (NPC). The evolution of radiotherapy techniques has facilitated improved dose delivery to target volumes while reducing dose to the surrounding normal tissue, improving both disease control and quality of life (QoL). In parallel, clinical trials focusing on determining the optimal systemic therapy to use in conjunction with radiotherapy have been largely successful, resulting in improved locoregional, and distant control. As a consequence, neoadjuvant chemotherapy (NACT) prior to definitive chemoradiotherapy has recently emerged as the preferred standard for patients with locally advanced NPC. Two of the major challenges in interpreting toxicity and QoL data from the published literature have been the reliance on: (1) clinician rather than patient reported outcomes; and (2) reporting statistical rather than clinical meaningful differences in measures. Despite the lower rates of toxicity that have been achieved with highly conformal radiotherapy techniques, survivors remain at moderate risk of persistent and long-lasting treatment effects, and the development of late radiation toxicities such as hearing loss, cranial neuropathies and cognitive impairment many years after successful treatment can herald a significant decline in QoL. Future approaches to reduce long-term toxicity will rely on: (1) identifying individual patients most likely to benefit from NACT; (2) development of response-adapted radiation strategies following NACT; and (3) anticipated further dose reductions to organs at risk with proton and particle therapy. With increasing numbers of survivors, many in the prime of their adult life, research to identify, and strategies to address the unmet needs of NPC survivors are required. This contemporary review will summarize our current knowledge of long-term toxicity, QoL and unmet needs of this survivorship group.
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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
| | - June Corry
- GenesisCare Radiation Oncology, Division Radiation Oncology, St. Vincent's Hospital, Melbourne, VIC, Australia.,Department of Medicine St Vincent's, The University of Melbourne, Melbourne, VIC, Australia
| | - Jolie Ringash
- Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, ON, Canada
| | - 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
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Braun LH, Braun K, Frey B, Wolpert SM, Löwenheim H, Zips D, Welz S. Unilateral cochlea sparing in locoregionally advanced head and neck cancer: a planning study. Strahlenther Onkol 2018; 194:1124-1131. [PMID: 30109361 DOI: 10.1007/s00066-018-1344-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 07/19/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND Cochlea sparing can reduce late ototoxicity in head and neck cancer patients treated with cisplatin-based radiochemotherapy. In this situation, a mean cochlear dose (MCD) constraint of 10 Gy has been suggested by others based on the dose-effect relationship of clinical data. We aimed to investigate whether this is feasible for primary and postoperative radiochemotherapy in locoregionally advanced tumors without compromising target coverage. PATIENTS AND METHODS Ten patients treated with definitive and ten patients treated with adjuvant intensity-modulated radiotherapy (IMRT) and concurrent chemotherapy were investigated. The cochleae and a planning risk volume (PRV) with a 3 mm margin were newly delineated, whereas target volumes and other organs at risk were not changed. The initial plan was recalculated with a constraint of 10 Gy (MCD) on the low-risk side. The quality of the resulting plan was evaluated using the difference in the equivalent uniform dose (EUD). RESULTS A unilateral MCD of below 10 Gy could be achieved in every patient. The mean MCD was 6.8 Gy in the adjuvant cohort and 7.6 Gy in the definitive cohort, while the non-spared side showed a mean MCD of 18.7 and 30.3 Gy, respectively. The mean PRV doses were 7.8 and 8.4 Gy for the spared side and 18.5 and 29.8 Gy for the non-spared side, respectively. The mean EUD values of the initial and recalculated plans were identical. Target volume was not compromised. CONCLUSION Unilateral cochlea sparing with an MCD of less than 10 Gy is feasible without compromising the target volume or dose coverage in locoregionally advanced head and neck cancer patients treated with IMRT. A prospective evaluation of the clinical benefit of this approach as well as further investigation of the dose-response relationship for future treatment modification appears promising.
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Affiliation(s)
- L H Braun
- Universitätsklinik für Radioonkologie, Universitätsklinikum Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany
| | - K Braun
- Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Tübingen, Elfriede-Aulhorn-Straße 5, 72076, Tübingen, Germany.
| | - B Frey
- Universitätsklinik für Radioonkologie, Universitätsklinikum Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany
| | - S M Wolpert
- Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Tübingen, Elfriede-Aulhorn-Straße 5, 72076, Tübingen, Germany
| | - H Löwenheim
- Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Tübingen, Elfriede-Aulhorn-Straße 5, 72076, Tübingen, Germany
| | - D Zips
- Universitätsklinik für Radioonkologie, Universitätsklinikum Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany
| | - S Welz
- Universitätsklinik für Radioonkologie, Universitätsklinikum Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany
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Xiao W, Chan CW, Fan Y, Leung DY, Xia W, He Y, Tang L. Symptom clusters in patients with nasopharyngeal carcinoma during radiotherapy. Eur J Oncol Nurs 2017; 28:7-13. [DOI: 10.1016/j.ejon.2017.02.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Revised: 12/16/2016] [Accepted: 02/20/2017] [Indexed: 12/23/2022]
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Concurrent chemoradiotherapy degrades the quality of life of patients with stage II nasopharyngeal carcinoma as compared to radiotherapy. Oncotarget 2017; 8:14029-14038. [PMID: 28152511 PMCID: PMC5355159 DOI: 10.18632/oncotarget.14932] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 12/28/2016] [Indexed: 11/25/2022] Open
Abstract
The purpose of this study was to compare the quality of life (QoL) of stage II nasopharyngeal carcinoma (NPC) patients treated with radiotherapy (RT) versus concurrent chemoradiotherapy (CCRT). In a cross-sectional study, these patients were treated with RT (n = 55) or CCRT (n = 51) between June 2008 and June 2013. For all subjects, disease-free survival was more than 3 years. QoL was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) questions and the Head and Neck 35 (EORTC QLQ-H&N35) questions. RT had better outcomes than CCRT for global QoL, functional scales, symptom scales of fatigue and insomnia, financial problems, and weight gain. Survivors receiving 1 cycle of concurrent chemotherapy had worse QoL outcomes than survivors receiving 2 cycles of concurrent chemotherapy. Patients receiving 3 cycles of concurrent chemotherapy had the best QoL outcomes. Thus, CCRT adversely affects the QoL of patients with stage II NPC as compared to radiotherapy.
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Su Y, Mo CW, Cheng WQ, Wang L, Xu Q, Wu ZC, Wu ZL, Liu LZ, Chen XL. Development and validation of quality of life scale of nasopharyngeal carcinoma patients: the QOL-NPC (version 2). Health Qual Life Outcomes 2016; 14:76. [PMID: 27164979 PMCID: PMC4862168 DOI: 10.1186/s12955-016-0480-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 05/03/2016] [Indexed: 11/12/2022] Open
Abstract
Background The aim was to develop and validate the quality of life scale for nasopharyngeal carcinoma (NPC) patients, the QOL-NPC (version 2), a specific instrument to measure quality of life for NPC patients. Methods The QOL-NPC was developed and validated according to standard procedures. The patients were assessed using the QOL-NPC, FACT-G, and FACT-H&N. Classical test theory was used to evaluate the reliability, validity, and responsiveness of the QOL-NPC. Results A total of 487 patients (97.4 %) completed the questionnaire. The QOL-NPC comprised four domains, as follows: physical function (eight items); psychological function (five items); social function (five items); and side effects (eight items). All of the items had a lower proportion of missing data. Cronbach's alpha values of the domains ranged from 0.72 to 0.84. The split-half reliability coefficients ranged from 0.77 to 0.84. All of the intra-class correlation coefficients were > 0.8. The normed fit index, non-normed fit index, and comparative fit index were >0.89. The root mean square error of approximation was 0.097, with a 90 % confidence interval (0.093, 0.100). The domain scores of the QOL-NPC were significantly correlated with the FACT-G and FACT-H&N (P < 0.05). All of the domain scores of patients using different amounts of radiotherapy were significantly different (P < 0.001). All domain scores decreased at the completion of radiotherapy, with effect sizes ranging from −0.82 to −0.22. Conclusions The QOL-NPC is valid for measuring QOL with good reliability, validity, and responsiveness. The QOL-NPC is recommended to measure the QOL for Chinese NPC patients.
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Affiliation(s)
- Yong Su
- Department of Radiation Oncology, Cancer Centre, Sun Yat-sen University, Guangzhou, Guangdong Province, China.,Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Guangzhou, Guangdong Province, China
| | - Chuan-Wei Mo
- Department of Biostatistics and Preventive Medicine, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Wan-Qin Cheng
- Department of Radiation Oncology, Cancer Centre, Sun Yat-sen University, Guangzhou, Guangdong Province, China.,Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Guangzhou, Guangdong Province, China
| | - Lei Wang
- Department of Radiation Oncology, Cancer Centre, Sun Yat-sen University, Guangzhou, Guangdong Province, China.,Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Guangzhou, Guangdong Province, China
| | - Qian Xu
- Department of Biostatistics and Preventive Medicine, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Zu-Chun Wu
- School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Zhe-Li Wu
- School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Li-Zhi Liu
- Department of Radiation Oncology, Cancer Centre, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Xin-Lin Chen
- Department of Biostatistics and Preventive Medicine, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China.
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Xu BQ, Tu ZW, Tao YL, Liu ZG, Li XH, Yi W, Jiang CB, Xia YF. Forty-six cases of nasopharyngeal carcinoma treated with 50 Gy radiotherapy plus hematoporphyrin derivative: 20 years of follow-up and outcomes from the Sun Yat-sen University Cancer Center. CHINESE JOURNAL OF CANCER 2016; 35:37. [PMID: 27056488 PMCID: PMC4823847 DOI: 10.1186/s40880-016-0098-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Accepted: 01/07/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND With the improved overall survival (OS) of nasopharyngeal carcinoma (NPC) patients, the importance of quality of life (QoL) is increasingly being recognized. For some radiosensitive NPC patients, whether low-dose radiotherapy can improve the QoL without affecting clinical efficacy is unknown. This study aimed to assess the survival rates and QoL of NPC patients treated with 50 Gy radiotherapy plus hematoporphyrin derivative (HPD). METHODS Forty-six newly diagnosed NPC patients treated with 50 Gy radiotherapy plus HPD between June 1988 and July 1992 were analyzed. All patients were restaged according to the 7th edition of the American Joint Committee on Cancer staging system. The radiotherapy plan was designed on the basis of pretreatment computed tomography. The OS, local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), and disease-free survival (DFS) rates were estimated using the Kaplan-Meier method. QoL was assessed using the Late Radiation Morbidity Scoring Criteria of the Radiation Therapy Oncology Group. RESULTS The 5-year OS, LRFS, DMFS, and DFS rates were 74.3%, 72.6%, 82.1%, and 61.2%, respectively. The corresponding 10-year rates were 38.4%, 62.9%, 78.5%, and 49.8%, respectively, and the 20-year rates were 27.7%, 51.4%, 78.5%, and 40.7%, respectively. None of the patients developed severe radiation-related complications, such as radiation-induced temporal lobe necrosis, hearing loss, trismus, and dysphagia. CONCLUSION Some NPC patients were sensitive to 50 Gy radiotherapy plus HPD, and this sensitivity was characterized by long-term survival without significant late treatment morbidities.
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Affiliation(s)
- Bing-Qing Xu
- State Key Laboratory of Oncology in South China, Department of Radiation Oncology, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, Guangdong, P.R. China
| | - Zi-Wei Tu
- State Key Laboratory of Oncology in South China, Department of Radiation Oncology, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, Guangdong, P.R. China
| | - Ya-Lan Tao
- State Key Laboratory of Oncology in South China, Department of Radiation Oncology, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, Guangdong, P.R. China
| | - Zhi-Gang Liu
- State Key Laboratory of Oncology in South China, Department of Radiation Oncology, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, Guangdong, P.R. China
| | - Xiao-Hui Li
- State Key Laboratory of Oncology in South China, Department of Radiation Oncology, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, Guangdong, P.R. China
| | - Wei Yi
- Department of Radiation Oncology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510060, Guangdong, P.R. China
| | - Chang-Bing Jiang
- Department of Radiation Oncology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510060, Guangdong, P.R. China
| | - Yun-Fei Xia
- State Key Laboratory of Oncology in South China, Department of Radiation Oncology, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, Guangdong, P.R. China.
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Huang TL, Chien CY, Tsai WL, Liao KC, Chou SY, Lin HC, Dean Luo S, Lee TF, Lee CH, Fang FM. Long-term late toxicities and quality of life for survivors of nasopharyngeal carcinoma treated with intensity-modulated radiotherapy versus non-intensity-modulated radiotherapy. Head Neck 2015; 38 Suppl 1:E1026-32. [PMID: 26041548 DOI: 10.1002/hed.24150] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Revised: 04/20/2015] [Accepted: 05/31/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The purpose of this study was to investigate late toxicities and quality of life (QOL) of patients with nasopharyngeal carcinoma (NPC) with long-term survival after treatment by intensity-modulated radiotherapy (IMRT) versus non-IMRT. METHODS An observational, cross-sectional study of QOL and late toxicities was conducted in 242 patients with NPC with survival of >5 years after treatment with IMRT (n = 100) or non-IMRT (n = 142) by using physician-assessed toxicities (Common Terminology Criteria for Adverse Events [CTCAE] version 4) and the patient-reported European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30-questions (EORTC QLQ-C30) and the Head and Neck 35-questions (EORTC QLQ-C30-H&N35) module. RESULTS The IMRT group had both statistically (p < .05) and clinically (difference of predicted mean scores ≥10 points) better outcome in global QOL, cognitive functioning, social functioning, fatigue, and 11 scales of the head and neck module. Late toxicities, including neuropathy, hearing loss, dysphagia, xerostomia, and neck fibrosis were significantly less severe in the IMRT group. Multivariate analysis revealed that the radiotherapy (RT) technique was statistically significantly associated with late toxicities and QOL outcome after adjusting for other clinical and demographic variables. CONCLUSION The use of the IMRT technique was associated with the improvement of physician-assessed late toxicities and patient-reported QOL in NPC survivors. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1026-E1032, 2016.
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Affiliation(s)
- Tai-Lin Huang
- Department of Hematology and Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chih-Yen Chien
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wen-Ling Tsai
- Department of Cosmetics and Fashion Styling, Cheng Shiu University, Kaohsiung, Taiwan
| | - Kuan-Cho Liao
- Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shang-Yu Chou
- Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hsin-Ching Lin
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Sheng Dean Luo
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Tsair-Fwu Lee
- Department of Electronics Engineering, National Kaohsiung University of Applied Sciences, Kaohsiung, Taiwan
| | - Chien-Hung Lee
- Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Fu-Min Fang
- Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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10
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Hong JS, Tian J, Han QF, Ni QY. Quality of life of nasopharyngeal cancer survivors in China. ACTA ACUST UNITED AC 2015; 22:e142-7. [PMID: 26089724 DOI: 10.3747/co.22.2323] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE We assessed the quality of life (qol) of nasopharyngeal carcinoma (npc) survivors with a survival time of more than 2 years in Fujian, China, and we analyzed factors influencing qol. METHODS We calculated the prevalence of psychological distress and radiotherapy (rt)-induced symptoms in 216 npc survivors who participated in a cross-sectional survey. The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (version 3.0) was used to assess the qol of npc survivors. Multiple linear regression was applied to analyze the factors influencing qol. RESULTS The prevalence rates of rt-induced symptoms and psychological problems were 11.58% (95% ci: 7.21% to 15.58%) for difficulty in swallowing, 17.59% (95% ci: 12.51% to 22.67%) for mouth dryness or sores, 13.89% (95% ci: 9.28% to 18.50%) for nasal dryness or congestion, 18.52% (95% ci: 13.34% to 23.70%) for fatigue, 11.11% (95% ci: 6.92% to 15.30%) for frequent dizziness, 18.06% (95% ci: 12.93% to 23.19%) for decline in hearing, 14.81% (95% ci: 10.07% to 19.55%) for poor sleep quality, 18.52% (95% ci: 13.34% to 23.70%) for worry about disease recurrence, 18.98% (95% ci: 13.75% to 24.21%) for anxiety, and 25.00% (95% ci: 19.23% to 30.77%) for depression. Mean survival times were 4.32 ± 2.63 years in patients with mouth dryness or sores, 4.26 ± 2.90 years in patients with fatigue, and 5.60 ± 2.94 years in patients with a decline in hearing. The mean global qol score was 74.21 (95% ci: 72.22 to 76.20). At a significance level of α = 0.05, the factors influencing qol were age (p = 0.032), education level (p = 0.001), anxiety score (p < 0.001), depression score (p < 0.001), mouth dryness or sores (p < 0.001), fatigue (p = 0.027), and disease stage (p = 0.044). CONCLUSIONS The prevalence rates of mouth dryness or sores, fatigue, decline in hearing, depression, and anxiety were high in npc survivors with a survival time of more than 2 years. These rt-induced symptoms and psychological problems can last for many years after rt. The qol of the npc survivors was good. Factors influencing qol were age, education level, anxiety, depression, mouth dryness or sores, fatigue, and disease stage. Our results suggest that during clinical treatment, doctors should minimize the radiation dose to the ears of patients. In addition, our results emphasize the importance of providing oral and ear nursing and psychological care to npc survivors.
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Affiliation(s)
- J S Hong
- Department of Radiotherapy, First Affiliated Hospital of Fujian Medical University, Fuzhou, PR China; ; Key Laboratory of Radiation Biology, Fujian Medical University, Fujian Province University, Fuzhou, PR China
| | - J Tian
- Department of Epidemiology and Health Statistics, Fujian Medical University, Fuzhou, PR China
| | - Q F Han
- Department of Radiotherapy, First Affiliated Hospital of Fujian Medical University, Fuzhou, PR China; ; Key Laboratory of Radiation Biology, Fujian Medical University, Fujian Province University, Fuzhou, PR China
| | - Q Y Ni
- Department of Epidemiology and Health Statistics, Fujian Medical University, Fuzhou, PR China
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Alon EE, Lipschitz N, Bedrin L, Gluck I, Talmi Y, Wolf M, Yakirevitch A. Delayed Sino-nasal Complications of Radiotherapy for Nasopharyngeal Carcinoma. Otolaryngol Head Neck Surg 2014; 151:354-8. [PMID: 24732689 DOI: 10.1177/0194599814530858] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Accepted: 03/18/2014] [Indexed: 11/16/2022]
Abstract
OBJECTIVE There are only sporadic reports of delayed sino-nasal complications associated with nasopharyngeal carcinoma (NPC) treated with radiotherapy. These include choanal stenosis, osteoradionecrosis, chronic sinusitis, and intranasal synechiae. Most likely, these complications are underestimated as in many institutions nasal endoscopies in NPC patients are not performed routinely. The aim of this study was to identify the onset and incidence of delayed sino-nasal complications in NPC patients and their effect on quality of life (QOL). STUDY DESIGN Case series with chart review. SETTING Tertiary medical center. SUBJECTS AND METHODS A retrospective chart review was performed on all patients treated for NPC in our institution between 1988 through 2009. The inclusion criteria required at least a 3-year follow-up without recurrence. Included patients were contacted prospectively and asked to fill a SNOT-16 questionnaire. RESULTS Sixty-two patients were included in our review. There were 42 males and 20 females. The average age at onset was 42 years. The AJCC staging for T1, T2, T3, and T4 tumors was 22 (35%), 11 (18%), 18 (29%), and 11 (18%), respectively. Eleven patients (18%) suffered from chronic sinusitis. Nine patients (15%) developed choanal stenosis. Five patients (8%) developed osteoradionecrosis. Two patients suffered from nasal synechiae. Forty-eight patients completed the SNOT-16 questionnaire. Patients with choanal stenosis had the lowest QOL scores out of the cohort. CONCLUSION The incidence of delayed sino-nasal complications after radiation treatment for NPC is not negligible and should be kept in mind when addressing the quality of life of NPC survivors.
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Affiliation(s)
- Eran E Alon
- Department of Otolaryngology Head and Neck Surgery, the Chaim Sheba Medical Central, Tel Hashomer and the Tel Aviv University, Israel
| | - Noga Lipschitz
- Department of Otolaryngology Head and Neck Surgery, the Chaim Sheba Medical Central, Tel Hashomer and the Tel Aviv University, Israel
| | - Lev Bedrin
- Department of Otolaryngology Head and Neck Surgery, the Chaim Sheba Medical Central, Tel Hashomer and the Tel Aviv University, Israel
| | - Iris Gluck
- Department of Oncology, the Chaim Sheba Medical Center, Tel Hashomer and the Tel Aviv University, Israel
| | - Yoav Talmi
- Department of Otolaryngology Head and Neck Surgery, the Chaim Sheba Medical Central, Tel Hashomer and the Tel Aviv University, Israel
| | - Michael Wolf
- Department of Otolaryngology Head and Neck Surgery, the Chaim Sheba Medical Central, Tel Hashomer and the Tel Aviv University, Israel
| | - Arkadi Yakirevitch
- Department of Otolaryngology Head and Neck Surgery, the Chaim Sheba Medical Central, Tel Hashomer and the Tel Aviv University, Israel
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Collie K, McCormick J, Waller A, Railton C, Shirt L, Chobanuk J, Taylor A, Lau H, Hao D, Walley B, Kapusta B, Joy AA, Carlson LE, Giese-Davis J. Qualitative evaluation of care plans for Canadian breast and head-and-neck cancer survivors. ACTA ACUST UNITED AC 2014; 21:e18-28. [PMID: 24523618 DOI: 10.3747/co.21.1698] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Survivorship care plans (scps) have been recommended as a way to ease the transition from active cancer treatment to follow-up care, to reduce uncertainty for survivors in the management of their ongoing health, and to improve continuity of care. The objective of the demonstration project reported here was to assess the value of scps for cancer survivors in western Canada. METHODS The Alberta CancerBridges team developed, implemented, and evaluated scps for 36 breast and 21 head-and-neck cancer survivors. For the evaluation, we interviewed 12 of the survivors, 9 nurses who delivered the scps, and 3 family physicians who received the scps (n = 24 in total). We asked about satisfaction, usefulness, emotional impact, and communication value. We collected written feedback from the three groups about positive aspects of the scps and possible improvements (n = 85). We analyzed the combined data using qualitative thematic analysis. RESULTS Survivors, nurses, and family physicians agreed that scps could ease the transition to survivorship partly by enhancing communication between survivors and care providers. Survivors appreciated the individualized attention and the comprehensiveness of the plans. They described positive emotional impacts, but wanted a way to ensure that their physicians received the scps. Nurses and physicians responded positively, but expressed concern about the time required to implement the plans. Suggestions for streamlining the process included providing survivors with scp templates in advance, auto-populating the templates for the nurses, and creating summary pages for physicians. CONCLUSIONS The results suggest ways in which scps could help to improve the transition to cancer survivorship and provide starting points for larger feasibility studies.
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Affiliation(s)
- K Collie
- Department of Psychosocial and Spiritual Resources, Cross Cancer Institute, Edmonton, AB. ; Department of Oncology, Palliative Care Division, University of Alberta, Edmonton, AB
| | - J McCormick
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, AB. ; Psychosocial Resources, Tom Baker Cancer Centre, Calgary, AB
| | - A Waller
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, AB. ; Psychosocial Resources, Tom Baker Cancer Centre, Calgary, AB
| | - C Railton
- Department of Oncology, Calgary Region Breast Health Program, Tom Baker Cancer Centre, Calgary, AB
| | - L Shirt
- Department of Radiation Oncology, Head-and-Neck Tumour Group, Tom Baker Cancer Centre, Calgary, AB
| | - J Chobanuk
- Comprehensive Breast Care Program, Community Oncology, Alberta Health Services-Cancer Care, Edmonton, AB
| | - A Taylor
- Breast Cancer Supportive Care Foundation, Calgary, AB
| | - H Lau
- Department of Radiation Oncology, Head-and-Neck Tumour Group, Tom Baker Cancer Centre, Calgary, AB
| | - D Hao
- Department of Radiation Oncology, Head-and-Neck Tumour Group, Tom Baker Cancer Centre, Calgary, AB
| | - B Walley
- Department of Oncology, Calgary Region Breast Health Program, Tom Baker Cancer Centre, Calgary, AB
| | | | - A A Joy
- Division of Medical Oncology, Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, AB
| | - L E Carlson
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, AB. ; Psychosocial Resources, Tom Baker Cancer Centre, Calgary, AB
| | - J Giese-Davis
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, AB. ; Psychosocial Resources, Tom Baker Cancer Centre, Calgary, AB
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Cervical oesophagostomy in patients with severe dysphagia following radiotherapy for nasopharyngeal carcinoma. The Journal of Laryngology & Otology 2014; 128:142-6. [PMID: 24472660 PMCID: PMC3941040 DOI: 10.1017/s0022215113003423] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Objective: This study aimed to investigate the validity and feasibility of cervical oesophagostomy as a treatment for patients with severe dysphagia after radiotherapy for nasopharyngeal carcinoma. Methods: The study retrospectively analysed the clinical data, symptoms, physical signs, treatment and outcomes of 12 patients treated with cervical oesophagostomy for severe dysphagia after radiotherapy for nasopharyngeal carcinoma, from 2006 to 2010. Results: In all 12 cases, the oesophageal stoma remained stable, without any complications such as pharyngeal fistula or inflammation. No oesophageal stricture or granuloma growth was observed. All patients reported significant improvement in their nutritional status and quality of life after the oesophagostomy surgery. Conclusion: Cervical oesophagostomy is a valid and feasible method of treating severe dysphagia following radiotherapy for nasopharyngeal carcinoma. Oesophagostomy shows specific advantages over nasogastric tubing, gastrostomy and jejunostomy. Patients' nutrition and quality of life can be improved significantly if cervical oesophagostomy is executed in a timely fashion, especially in cases with severe trismus and multiple radiation-induced cranial nerve palsies unresponsive to rehabilitation.
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14
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Deng YT, Zhong WN, Jiang Y. Measurement of distress and its alteration during treatment in patients with nasopharyngeal carcinoma. Head Neck 2014; 36:1077-86. [PMID: 23804505 DOI: 10.1002/hed.23412] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2012] [Revised: 04/20/2013] [Accepted: 06/06/2013] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND We examined the criterion-related validity of the Distress Thermometer (DT) for screening distress in patients with nasopharyngeal carcinoma (NPC) and investigated prospectively how distress changes. METHODS In the cross-sectional study, the DT was tested against the Hospital Anxiety and Depression Scale (HADS) in 295 patients with NPC. In the prospective study, 61 newly diagnosed patients with NPC completed the DT and HADS 6 times. RESULTS Adopting HADS as the standard tool for screening distress, 31.5% of the patients with NPC had distress. A DT cutoff score ≥ 4 had best sensitivity (0.73) and specificity (0.85). In the prospective study, the proportion of patients with distress rose significantly during treatment. CONCLUSION Receiver operating characteristic (ROC) findings provide initial support for the validity of the DT among patients with NPC. Nearly one third of patients with NPC exceeded cutoff values for distress in the cross-sectional study. In the prospective study, the level of distress increased significantly during concurrent chemoradiotherapy for patients with NPC.
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Affiliation(s)
- Yao-Tiao Deng
- Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, People's Republic of China
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16
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So WK, Choi K, Chan CW, Tang WP, Leung AW, Chair S, Wan RW, Mak SS, Ling W, Ng W, Yu BW. Perceived unmet supportive care needs and determinants of quality of life among head and neck cancer survivors: a research protocol. J Adv Nurs 2013; 69:2750-8. [PMID: 23656361 DOI: 10.1111/jan.12164] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Winnie K.W. So
- The Nethersole School of Nursing; The Chinese University of Hong Kong; Hong Kong SAR China
| | - K.C. Choi
- The Nethersole School of Nursing; The Chinese University of Hong Kong; Hong Kong SAR China
| | - Carmen W.H. Chan
- The Nethersole School of Nursing; The Chinese University of Hong Kong; Hong Kong SAR China
| | - Winnie P.Y. Tang
- The Nethersole School of Nursing; The Chinese University of Hong Kong; Hong Kong SAR China
| | - Alice W.Y. Leung
- The Nethersole School of Nursing; The Chinese University of Hong Kong; Hong Kong SAR China
| | - S.Y. Chair
- The Nethersole School of Nursing; The Chinese University of Hong Kong; Hong Kong SAR China
| | - Rayman W.M. Wan
- Department of Clinical Oncology; Prince of Wales Hospital; Hong Kong SAR China
| | - Suzanne S.S. Mak
- Department of Clinical Oncology; Prince of Wales Hospital; Hong Kong SAR China
| | - W.M. Ling
- Department of Clinical Oncology; Pamela Youde Nethersole Eastern Hospital; Hong Kong SAR China
| | - W.T. Ng
- Department of Clinical Oncology; Pamela Youde Nethersole Eastern Hospital; Hong Kong SAR China
| | - Bernice W.L. Yu
- Department of Clinical Oncology; Princess Margaret Hospital; Hong Kong SAR China
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17
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Nguyen NP, Ceizyk M, Vinh-Hung V, Sroka T, Jang S, Khan R, Locke A, Albala G, Truong C, Godinez J, Vo R, Smith-Raymond L. Feasibility of tomotherapy to reduce cochlea radiation dose in patients with locally advanced nasopharyngeal cancer. TUMORI JOURNAL 2012; 98:709-14. [DOI: 10.1177/030089161209800606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims and background To evaluate the effectiveness of tomotherapy-based image-guided radiotherapy (IGRT) on the radiation dose to the cochlea in patients with nasopharyngeal cancer. Methods and study design A retrospective review of five patients undergoing concurrent chemoradiation with tomotherapy for locally advanced nasopharyngeal cancer was performed. Results The mean dose to the right and left cochlea was 25 Gy and 35.3 Gy respectively, while the dose to the gross tumor ranged from 70 to 75 Gy. All patients had excellent clinical response to the treatment at a median follow-up of five months. Conclusions IGRT for head and neck cancer delivered by tomotherapy can significantly decrease the radiation dose to the cochlea without sacrificing target volume coverage.
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Affiliation(s)
- Nam P Nguyen
- Department of Radiation Oncology, University of Arizona, Tucson, AZ, USA
| | - Misty Ceizyk
- Department of Radiation Oncology, University of Arizona, Tucson, AZ, USA
| | - Vincent Vinh-Hung
- Department of Radiation Oncology, University Hospitals of Geneva, Geneva, Switzerland
| | - Thomas Sroka
- Department of Radiation Oncology, University of Arizona, Tucson, AZ, USA
| | - Siyoung Jang
- Department of Radiation Oncology, University of Arizona, Tucson, AZ, USA
| | - Rihan Khan
- Department of Radiology, University of Arizona, Tucson, AZ, USA
| | - Angela Locke
- Department of Radiation Oncology, University of Arizona, Tucson, AZ, USA
| | - Gabby Albala
- Department of Radiation Oncology, University of Arizona, Tucson, AZ, USA
| | - Christina Truong
- Department of Radiation Oncology, University of Arizona, Tucson, AZ, USA
| | - Juan Godinez
- Florida Radiation Oncology Group, Palatka, FL, USA
| | - Richard Vo
- University of Galveston Medical School, Galveston, TX, USA
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Lam WWT, Ye M, Fielding R. Trajectories of quality of life among Chinese patients diagnosed with nasopharynegeal cancer. PLoS One 2012; 7:e44022. [PMID: 23028484 PMCID: PMC3445583 DOI: 10.1371/journal.pone.0044022] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Accepted: 07/31/2012] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE This secondary longitudinal analysis describes distinct quality of life trajectories during eight months of radiation therapy (RT) among patients with nasopharyngeal cancer (NPC) and examines factors differentiating these trajectories. METHODS 253 Chinese patients with NPC scheduled for RT were assessed at pre-treatment, and 4 months and 8 months later on QoL (Chinese version of the FACT-G), optimism, pain, eating function, and patient satisfaction. Latent growth mixture modelling identified different trajectories within each of four QoL domains: Physical, Emotional, Social/family, and Functional well-being. Multinomial logistic regression compared optimism, pain, eating function, and patient satisfaction by trajectories adjusted for demographic and medical characteristics. RESULTS We identified three distinct trajectories for physical and emotional QoL domains, four trajectories for social/family, and two trajectories for functional domains. Within each domain most patients (physical (77%), emotional (85%), social/family (55%) and functional (63%)) experienced relatively stable high levels of well-being over the 8-month period. Different Physical trajectory patterns were predicted by pain and optimism, whereas for Emotion-domain trajectories pain, optimism, eating enjoyment, patient satisfaction with information, and gender were predictive. Age, appetite, optimism, martial status, and household income predicted Social/family trajectories; household income, eating enjoyment, optimism, and patient satisfaction with information predicted Functional trajectories. CONCLUSION Most patients with NPC showed high stable QoL during radiotherapy. Optimism predicted good QoL. Symptom impacts varied by QoL domain. Information satisfaction was protective in emotional and functional well-being, reflecting the importance in helping patients to establish a realistic expectation of treatment impacts.
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Affiliation(s)
| | | | - Richard Fielding
- Centre for Psycho-oncology Research and Teaching, School of Public Health, The University of Hong Kong, Hong Kong, People's Republic of China
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19
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Gu MF, Su Y, Chen XL, He WL, He ZY, Li JJ, Chen MQ, Mo CW, Xu Q, Diao YM. Quality of life and radiotherapy complications of Chinese nasopharyngeal carcinoma patients at different 3DCRT. Asian Pac J Cancer Prev 2012; 13:75-9. [PMID: 22502717 DOI: 10.7314/apjcp.2012.13.1.075] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
PURPOSE the study aimed to compare the quality of life (QOL) and radiotherapy complications among Chinese nasopharyngeal carcinoma (NPC) patients at different 3-dimensional conformal radiotherapy (3DCRT) stages adjusting for other variables. METHODS 511 NPC patients at different 3DCRT stages were enrolled. They were interviewed regarding SF-36, complications and socio-demographic variables and cancer- or treatment- related variables. Analysis of covariance (ANCOVA) based on SF-36, complications scores as dependent variables, 3DCRT stages as independent variables, and other variables as covariate were established. RESULTS The influencing factors of PCS included 3DCRT stages and age group. The influencing factors of MCS included 3DCRT stages and income. Most QOL scores of NPC patients were significantly associated with 3DCRT stage, after accounting for other variables. QOL scores of the patients receiving 3DCRT were the lowest, QOL scores of people after 3DCRT gradually increased. PCS scores of people greater than 5 years after 3DCRT was improved to or even better than the level before 3DCRT. The complications with significantly different scores of patients at different 3DCRT status included xerostomia, throat ache, hypogeusia, caries, hearing loss, snuffles. CONCLUSIONS Clinicians should pay more attention to older NPC patients and patients with lower income. When patients receive 3DCRT, measures should be taken to reduce radiation injury to improve the patients' QOL.
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Affiliation(s)
- Mo-Fa Gu
- Department of Radiation Oncology, Cancer Centre, Guangzhou, China
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20
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Tong MCF, Lee KYS, Yuen MTY, Lo PSY. Perceptions and experiences of post-irradiation swallowing difficulties in nasopharyngeal cancer survivors. Eur J Cancer Care (Engl) 2011; 20:170-8. [PMID: 20412286 DOI: 10.1111/j.1365-2354.2010.01183.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study aimed to explore the perceptions and experiences of swallowing difficulties in irradiated survivors of nasopharyngeal carcinoma (NPC). Qualitative semi-structured interviews were conducted with 60 post-irradiation NPC patients after they had answered a set of self-report questions. The interviews were transcribed verbatim for analysis. Results of the self-report data showed that in response to a global question 'Do you have any swallowing difficulties?' eight-five per cent of the respondents reported a certain degree of difficulty. The qualitative interview findings, however, suggested that this figure might have been underestimated. Patient interpretations of swallowing difficulties had excluded part of the symptoms. Some respondents who claimed to have no difficulty swallowing, in fact, were suffering from oral retention of food bolus, regurgitation of food or liquids through the nose, and/or even choking. The risk of aspiration was generally neglected. Informants' concerns focused more on the threat of cancer recurrence, thus paid less attention to the radiation-induced swallowing complication. Respondents did not possess sufficient knowledge to judge their swallowing abilities at a general level. This study suggests ways to enhance patient-provider communication and health education to improve patient knowledge.
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Affiliation(s)
- M C F Tong
- Department of Otorhinolaryngology, Head & Neck Surgery, The Chinese University of Hong Kong, Hong Kong, China
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21
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Measures of relative importance for health-related quality of life. Qual Life Res 2011; 21:1-11. [PMID: 21516478 DOI: 10.1007/s11136-011-9914-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2011] [Indexed: 02/03/2023]
Abstract
PURPOSE In health-related quality of life (HRQOL) studies, data are often collected on multiple domains for two or more groups of study participants. Quantitative measures of relative importance, which are used to rank order the domains based on their ability to discriminate between groups, are an alternative to multiple tests of significance on the group differences. This study describes relative importance measures based on logistic regression (LR) and multivariate analysis of variance (MANOVA) models. METHODS Relative importance measures are illustrated using data from the Manitoba Inflammatory Bowel Disease (IBD) Cohort Study. Study participants with self-reported active (n = 244) and inactive (n = 105) disease were compared on 12 HRQOL domains from the Inflammatory Bowel Disease Questionnaire (IBDQ) and Medical Outcomes Study 36-item Short-Form (SF-36) Questionnaire. RESULTS All but two relative importance measures ranked the IBDQ bowel symptoms and emotional health domains as most important. CONCLUSIONS MANOVA-based importance measures are recommended for multivariate normal data and when group covariances are equal, while LR measures are recommended for non-normal data and when the correlations among the domains are small. Relative importance measures can be used in exploratory studies to identify a small set of domains for further research.
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Wang TG, Chang YC, Chen WS, Lin PH, Hsiao TY. Reduction in hyoid bone forward movement in irradiated nasopharyngeal carcinoma patients with dysphagia. Arch Phys Med Rehabil 2010; 91:926-31. [PMID: 20510985 DOI: 10.1016/j.apmr.2010.02.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2009] [Revised: 02/08/2010] [Accepted: 02/08/2010] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To quantitatively assess the movement of the hyoid bone and pyriform sinus stasis in irradiated nasopharyngeal carcinoma (NPC) patients suffering from dysphagia. DESIGN Retrospective data analysis. SETTING A tertiary teaching hospital. PARTICIPANTS NPC subjects (n=33, 25 men and 8 women) and healthy subjects (n=10, 7 men and 3 women) participated in the study. INTERVENTION Videofluoroscopic swallowing study (VFSS) of all subjects. MAIN OUTCOME MEASURES The displacement and velocity of hyoid bone movement, the amount of pyriform sinus stasis, and the widest opening distance of the cricopharyngeal muscle during swallowing. RESULTS The displacement of the hyoid bone in the NPC patients was significantly less than that of the healthy subjects (1.58+/-0.59 vs 2.23+/-0.49 cm, P=.0033). The displacement of the hyoid bone was divided into forward and vertical directions, and the forward displacement in the NPC patients was found to be less than that of the healthy subjects (0.85+/-0.50 vs 1.65+/-0.51 cm), achieving statistic significance (P<.0001). The pyriform sinus stasis of the NPC subjects was significantly more than that of the healthy subjects (2.24+/-0.98 vs 0.30+/-0.17 cm(2), P<.0001). The movement velocity of the NPC subjects was less than that of the healthy subjects (2.49+/-1.41 vs 5.10+/-0.85 cm/s, P=.0086). Furthermore, the NPC subjects with aspiration experienced less displacement of the hyoid bone than those without aspiration (1.23+/-0.45 vs 1.76+/-0.58 cm, P=.029). CONCLUSION The irradiated NPC subjects with dysphagia experienced a reduction in hyoid bone displacement, occurring in a forward direction. The displacement of the hyoid bone was less in the aspiration subjects than in those without aspiration.
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Affiliation(s)
- Tyng-Guey Wang
- Department of Physical Medicine and Rehabilitation, Taipei, Taiwan
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23
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Jensen SB, Pedersen AML, Vissink A, Andersen E, Brown CG, Davies AN, Dutilh J, Fulton JS, Jankovic L, Lopes NNF, Mello ALS, Muniz LV, Murdoch-Kinch CA, Nair RG, Napeñas JJ, Nogueira-Rodrigues A, Saunders D, Stirling B, von Bültzingslöwen I, Weikel DS, Elting LS, Spijkervet FKL, Brennan MT. A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: prevalence, severity and impact on quality of life. Support Care Cancer 2010; 18:1039-60. [PMID: 20237805 DOI: 10.1007/s00520-010-0827-8] [Citation(s) in RCA: 257] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2009] [Accepted: 01/26/2010] [Indexed: 01/09/2023]
Abstract
PURPOSE This systematic review aimed to assess the literature for prevalence, severity, and impact on quality of life of salivary gland hypofunction and xerostomia induced by cancer therapies. METHODS The electronic databases of MEDLINE/PubMed and EMBASE were searched for articles published in English since the 1989 NIH Development Consensus Conference on the Oral Complications of Cancer Therapies until 2008 inclusive. Two independent reviewers extracted information regarding study design, study population, interventions, outcome measures, results and conclusions for each article. RESULTS The inclusion criteria were met by 184 articles covering salivary gland hypofunction and xerostomia induced by conventional, 3D conformal radiotherapy or intensity-modulated radiotherapy in head and neck cancer patients, cancer chemotherapy, total body irradiation/hematopoietic stem cell transplantation, radioactive iodine treatment, and immunotherapy. CONCLUSIONS Salivary gland hypofunction and xerostomia are induced by radiotherapy in the head and neck region depending on the cumulative radiation dose to the gland tissue. Treatment focus should be on optimized/new approaches to further reduce the dose to the parotids, and particularly submandibular and minor salivary glands, as these glands are major contributors to moistening of oral tissues. Other cancer treatments also induce salivary gland hypofunction, although to a lesser severity, and in the case of chemotherapy and immunotherapy, the adverse effect is temporary. Fields of sparse literature included pediatric cancer populations, cancer chemotherapy, radioactive iodine treatment, total body irradiation/hematopoietic stem cell transplantation, and immunotherapy.
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Affiliation(s)
- S B Jensen
- Department of Oral Medicine, University of Copenhagen, Copenhagen, Denmark.
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A systematic review of trismus induced by cancer therapies in head and neck cancer patients. Support Care Cancer 2010; 18:1033-8. [DOI: 10.1007/s00520-010-0847-4] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2009] [Accepted: 02/18/2010] [Indexed: 10/19/2022]
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Liu C, Li N, Ren X, Liu D. Is traditional rural lifestyle a barrier for quality of life assessment? A case study using the Short Form 36 in a rural Chinese population. Qual Life Res 2009; 19:31-6. [PMID: 20013158 DOI: 10.1007/s11136-009-9567-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2009] [Indexed: 12/17/2022]
Abstract
PURPOSE The majority of existing quality of life measures are based on urban-living environments. This study aimed at exploring the validity of using an urban-lifestyle-based health questionnaire with individuals living a traditional rural lifestyle. METHODS The Short Form-36 (SF-36) interview was administered to 1603 rural Chinese residents. Semantic ambiguity of the items was investigated using tests of internal consistency, test-retest reliability, exploratory factor analysis, and clustering and ordering of item mean scores. The self-explanations from the respondents were adopted to interpret the implications of the changes in meanings of the items. RESULTS Cronbach's alpha reliability coefficients were high, whereas test-retest reliabilities were low. Consistent with the original factor structure, eight factors were extracted using exploratory factor analysis. However, the composition of these eight factors was not in full accordance with the priori assignment of items to scales. Seven items violated the clustering and ordering of item mean scores. The association between the identified problems in validity and the change in semantic meanings in the context of the rural lifestyle was established. CONCLUSIONS Quality of life assessment instruments based on urban-living arrangements may not be reliably used with individuals living in rural environments.
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Affiliation(s)
- Chaojie Liu
- School of Public Health, La Trobe University, Bundoora, VIC, Australia.
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Wang L, Su YX, Liao GQ. Quality of life in osteoradionecrosis patients after mandible primary reconstruction with free fibula flap. ACTA ACUST UNITED AC 2009; 108:162-8. [DOI: 10.1016/j.tripleo.2009.03.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2008] [Revised: 02/09/2009] [Accepted: 03/03/2009] [Indexed: 11/24/2022]
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Dorjgochoo T, Kallianpur A, Zheng Y, Gu K, Chen Z, Zheng W, Lu W, Shu XO. Impact of menopausal symptoms on quality of life 6 months after systemic breast cancer treatment: results from the Shanghai Breast Cancer Survival Study. Breast Cancer Res Treat 2009; 119:725-35. [PMID: 19543973 DOI: 10.1007/s10549-009-0434-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2009] [Accepted: 05/29/2009] [Indexed: 11/26/2022]
Abstract
Menopausal symptoms (MPS) after breast cancer treatment are associated with reduced health-related quality of life (QOL) among Caucasian women. Little is known about whether MPS similarly impact QOL in Asian women with breast cancer. QOL was assessed by using the generic quality of life instruments, Medical Outcome Study of Quality of Life Inventory (MOSQOL-74) or Short Form-36 Health Survey (SF-36) in 4,976 Chinese participants of the Shanghai Breast Cancer Survival Study who were treated for incident, non-metastatic breast cancer within the 6 months before the study interview. Relationships between MPS and QOL were assessed by multiple linear regression, controlling for potential confounders. About 71.4% of study participants experienced MPS, including hot flashes, night sweats, vaginal dryness, depressed mood, and/or dry skin. Women with MPS reported lower overall QOL than women without MPS [mean scores 61.0 vs. 64.0, respectively (MOSQOL-74) and 54.9 vs. 66.9, respectively (SF-36); P < 0.01]. Adjusted mean differences (beta) in overall QOL in the presence and absence of MPS were -3.1 (95% CI -3.8, -2.4) with the MOSQOL-74 and -12.3 (95% CI -13.8, -10.9) with the SF-36. Women with any MPS had lower scores for the MOSQOL-74 physical and psychological domains and for the SF-36 social and emotional subscales than those without MPS (P < 0.05 for all). Having several MPS predicted poorer QOL in all domains measured regardless of the instrument used (P (trend) < 0.01 for all). Our study indicates that in Chinese women recently treated for breast cancer, MPS adversely impacts QOL. Actively soliciting and treating MPS in these women should significantly improve their QOL.
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Affiliation(s)
- Tsogzolmaa Dorjgochoo
- Department of Medicine, Vanderbilt Epidemiology Center, Institute for Medicine & Public Health, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 600, Nashville, TN 37203-1738, USA
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