1
|
Heirman AN, Arends CR, de Jel DVC, Dirven R, van der Molen L, Halmos GB, van den Brekel MWM, Stuiver MM. Decisional Conflict and Decision Regret in Head and Neck Oncology: A Systematic Review and Meta-Analysis. JAMA Otolaryngol Head Neck Surg 2024; 150:393-404. [PMID: 38512270 PMCID: PMC10958390 DOI: 10.1001/jamaoto.2024.0214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 01/30/2024] [Indexed: 03/22/2024]
Abstract
Importance Head and neck cancer (HNC) often requires treatment with a major impact on quality of life. Treatment decision-making is often challenging, as it involves balancing survival against the preservation of quality of life and choosing among treatments with comparable outcomes but variation in morbidity and adverse events; consequently, the potential for decisional conflict (DC) and decision regret (DR) is high. Objectives To summarize the literature on DC and DR in HNC, to give an overview of its prevalence and extent, and to advise on clinical practice and future research. Data Sources Embase, Web of Science, MEDLINE, and PsycINFO were searched up to February 24, 2023, including all years of publication. Study Selection Eligible studies addressed DC and/or DR as primary or secondary outcomes with any instrument in HNC, except cutaneous tumors. Two mutually blinded researchers conducted screening and inclusion with support of an artificial intelligence assistant and conducted risk of bias (ROB) assessment. Data Extraction and Synthesis The Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines were followed for data extraction. ROB assessments were done using Critical Appraisal Skills Programme (qualitative) and CLARITY (quantitative). Meta-analysis with a random-effects model was used to obtain pooled prevalence estimates for DC and DR when at least 4 sufficiently clinically homogeneous studies were available. Main Outcomes and Measures Prevalence of DC (qualitative, Decisional Conflict Scale, SURE questionnaire) and DR (qualitative, study-specific questionnaires, Decision Regret Scale, Shame and Stigma Scale). Results Overall, 28 studies were included, with 16 included in meta-analyses for DR prevalence. The pooled prevalence of clinically relevant DR above the cutoff score for validated questionnaires (11 studies; 2053 participants) was 71% (95% CI, 58%-82%; I2 = 94%), while for study-specific questionnaires (5 studies; 674 participants) it was 11% (95% CI, 5%-22%; I2 = 92%). Only 4 studies investigated DC, showing a prevalence of 22.6% to 47.5% above cutoff values. Derived overarching themes found in qualitative studies were preparation, shared decision-making roles, information, time pressure, stress of diagnosis, and consequences. Conclusions and Relevance Although limited data on DC and DR were available, the studies performed indicated that DC and DR are highly prevalent issues in HNC. Results suggest that study-specific questionnaires underestimated DR. The findings underscore the rationale to improve counseling and shared decision-making for this patient population.
Collapse
Affiliation(s)
- Anne Nadine Heirman
- Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Coralie Romé Arends
- Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | | | - Richard Dirven
- Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Lisette van der Molen
- Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Gyorgy Bela Halmos
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Michiel Wilhelmus Maria van den Brekel
- Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, the Netherlands
- Amsterdam Center of Language and Communication, University of Amsterdam, Amsterdam, the Netherlands
| | - Martijn Matthias Stuiver
- Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, the Netherlands
- Division of Psychosocial Research and Epidemiology and Center for Quality of Life, Netherlands Cancer Institute, Amsterdam, the Netherlands
- Department of Epidemiology and Data Science, Cancer Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| |
Collapse
|
2
|
Mukoyama N, Nishio N, Kimura H, Tokura T, Kishi S, Ogasawara K, Tsuzuki H, Yokoi S, Wada A, Shigeyama M, Ozaki N, Fujimoto Y, Sone M. Anxiety, depression and quality of life in patients with head and neck cancer undergoing laryngectomy: A long-term prospective evaluation. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024. [PMID: 38647077 DOI: 10.1111/1460-6984.13036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 04/09/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND This study aimed to assess anxiety, depression and quality of life (QoL) in patients with head and neck cancer undergoing laryngectomy using comprehensive self-reported questionnaires for a period of up to 5 years. METHODS This prospective observational study enrolled 150 consecutive patients with locally advanced head and neck cancer who underwent laryngectomy at Nagoya University Hospital between 2007 and 2020. Anxiety, depression and QoL were assessed at baseline (preoperative) and at 3, 6, 12, 24, 36, 48 and 60 months after surgery using two brief self-reported questionnaires, such as the eight-item Short Form Health Survey (SF-8) and the Hospital Anxiety and Depression Scale (HADS). RESULTS The surgical procedures were total laryngectomy, pharyngo-laryngectomy and pharyngo-laryngo-oesophagectomy in 97 (65%), 41 (27%) and 12 (8%) patients, respectively. All eight items of the SF-8 were significantly worse than those of the normal population at baseline and at 3 months after surgery. However, general health, vitality, mental health and bodily pain improved to normal levels within 1 year after surgery and were maintained for 5 years. In this study, 35% of patients were categorised as potential cases of depression, and 35% were potential cases of anxiety. During the follow-up period, the proportion of patients with anxiety gradually decreased after surgery. Further analysis revealed that the SF-8 and HADS scores and trends in 89 patients without tumour recurrence were similar to those in the total enrolled 150 patients. CONCLUSION Anxiety, depression and QoL in laryngectomised patients improved at 1 year after surgery and were maintained for up to 5 years. WHAT THIS PAPER ADDS What is already known on the subject Laryngectomy is associated with prolonged functional and psychological effects and has a major impact on patient quality of life (QoL). Several prospective studies evaluating the QoL in laryngectomised patients have been reported, in which significant deterioration in social functioning was found even 1 year after surgery. What this paper adds to existing knowledge One year is not a sufficient period for laryngectomised patients to return to normal life and spend their time in a social community. A recent review showed that most studies on QoL in laryngectomised patients were conducted under 1 year after the procedure, and there were not enough studies of sufficient quality. This is the first long-term prospective observational study of Japanese patients with head and neck cancer who underwent laryngectomy up to 5 years after surgery. What are the potential or actual clinical implications of this work? Our long-term observational study showed that the scores for anxiety, depression and QoL in laryngectomised patients improved at 1 year after surgery and were maintained for up to 5 years. Clinicians should recognize the importance of psychosocial risk factors in their QoL and multidisciplinary management, including social and psychological support, is essential for long-term laryngectomised survivors.
Collapse
Affiliation(s)
- Nobuaki Mukoyama
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Naoki Nishio
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroyuki Kimura
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tatsuya Tokura
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shinichi Kishi
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazuyoshi Ogasawara
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Center for Postgraduate Clinical Training and Career Development, Nagoya University Hospital, Nagoya, Japan
| | - Hidenori Tsuzuki
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Sayaka Yokoi
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akihisa Wada
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mayu Shigeyama
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Norio Ozaki
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Institute for Glyco-core Research (iGCORE), Nagoya University, Nagoya, Japan
| | - Yasushi Fujimoto
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Otorhinolaryngology, Head and Neck Surgery, Aichi Medical University, Aichi, Japan
| | - Michihiko Sone
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| |
Collapse
|
3
|
Chan HF, Rosen CA, Schneider SL. An investigation of the cutoff point of the English version of speech handicap index in the American total laryngectomees. LOGOP PHONIATR VOCO 2024; 49:34-40. [PMID: 35895076 DOI: 10.1080/14015439.2022.2102206] [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: 07/07/2021] [Revised: 05/24/2022] [Accepted: 07/08/2022] [Indexed: 10/16/2022]
Abstract
OBJECTIVES The present article aims to identify the optimal cutoff score and the diagnostic accuracy for the English version of Speech Handicap Index (SHI) to screen out individuals with and without speech disorders in daily life. MATERIALS AND METHODS In this cross-sectional cohort study, a volunteer sample of 104 adult patients after total laryngectomy and 99 healthy controls in the United States completed the English version of SHI online questionnaire. Sensitivity and specificity were computed for a range of cut-off values using the Receiving Operating Characteristics (ROC) analysis to establish an optimal cutoff point for the SHI. Other measures of diagnostic accuracy, such as likelihood ratios (LR), positive predictive values (PPV), and negative predictive values (NPV) were also computed. RESULTS Patients after total laryngectomy obtained a higher score than the healthy controls on the mean scores of SHI. According to the ROC analysis, an optimal cutoff score of 17 points determined by Youden index was identified on the head and neck cancer population with a sensitivity of 92.31%, specificity of 92.31%, PPV of 90.60%, NPV of 91.75%, LR + of 9.14, and LR- of 0.09. CONCLUSIONS The cutoff score of the English version of SHI applied on the English-speaking population in the United States demonstrated promising diagnostic accuracy.
Collapse
Affiliation(s)
- Hiu Fung Chan
- Department of Otolaryngology - Head and Neck Surgery, University of California - San Francisco, San Francisco, CA, USA
| | - Clark A Rosen
- Department of Otolaryngology - Head and Neck Surgery, University of California - San Francisco, San Francisco, CA, USA
| | - Sarah L Schneider
- Department of Otolaryngology - Head and Neck Surgery, University of California - San Francisco, San Francisco, CA, USA
| |
Collapse
|
4
|
Gosselin LE, Villemure-Poliquin N, Audet N. Quality of Life After Head and Neck Cancer Surgery and Free Flap Reconstruction: A Systematic Review. J Otolaryngol Head Neck Surg 2024; 53:19160216241248666. [PMID: 38888940 PMCID: PMC11155320 DOI: 10.1177/19160216241248666] [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: 02/05/2024] [Accepted: 03/03/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Different factors can affect the quality of life of patients treated for head and neck cancer undergoing major surgical intervention. However, it remains unclear which specific factors and what possible interventions could have the greatest influence on quality of life postoperatively for patients undergoing surgical resection with free flap reconstruction. The objective of our systematic review was to identify which factors, at the time of surgical treatment, are associated with a worse postoperative quality of life for patients undergoing surgical resection with free flap reconstruction for head and neck cancer. METHODS We performed a systematic review of MEDLINE, Embase, CINAHL, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL), from their inception through November 2021. We included peer reviewed studies that evaluated the impact of specific factors on quality of life for adult patients who underwent surgery with free flap reconstruction for head and neck cancer. Two reviewers independently screened citations for eligibility and extracted data. Risk of bias of each study was evaluated using the New-Castle Ottawa Scale. Vote counting and qualitative review were used to synthesize results. All relevant findings were reported. RESULTS We initially identified 1971 articles. We included 22 articles in our systematic review, totaling 1398 patients. There was a high level of variability for factors evaluated throughout studies and many studies presented small sample sizes. However, some factors were associated with worse long-term quality of life, including older age, radiotherapy, higher tumor stage, dysphagia, anxiety as well as depressive symptoms. Very few articles analyzed their data for specific tumor subsites and the impact of psychosocial factors was rarely evaluated throughout studies. CONCLUSIONS For patients with head and neck cancer requiring free flap reconstruction, some specific factors may correlate with changes in quality of life. However, these findings are based on very few and mostly underpowered studies. A better understanding of factors affecting quality of life could allow a more personalized and overall better quality of care for patients.
Collapse
Affiliation(s)
- Laura-Elisabeth Gosselin
- Department of Ophthalmology and Otorhinolaryngology—Head and Neck Surgery, Faculty of Medicine, Université Laval, Quebec City, QC, Canada
| | - Noémie Villemure-Poliquin
- Department of Ophthalmology and Otorhinolaryngology—Head and Neck Surgery, Faculty of Medicine, Université Laval, Quebec City, QC, Canada
| | - Nathalie Audet
- Department of Ophthalmology and Otorhinolaryngology—Head and Neck Surgery, Faculty of Medicine, Université Laval, Quebec City, QC, Canada
- Department of Surgery, Service of Otorhinolaryngology—Head and Neck Surgery, Centre Hospitalier Universitaire de Québec, Université Laval, Quebec City, QC, Canada
| |
Collapse
|
5
|
Dias Gomes da Silva N, Sérgio da Silva Santos P, Carolina Magalhães A, Afonso Rabelo Buzalaf M. Antibacterial, antibiofilm and anticaries effect of BioXtra® mouthrinse for head and neck cancer (HNC) patients under a microcosm biofilm model. Radiother Oncol 2023; 187:109846. [PMID: 37543054 DOI: 10.1016/j.radonc.2023.109846] [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: 01/22/2023] [Revised: 06/30/2023] [Accepted: 07/31/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND AND PURPOSE Considering the lack of studies investigating salivary substitutes to control post-radiation caries for patients with head and neck cancer (HNC), this study aimed to evaluate the antibacterial, antibiofilm, and anticaries effects of BioXtra® on the microcosm biofilm formed on different enamel types (non-irradiated and irradiated) and from distinct saliva sources (control and HNC patients). MATERIALS AND METHODS Non-irradiated and irradiated enamel specimens were treated with BioXtra®, phosphate-buffered-saline (PBS; negative control), or 0.12% chlorhexidine (CHX; positive control) for 1 min. Biofilm was produced from human saliva (healthy participants with normal salivary flow for the control group or irradiated HNC patients with hyposalivation for the HNC group), mixed with McBain saliva, under 0.2% sucrose exposure, daily submitted to the treatments (1 min), for 5 days. Bacterial metabolic activity, biofilm viability, CFU counting, and enamel demineralization were determined. RESULTS BioXtra® significantly reduced the bacterial metabolic activity for both enamel types and the inoculum sources, being more effective for the irradiated enamel or for the saliva from the control group. Similarly, BioXtra® significantly reduced the biofilm viability, the CFU for total microorganisms, mutans streptococci, and lactobacilli, and was able to significantly reduce the mineral loss and the lesion depth compared to PBS. CHX was an effective treatment to significantly reduce all parameters, performing better than BioXtra® and reinforcing its reliable efficiency as a positive control. CONCLUSION Regardless of the enamel type and the inoculum source, BioXtra® presented antibacterial, antibiofilm, and anticaries effects under this experimental model, which should be confirmed in further clinical studies.
Collapse
Affiliation(s)
- Natara Dias Gomes da Silva
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Paulo Sérgio da Silva Santos
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Ana Carolina Magalhães
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | | |
Collapse
|
6
|
Nieri CA, Benaim EH, Zhang YH, Garcia-Godoy F, Herr MJ, Zhang W, Schwartz D, Coca KK, Gleysteen JP, Gillespie MB. Botox for the prevention of radiation-induced Sialadenitis and xerostomia in head and neck cancer patients: A pilot study. Head Neck 2023; 45:2198-2206. [PMID: 37403447 DOI: 10.1002/hed.27449] [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: 04/24/2023] [Revised: 06/19/2023] [Accepted: 06/26/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND To determine the safety of Botox and its potential effect on alleviating radiation therapy (RT)-induced sialadenitis in head and neck cancer patients. METHODS Twenty patients with stage III/IV head and neck cancer were randomized to receive Botox or saline injections into both submandibular glands (SMG). There were three visits: one before RT (V1); 1 week after RT (V2); and 6 weeks after RT (V3), each of which included saliva collection, a 24-h dietary recall, and a quality-of-life survey. RESULTS No adverse events were observed. While the control group was much older, the Botox group more commonly underwent induction chemotherapy compared with controls. From V1 to V2, salivary flow decreased in both groups, but only in the control group from V1 to V3. CXCL-1 (GRO), a neutrophil chemoattractant, was lower in the Botox group compared with the control group at V3. CONCLUSION Botox can be safely administered to the salivary glands prior to external beam radiation without observed complications or side-effects. After an initial reduction in salivary flow following RT, the Botox group showed lack of further flow reduction compared with controls. The inflammatory marker CXCL 1, which was reduced in the in Botox group at V3, may be a candidate for further studies of radiation-induced sialadenitis.
Collapse
Affiliation(s)
- Chad Alexander Nieri
- Department of Otolaryngology- Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Ezer Haim Benaim
- Department of Otolaryngology- Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Yanhui H Zhang
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Franklin Garcia-Godoy
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tennessee, USA
- The Forsyth Institute, Cambridge, Massachusetts, USA
- Department of Surgery, Herbert Wertheim, College of Medicine, Florida International University, Miami, Florida, USA
| | - Michael J Herr
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA
| | - Weiqiang Zhang
- Department of Pediatrics, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
- Department of Physiology, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - David Schwartz
- Department of Radiation Oncology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Kimberly K Coca
- Department of Otolaryngology, Head and Neck Surgery, University of South Florida, Tampa, Florida, USA
| | - John P Gleysteen
- Department of Otolaryngology- Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Marion Boyd Gillespie
- Department of Otolaryngology- Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| |
Collapse
|
7
|
Moral Nakamura D, da Graça Pinto H, Baena Elchin C, Thomazotti Berard L, Abreu Alves F, Azeredo Alves Antunes L, Pena Coto N. Efficacy of bethanechol chloride in the treatment of radiation-induced xerostomia in patients with head and neck cancer: A systematic review and meta-analysis. Radiother Oncol 2023; 186:109715. [PMID: 37207874 DOI: 10.1016/j.radonc.2023.109715] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 05/09/2023] [Accepted: 05/11/2023] [Indexed: 05/21/2023]
Abstract
BACKGROUND AND PORPUSE Salivary glands sustain collateral damage following radiotherapy (RT) to treat cancers of the head and neck, leading to complications, including xerostomia and hyposalivation. This systematic review (SR) with meta-analysis was performed to determine the effectiveness of bethanechol chloride in preventing salivary gland dysfunction in this context. MATERIALS AND METHODS Medline/Pubmed, Embase, Scopus, LILACS via Portal Regional BVS and Web of Science were searched electronically in accordance with the Cochrane manual and reported PRISMA guidelines. RESULTS 170 patients from three studies were included. Results from the meta-analysis suggest that bethanechol chloride is associated with increases in: whole stimulating saliva (WSS) after RT (Std. MD 0.66, 95% CI 0.28 to 1.03, P < 0.001); whole resting saliva (WRS) during RT (Std. MD 0.4, 95% CI 0.04 to 0.76, P = 0.03); and WRS after RT (Std. MD 0.45, 95% CI 0.04 to 0.86, P = 0.03). CONCLUSION The present study suggests that bethanechol chloride therapy may be effective in patients with xerostomia and hyposalivation.
Collapse
Affiliation(s)
- Denise Moral Nakamura
- School of Dentistry, University of Sao Paulo, Av. Prof. Lineu Prestes, 2227, 05508-900 São Paulo, SP, Brazil.
| | - Henrique da Graça Pinto
- School of Dentistry, University of Sao Paulo, Av. Prof. Lineu Prestes, 2227, 05508-900 São Paulo, SP, Brazil.
| | - Cintia Baena Elchin
- School of Dentistry, University of Sao Paulo, Av. Prof. Lineu Prestes, 2227, 05508-900 São Paulo, SP, Brazil.
| | - Lucas Thomazotti Berard
- School of Dentistry, University of Sao Paulo, Av. Prof. Lineu Prestes, 2227, 05508-900 São Paulo, SP, Brazil.
| | - Fabio Abreu Alves
- School of Dentistry, University of Sao Paulo, Av. Prof. Lineu Prestes, 2227, 05508-900 São Paulo, SP, Brazil.
| | - Lívia Azeredo Alves Antunes
- School of Dentistry, Fluminense Federal University, R. Dr. Silvio Henrique Braune, 22, 28625-650 Nova Friburgo, RJ, Brazil.
| | - Neide Pena Coto
- School of Dentistry, University of Sao Paulo, Av. Prof. Lineu Prestes, 2227, 05508-900 São Paulo, SP, Brazil.
| |
Collapse
|
8
|
Honma R, I T, Seki M, Iwatake M, Ogaeri T, Hasegawa K, Ohba S, Tran SD, Asahina I, Sumita Y. Immunomodulatory Macrophages Enable E-MNC Therapy for Radiation-Induced Salivary Gland Hypofunction. Cells 2023; 12:1417. [PMID: 37408251 DOI: 10.3390/cells12101417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 07/07/2023] Open
Abstract
A newly developed therapy using effective-mononuclear cells (E-MNCs) is reportedly effective against radiation-damaged salivary glands (SGs) due to anti-inflammatory and revascularization effects. However, the cellular working mechanism of E-MNC therapy in SGs remains to be elucidated. In this study, E-MNCs were induced from peripheral blood mononuclear cells (PBMNCs) by culture for 5-7 days in medium supplemented with five specific recombinant proteins (5G-culture). We analyzed the anti-inflammatory characteristics of macrophage fraction of E-MNCs using a co-culture model with CD3/CD28-stimulated PBMNCs. To test therapeutic efficacy in vivo, either E-MNCs or E-MNCs depleted of CD11b-positive cells were transplanted intraglandularly into mice with radiation-damaged SGs. Following transplantation, SG function recovery and immunohistochemical analyses of harvested SGs were assessed to determine if CD11b-positive macrophages contributed to tissue regeneration. The results indicated that CD11b/CD206-positive (M2-like) macrophages were specifically induced in E-MNCs during 5G-culture, and Msr1- and galectin3-positive cells (immunomodulatory macrophages) were predominant. CD11b-positive fraction of E-MNCs significantly inhibited the expression of inflammation-related genes in CD3/CD28-stimulated PBMNCs. Transplanted E-MNCs exhibited a therapeutic effect on saliva secretion and reduced tissue fibrosis in radiation-damaged SGs, whereas E-MNCs depleted of CD11b-positive cells and radiated controls did not. Immunohistochemical analyses revealed HMGB1 phagocytosis and IGF1 secretion by CD11b/Msr1-positive macrophages from both transplanted E-MNCs and host M2-macrophages. Thus, the anti-inflammatory and tissue-regenerative effects observed in E-MNC therapy against radiation-damaged SGs can be partly explained by the immunomodulatory effect of M2-dominant macrophage fraction.
Collapse
Affiliation(s)
- Ryo Honma
- Department of Medical Research and Development for Oral Disease, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8588, Japan
- Department of Regenerative Oral Surgery, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8588, Japan
| | - Takashi I
- Department of Medical Research and Development for Oral Disease, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8588, Japan
| | | | - Mayumi Iwatake
- Department of Medical Research and Development for Oral Disease, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8588, Japan
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8588, Japan
| | - Takunori Ogaeri
- Department of Medical Research and Development for Oral Disease, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8588, Japan
| | - Kayo Hasegawa
- Department of Medical Research and Development for Oral Disease, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8588, Japan
| | - Seigo Ohba
- Department of Regenerative Oral Surgery, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8588, Japan
| | - Simon D Tran
- Laboratory of Craniofacial Tissue Engineering and Stem Cells, Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC H3A 1G1, Canada
| | - Izumi Asahina
- Department of Regenerative Oral Surgery, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8588, Japan
| | - Yoshinori Sumita
- Department of Medical Research and Development for Oral Disease, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8588, Japan
| |
Collapse
|
9
|
Liu S, Zhang S, Su YX, Zhou X, Gong ZJ, Wu HJ. Optimization of total tongue functional reconstruction with the sushi roll technique and its application in pectoralis major myocutaneous flaps. Int J Oral Maxillofac Surg 2023:S0901-5027(23)00003-6. [PMID: 36653273 DOI: 10.1016/j.ijom.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 12/27/2022] [Accepted: 01/05/2023] [Indexed: 01/18/2023]
Abstract
A protuberant shape and sufficient volume are the most important parameters for total tongue reconstruction. The conventional pectoralis major myocutaneous (PMMC) flap undergoes collapse due to atrophy of the denervated muscle. In a new technique, this flap was rolled up like sushi to reshape the neotongue. This study explored the feasibility and effect of the 'sushi roll' technique for precise total functional reconstruction of the tongue using a PMMC flap. Thirty patients scheduled for total glossectomy and PMMC flap reconstruction were recruited. The sushi roll technique was performed in 15 patients and the conventional repair in 15 patients. Outcomes were compared between the two groups. The flap survived in all 30 patients. The sushi roll group showed superior results to the conventional group in terms of time to oral alimentation (P = 0.012) and decannulation (P = 0.041), as well as swallowing function (P = 0.032), speech intelligibility (P < 0.001), shape (P < 0.001), and quality of life score (P < 0.001) at 12 months. The innovative sushi roll technique uses a folding method that utilizes the length rather than the thickness and width of the flap to maintain the volume and protuberance of the neotongue, which results in acceptable function and improved quality of life.
Collapse
Affiliation(s)
- S Liu
- Discipline of Oral and Maxillofacial Surgery, Second Xiangya Hospital, Central South University, Changsha, China
| | - S Zhang
- Discipline of Oral and Maxillofacial Surgery, Second Xiangya Hospital, Central South University, Changsha, China
| | - Y-X Su
- Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong, China
| | - X Zhou
- Discipline of Oral and Maxillofacial Surgery, Second Xiangya Hospital, Central South University, Changsha, China.
| | - Z J Gong
- Discipline of Oral and Maxillofacial Surgery, Second Xiangya Hospital, Central South University, Changsha, China
| | - H J Wu
- Discipline of Oral and Maxillofacial Surgery, Second Xiangya Hospital, Central South University, Changsha, China
| |
Collapse
|
10
|
Parkar S, Sharma A. Validation of European Organization for Research and Treatment of Cancer Head and Neck Cancer Quality of Life Questionnaire (EORTC QLQ-H&N35) Across Languages: A Systematic Review. Indian J Otolaryngol Head Neck Surg 2022; 74:6100-6107. [PMID: 36742587 PMCID: PMC9895643 DOI: 10.1007/s12070-021-02755-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 07/04/2021] [Indexed: 02/07/2023] Open
Abstract
The purpose of this review was to identify cross-cultural and psychometric characteristics of the European Organization for Research and Treatment of Cancer Head and neck cancer questionnaire (EORTC QLQ-H&N35) in various languages. A literature search was performed for original papers in PubMed, EMBASE, and Google scholar electronic databases on validation, psychometric properties of the EORTC-H&N35 questionnaire for patients with head and neck cancer. A total of 17 papers had been reviewed systematically. The studies were conducted in 28 countries and EORTC QLQ-H&N35 questionnaire was validated in 21 different languages. The majority of papers reported high reliability having Cronbach's coefficient above 0.70. Low reliability was reported for senses and speech problems, pain, and less sexuality. Moderate to good convergent validity was found as the correlation coefficient was above 0.40 except for speech problems and social contact trouble. Discriminant validity (weak correlations < 0.70) was confirmed in 14 papers. This review provides comprehensive information on cross-cultural and psychometric properties of EORTC QLQ-H&N35 and can be recommended to implement in oncological practice.
Collapse
Affiliation(s)
- Sujal Parkar
- Department of Public Health Dentistry, Siddhpur Dental College and Hospital, Patan, Gujarat 384151 India
| | - Abhishek Sharma
- Department of Public Health Dentistry, Rajasthan University of Health Sciences College of Dental Sciences (Government Dental College), Jaipur, Rajasthan India
| |
Collapse
|
11
|
Trevisani LFM, Kulcsar IF, Leite AKN, Kulcsar MAV, Lima GAS, Dedivitis RA, Kowalski LP, Matos LL. Nutritional and immunological parameters as prognostic factors in patients with advanced oral cancer. Braz J Otorhinolaryngol 2022; 88 Suppl 4:S89-S97. [PMID: 35277368 DOI: 10.1016/j.bjorl.2021.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 10/05/2021] [Accepted: 11/10/2021] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE The aim of the present study was to analyze the prognostic relationship of weight loss and preoperative hematological indexes in patients surgically treated for pT4a squamous cell carcinoma of the oral cavity. METHODS A retrospective cohort study. RESULTS Percent weight loss greater than 10% was identified in 49 patients (28.2%), and any weight loss in relation to the usual weight occurred in 140 patients (78.7%). Percent weight loss greater than 10% (HR = 1.679), Red cell distribution width (RDW) values greater than 14.3% (HR = 2.210) and extracapsular spread (HR = 1.677) were independent variables associated with risk of death. CONCLUSION Patients with advanced squamous cell carcinoma of the oral cavity present significant weight loss and as significantly immunocompromised. Increased values of RDW and higher percentages of weight loss in relation to the individual's usual weight, together with extracapsular spread of metastatic lymph nodes, were risk factors for lower survival, regardless of other clinical and anatomopathological characteristics. LEVEL OF EVIDENCE: 3
Collapse
Affiliation(s)
- Lorenzo Fernandes Moça Trevisani
- Universidade de São Paulo, Faculdade de Medicina, Programa de Pós-Graduação em Anestesiologia, Ciências Cirúrgicas e Medicina Perioperatória, São Paulo, SP, Brazil
| | | | - Ana Kober Nogueira Leite
- Universidade de São Paulo, Faculdade de Medicina, Instituto do Câncer do Estado de São Paulo (Icesp), Departamento de Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| | - Marco Aurélio Vamondes Kulcsar
- Universidade de São Paulo, Faculdade de Medicina, Instituto do Câncer do Estado de São Paulo (Icesp), Departamento de Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| | - Graziele Aparecida Simões Lima
- Universidade de São Paulo, Faculdade de Medicina, Instituto do Câncer do Estado de São Paulo (Icesp), São Paulo, SP, Brazil
| | - Rogerio Aparecido Dedivitis
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| | - Luiz Paulo Kowalski
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| | - Leandro Luongo Matos
- Universidade de São Paulo, Faculdade de Medicina, Instituto do Câncer do Estado de São Paulo (Icesp), São Paulo, SP, Brazil; Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, SP, Brazil.
| |
Collapse
|
12
|
da Silva NDG, de Paiva PRB, Magalhães TVM, Braga AS, Santos PSDS, Henrique-Silva F, Magalhães AC, Buzalaf MAR. Effect of experimental and commercial artificial saliva formulations on the activity and viability of microcosm biofilm and on enamel demineralization for irradiated patients with head and neck cancer (HNC). BIOFOULING 2022; 38:674-686. [PMID: 36154759 DOI: 10.1080/08927014.2022.2111258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 06/14/2022] [Accepted: 08/02/2022] [Indexed: 06/16/2023]
Abstract
The effect of different artificial saliva formulations on biofilm activity and viability, and on enamel demineralization for head and neck cancer (HNC) patients was evaluated. Irradiated enamel samples were treated (1 min) with BioXtra® or with experimental formulations containing carboxymethylcellulose plus inorganic constituents alone (AS) or containing 0.1 mg mL-1 CaneCPI-5 (AS + Cane), 1.0 mg mL-1 hemoglobin (AS + Hb) or combination of both (AS + Cane + Hb). Phosphate-buffered-saline and chlorhexidine (0.12%) were negative and positive control, respectively. Biofilm was produced from the saliva of five male HNC patients, under 0.2% sucrose exposure for 5 days, and daily treated with the formulations (1 min). No significant effects were observed for the different experimental treatments. BioXtra® significantly reduced lactobacilli, demonstrating antibacterial potential for this group. Chlorhexidine was an effective treatment to significantly reduce all parameters, being an important antimicrobial and anticaries agent. Future in vitro studies must be performed using a new approach for the design of the experimental formulations.
Collapse
Affiliation(s)
- Natara Dias Gomes da Silva
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Pedro Renato Bodo de Paiva
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | | | - Aline Silva Braga
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Paulo Sérgio da Silva Santos
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Flávio Henrique-Silva
- Department of Genetics and Evolution, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Ana Carolina Magalhães
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | | |
Collapse
|
13
|
Matos LL, Capuzzo RC, Pedruzzi PAG, Farias T, de Farias JWM, Chone CT, Köhler HF, Vartanian JG, Dias FL, Couto EV, Pinto FR, Carvalho AL, Kowalski LP. Sentinel lymph node biopsy for early squamous cell carcinoma of the lip and oral cavity: Real-world experience in Brazil. Head Neck 2022; 44:1604-1615. [PMID: 35427429 DOI: 10.1002/hed.27061] [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: 12/20/2021] [Revised: 03/27/2022] [Accepted: 04/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the accuracy and oncological results of sentinel lymph node biopsy in patients with early lip and oral cavity squamous cell carcinoma (SCC) in a real-world scenario. METHODS Retrospective study including seven Brazilian centers. RESULTS Four-hundred and seven cN0 patients were accrued for 20 years. The rate of occult metastasis was 23.1% and 22 patients (5.4%) had regional failure. We found, for 5 years of follow-up, 85.3% of regional recurrence-free survival; 77.1% of disease-free survival; 73.7% of overall survival; and 86.7% of disease-specific survival. The rate of false-negative cases was 5.4%. CONCLUSION In a real-world scenario, sentinel lymph node biopsy for patients with SCC of the lip and oral cavity proved feasible in different settings and to be oncologically safe, with similar rates of occult lymph node metastasis and false-negative cases, when compared to elective neck dissection, and with similar long-term survival to that reported historically.
Collapse
Affiliation(s)
- Leandro Luongo Matos
- Department of Head and Neck Surgery, Instituto do Cancer do Estado de São Paulo (ICESP), University of São Paulo Medical School, and Faculdade Israelita de Ciências da Saúde Albert Einstein Medical School, São Paulo, Brazil
| | | | | | - Terence Farias
- Instituto Nacional do Câncer (INCA), Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Carlos Takahiro Chone
- Department of Otolaryngology - Head and Neck Surgery, State University of Campinas, São Paulo, Brazil
| | - Hugo Fontan Köhler
- Department of Head and Neck Surgery and Otolaryngology, A C Camargo Cancer Center, São Paulo, Brazil
| | - José Guilherme Vartanian
- Department of Head and Neck Surgery and Otolaryngology, A C Camargo Cancer Center, São Paulo, Brazil
| | - Fernando Luiz Dias
- Head and Neck Surgery Section, Instituto Nacional do Câncer (INCA), Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Eduardo Vieira Couto
- Department of Otolaryngology - Head and Neck Surgery, State University of Campinas, São Paulo, Brazil
| | | | | | - Luiz Paulo Kowalski
- Department of Head and Neck Surgery and Otolaryngology, A C Camargo Cancer Center, São Paulo, Brazil
- Department of Head and Neck Surgery, University of São Paulo Medical School, São Paulo, Brazil
| |
Collapse
|
14
|
Demoralization in oral cancer inpatients and its association with spiritual needs, quality of life, and suicidal ideation: a cross-sectional study. Health Qual Life Outcomes 2022; 20:60. [PMID: 35366908 PMCID: PMC8976948 DOI: 10.1186/s12955-022-01962-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 03/15/2022] [Indexed: 11/17/2022] Open
Abstract
Background Demoralization is a common problem in oral cancer patients owing to the chronic and severe nature of their affliction. However, the association between demoralization and the patient’s spiritual needs, quality of life, and suicidal ideation remains unclear. This study aims to provide insights into possible links between demoralization among oral cancer patients and its effects on the patient’s spiritual needs, quality of life, and suicidal ideation.
Methods We examined 155 Taiwanese oral cancer inpatients in Taichung Veterans General Hospital, Taiwan, using the following three rating scales: (a) Demoralization Scale Mandarin Version (DS-MV), (b) Spiritual Interests Related to Illness Tool, and (c) The Taiwan Chinese versions of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. Suicidal ideation was established if at least one of the two suicide-related items on the DS-MV scale were checked. We divided the participants into high- and low-demoralization groups, per the cutoff score of 30. We then explored group associations with sociodemographic features, quality of life, and spiritual needs. Logistic regression and receiver operating characteristic (ROC) curves were used to determine demoralization and its association between these variables. Results Fifty-five (35.5%) patients were categorized as having high demoralization (DS-MV scale score > 30), with scores for DS-MV for all patients being 27.2 ± 16.8. The rates of suicidal ideation were 29.1% (16/55) in the high-demoralization group and 2% (2/100) in the low-demoralization group, with an odds ratio (95% confidence interval) of 20.10 (4.41–91.55). Logistic regression analysis revealed significant effects of spiritual needs and global health status on the DS-MV scores (p < 0.001). Multivariate analyses further confirmed that only overall quality of life scores < 62.5 and spiritual needs < 3.7 significantly predicted the occurrence of high demoralization. Conclusion High demoralization is associated with low satisfaction with spiritual needs, poor quality of life, and high risk of suicidal ideation. DS-MV may potentially be an effective tool for achieving holistic health care among oral cancer patients.
Collapse
|
15
|
Manduchi B, Che Z, Fitch MI, Ringash J, Howell D, Martino R. Psychometric properties of patient-reported outcome measures for dysphagia in head and neck cancer: a systematic review protocol using COSMIN methodology. Syst Rev 2022; 11:27. [PMID: 35168687 PMCID: PMC8848952 DOI: 10.1186/s13643-022-01903-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 02/07/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Dysphagia (swallowing difficulty) is one of the most common and debilitating sequelae of head and neck cancer (HNC). Patient-reported outcome measures (PROMs) are a fundamental component of dysphagia outcomes evaluation, as they inform treatment consequences that cannot be captured by objective clinician measures. Many PROMs for dysphagia in HNC are available, but their validity is unclear. As a consequence, the selection of the most appropriate PROM for dysphagia in HNC is complex and often based on the clinician's personal preferences, rather than on valid psychometric properties. This protocol describes a systematic review aiming at (1) identifying PROMs specific to dysphagia symptoms, swallowing functional status, swallowing-related health status, and swallowing-related quality of life in HNC, (2) mapping them to our conceptual framework of dysphagia-related PROs, and (3) appraising their psychometric properties using the Consensus Based Standards for the Selection of Health Measurement Instrument (COSMIN) methodology. METHODS Six electronic databases will be searched from inception to December 2020 for all primary studies in any language and design detailing PROM development, reliability, validity, feasibility, interpretability, and/or cross-cultural adaptation. Eligibility criteria will target PROMs for patients with HNC (≥ 90% of the study sample) with ≥ 20% of their items pertaining to swallowing. Two independent raters will screen abstract and full texts and a third rater will resolve discrepancies. Data will be extracted on study, sample and PROM characteristics, and results of psychometric testing. PROMs will be mapped to our conceptual framework. The methodological quality of included PROMs and their psychometric properties will be appraised using the COSMIN risk of bias checklist and evidence will be summarized using a modified Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. DISCUSSION This systematic review will provide a summary of existing dysphagia-related PROMs for people with HNC and a comprehensive account of their psychometric properties. We will provide recommendations on PROMs selection which will aid healthcare professionals to the most appropriate PROM based on its validity, reliability, feasibility, interpretability and suitability for clinical and research settings. Further recommendations will be made on areas of measurement property requiring further testing. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration ID: CRD42021237877.
Collapse
Affiliation(s)
- Beatrice Manduchi
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada. .,Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada. .,The Swallowing Lab, University of Toronto, Toronto, ON, Canada.
| | - Zhiyao Che
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada.,The Swallowing Lab, University of Toronto, Toronto, ON, Canada
| | - Margaret I Fitch
- Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Jolie Ringash
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.,Department of Otolaryngology- Head and Neck Surgery, University of Toronto, Toronto, ON, Canada
| | - Doris Howell
- Princess Margaret Cancer Centre, Toronto, ON, Canada.,University of Toronto, Toronto, ON, Canada
| | - Rosemary Martino
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada.,The Swallowing Lab, University of Toronto, Toronto, ON, Canada.,Department of Otolaryngology- Head and Neck Surgery, University of Toronto, Toronto, ON, Canada.,Krembil Research Institute, University Health Network, Toronto, ON, Canada
| |
Collapse
|
16
|
Noel CW, Keshavarzi S, Forner D, Stephens RF, Watson E, Monteiro E, Hosni A, Hansen A, Goldstein DP, de Almeida JR. Construct Validity of the EuroQoL-5 Dimension and the Health Utilities Index in Head and Neck Cancer. Otolaryngol Head Neck Surg 2021; 166:877-885. [PMID: 34311628 PMCID: PMC9066667 DOI: 10.1177/01945998211030173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objective The objective of this study was to evaluate the construct validity of 2 health utility instruments—the EuroQoL–5 Dimension (EQ-5D) and the Health Utilities Index–Mark 3 (HUI-3)—and to compare them with disease-specific measures in patients with head and neck cancer. Study Design Prospective cross-sectional analysis. Setting Princess Margaret Cancer Centre. Methods Patients were administered the EQ-5D, HUI-3, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and its head and neck cancer module (EORTC QLQ-H&N35), and the University of Washington Quality of Life Questionnaire (UWQoL). Several a priori expected relations were examined. The correlative and discriminative properties of the various instruments were examined. Results A total of 209 patients completed the 4 questionnaires. A significant ceiling effect was observed among EQ-5D responses (23% reported a maximum score of 1). The EQ-5D (rho = 0.79) and HUI-3 (rho = 0.60) had a strong correlation with the social-emotional domain of the UWQoL. The EQ-5D had a moderate correlation with the physical domain of the UWQoL (rho = 0.42), whereas the HUI-3 had a weak correlation (rho = 0.29). The EQ-5D and HUI-3 were able to distinguish among levels of health severity measured on the EORTC QLQ-C30 though not the QLQ-H&N35. Comparatively, the UWQoL was able to distinguish levels of disease severity on the EORTC QLQ-C30 and QLQ-H&N35. Conclusion The results of this study demonstrate that disease-specific domains from head and neck quality-of-life instruments are not strongly correlated with the EQ-5D and HUI-3. Consideration should be put toward development of a disease-specific preference-based measure for health economic evaluation. Level of evidence 4.
Collapse
Affiliation(s)
- Christopher W Noel
- Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre-University Health Network, University of Toronto, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Sareh Keshavarzi
- Department of Biostatistics, University Health Network, Toronto, Canada
| | - David Forner
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Department of Otolaryngology-Head and Neck Surgery, Dalhousie University, Halifax, Canada
| | - Robert F Stephens
- Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre-University Health Network, University of Toronto, Toronto, Canada
| | - Erin Watson
- Department of Dentistry, Princess Margaret Cancer Centre-University Health Network, University of Toronto, Toronto, Canada
| | - Eric Monteiro
- Department of Otolaryngology-Head and Neck Surgery, Sinai Health System, University of Toronto, Toronto, Canada
| | - Ali Hosni
- Department of Radiation Oncology, Princess Margaret Cancer Centre-University Health Network, University of Toronto, Toronto, Canada
| | - Aaron Hansen
- Department of Medical Oncology, Princess Margaret Cancer Centre-University Health Network, University of Toronto, Toronto, Canada
| | - David P Goldstein
- Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre-University Health Network, University of Toronto, Toronto, Canada
| | - John R de Almeida
- Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre-University Health Network, University of Toronto, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| |
Collapse
|
17
|
Matsuda Y, Okui T, Karino M, Aoi N, Okuma S, Hayashida K, Sakamoto T, Kanno T. Postoperative oral dysfunction following oral cancer resection and reconstruction: A preliminary cross-sectional study. Oral Oncol 2021; 121:105468. [PMID: 34314945 DOI: 10.1016/j.oraloncology.2021.105468] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 07/17/2021] [Accepted: 07/20/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Oral cancer treatment reportedly causes decreased oral function, but few studies have examined the effects of oral cancer treatment on oral function in depth. This study aimed to comprehensively evaluate the oral function after treatment and classify the conditions related to oral dysfunction in patients with oral cancer. MATERIALS AND METHODS We recruited participants, collected their background data, and evaluated their oral function from September 2019 to March 2021. Principal component analysis was used to identify the components of oral function measurement and oral health perception. Receiver operating characteristic analysis was performed to investigate the accuracy of oral function measurements in predicting oral intake and nutritional status. RESULTS Fifty patients treated for oral cancer, including 33 (66.0%) males and 17 (34.0%) females, were included. Their median age was 71.0 years (interquartile range: 63.0-76.0). There were significant differences in oral dryness between males and females, occlusal force among different age groups, tongue pressure based on the tumor stage and performance of reconstructive procedures, and masticatory function and Eating Assessment Tool scores based on whether radiotherapy was performed (P < 0.05). The principal component analysis proposed that oral function measurements and subjective oral health perception could be divided into three main components (transport, oral hygiene, and occlusion type), which explain 61.5% of the variance of the phenomenon. CONCLUSION A significant decrease in oral function after oral cancer treatment should be diagnosed as postoperative oral dysfunction. Postoperative oral dysfunction can be classified into three types, each of which may present with different pathologies.
Collapse
Affiliation(s)
- Yuhei Matsuda
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan.
| | - Tatsuo Okui
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Masaaki Karino
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Noriaki Aoi
- Department of Otolaryngology, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Satoe Okuma
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Kenji Hayashida
- Department of Plastic and Reconstructive Surgery, Shimane University Hospital, Izumo, Shimane, Japan
| | - Tatsunori Sakamoto
- Department of Otolaryngology, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Takahiro Kanno
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| |
Collapse
|
18
|
Hoene G, Gruber RM, Leonhard JJ, Wiechens B, Schminke B, Kauffmann P, Schliephake H, Brockmeyer P. Combined quality of life and posttraumatic growth evaluation during follow-up care of patients suffering from oral squamous cell carcinoma. Mol Clin Oncol 2021; 15:189. [PMID: 34349989 PMCID: PMC8327079 DOI: 10.3892/mco.2021.2351] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/11/2021] [Indexed: 11/14/2022] Open
Abstract
Oral cancer therapy is associated with a loss in health-related quality of life (HRQOL) and can also lead to post-traumatic growth (PTG). The current study analyzed the relationship between HRQOL, PTG and influencing clinical factors after treatment. The coherent clinical data of 15 patients were retrospectively analyzed over a 1-year study period. HRQOL and PTG were studied using the University of Washington Quality of Life Version 4 (UW-QOL v4) and Posttraumatic Growth Inventory (PTGI) questionnaires. The results revealed that HRQOL was significantly decreased in a pre- to postoperative manner (P=0.011). Sex demonstrated a nearly significant effect on HRQOL (P=0.058). PTG was experienced the most after surgery, and continuously decreased over the 1-year study period. Patient age had a significant effect on PTG (P=0.040). A significant correlation was also established between HRQOL and PTG (P<0.05). HRQOL and PTG are important influencing factors during postoperative tumor follow-up care and should be simultaneously recorded to address individual patient needs and improve quality of treatment.
Collapse
Affiliation(s)
- Georg Hoene
- Department of Oral and Maxillofacial Surgery, University Medical Center Goettingen, Goettingen D-37575, Germany
| | - Rudolf M Gruber
- Department of Oral and Maxillofacial Surgery, University Medical Center Goettingen, Goettingen D-37575, Germany
| | - Johanna J Leonhard
- Department of Oral and Maxillofacial Surgery, University Medical Center Goettingen, Goettingen D-37575, Germany
| | - Bernhard Wiechens
- Department of Orthodontics, University Medical Center Goettingen, Goettingen D-37575, Germany
| | - Boris Schminke
- Department of Oral and Maxillofacial Surgery, University Medical Center Goettingen, Goettingen D-37575, Germany
| | - Philipp Kauffmann
- Department of Oral and Maxillofacial Surgery, University Medical Center Goettingen, Goettingen D-37575, Germany
| | - Henning Schliephake
- Department of Oral and Maxillofacial Surgery, University Medical Center Goettingen, Goettingen D-37575, Germany
| | - Phillipp Brockmeyer
- Department of Oral and Maxillofacial Surgery, University Medical Center Goettingen, Goettingen D-37575, Germany
| |
Collapse
|
19
|
Iacovelli NA, Ingargiola R, Facchinetti N, Franceschini M, Romanello DA, Bossi P, Bergamini C, Alfieri S, Cavalieri S, Baron G, Aldini G, Locati L, Orlandi E. A Randomized, Double-Blind, Placebo-Controlled, Cross-Over Study to Evaluate the Efficacy of Aqualief TM Mucoadhesive Tablets in Head and Neck Cancer Patients Who Developed Radiation-Induced Xerostomia. Cancers (Basel) 2021; 13:cancers13143456. [PMID: 34298670 PMCID: PMC8303446 DOI: 10.3390/cancers13143456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/03/2021] [Accepted: 07/08/2021] [Indexed: 11/16/2022] Open
Abstract
Xerostomia, the subjective complaint of dry mouth, is caused by therapeutic interventions or diseases. Nowadays, radiotherapy (RT) in patients with head and neck cancer (HNC) stands out as one of the most important causes of xerostomia. Currently available therapies for the treatment of xerostomia are still less than optimal and xerostomia still represents an unmet clinical need. In this article, we present the results of a prospective clinical study with a new product, AqualiefTM, in patients treated with curative RT with or without chemotherapy for HNC. AqualiefTM is based on two main ingredients, carnosine and karkadé, which have acid buffering and antioxidant properties. The study was performed on 30 patients, with 4 of the patients being lost during the study period. Each patient received randomly one of the two treatments, AqualiefTM or placebo, for 8 days. After a 10-day wash-out period, each patient received the other treatment for a further 8 days. The results show that AqualiefTM stimulated salivation in these patients and reduced the pH drop that was observed in an equivalent placebo-treated population of patients. Moreover, no serious, treatment-related adverse events were observed. AqualiefTM has shown positive results, although with limitations due to unsuccessful trial accrual. Therefore, it may be further investigated as a tool for the treatment of RT-related xerostomia.
Collapse
Affiliation(s)
- Nicola Alessandro Iacovelli
- Radiation Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133 Milan, Italy; (R.I.); (N.F.); (M.F.); (D.A.R.); (E.O.)
- Correspondence:
| | - Rossana Ingargiola
- Radiation Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133 Milan, Italy; (R.I.); (N.F.); (M.F.); (D.A.R.); (E.O.)
| | - Nadia Facchinetti
- Radiation Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133 Milan, Italy; (R.I.); (N.F.); (M.F.); (D.A.R.); (E.O.)
| | - Marzia Franceschini
- Radiation Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133 Milan, Italy; (R.I.); (N.F.); (M.F.); (D.A.R.); (E.O.)
| | - Domenico Attilio Romanello
- Radiation Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133 Milan, Italy; (R.I.); (N.F.); (M.F.); (D.A.R.); (E.O.)
| | - Paolo Bossi
- Head and Neck Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133 Milan, Italy; (P.B.); (C.B.); (S.A.); (S.C.); (L.L.)
| | - Cristiana Bergamini
- Head and Neck Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133 Milan, Italy; (P.B.); (C.B.); (S.A.); (S.C.); (L.L.)
| | - Salvatore Alfieri
- Head and Neck Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133 Milan, Italy; (P.B.); (C.B.); (S.A.); (S.C.); (L.L.)
| | - Stefano Cavalieri
- Head and Neck Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133 Milan, Italy; (P.B.); (C.B.); (S.A.); (S.C.); (L.L.)
| | - Giovanna Baron
- Department of Pharmaceutical Sciences (DISFARM), Università degli Studi di Milano, Via Mangiagalli 25, 20133 Milan, Italy; (G.B.); (G.A.)
| | - Giancarlo Aldini
- Department of Pharmaceutical Sciences (DISFARM), Università degli Studi di Milano, Via Mangiagalli 25, 20133 Milan, Italy; (G.B.); (G.A.)
| | - Laura Locati
- Head and Neck Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133 Milan, Italy; (P.B.); (C.B.); (S.A.); (S.C.); (L.L.)
| | - Ester Orlandi
- Radiation Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133 Milan, Italy; (R.I.); (N.F.); (M.F.); (D.A.R.); (E.O.)
- Radiation Oncology Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133 Milan, Italy
| |
Collapse
|
20
|
Nordvik Ø, Heggdal POL, Brännström KJ, Aarstad AK, Aarstad HJ. Importance of personality and coping expectancy on patient-reported hearing disability, quality of life and distress level: a study of patients referred to an audiology service. Health Qual Life Outcomes 2021; 19:168. [PMID: 34158058 PMCID: PMC8220799 DOI: 10.1186/s12955-021-01802-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 06/10/2021] [Indexed: 11/28/2022] Open
Abstract
Purpose According to the World Health Organization (WHO), hearing loss (HL) affects up to 15% of the world’s adult population. Coping and personality are hypothesized to underlie quality of life (QoL) and distress scores. We aimed to study the importance of personality and coping in persons with HL for self-reported hearing disability, QoL, and distress. Methods A cross-sectional survey was carried out, including one hundred and fifty-eight adults seeking hearing aids. Pure-tone average hearing thresholds (PTA) were determined for each ear. A revised version of the Abbreviated Profile of Hearing Aid Benefit (APHAB) served as a measure of self-reported hearing disability. Further, the generic part of the European Organization for Research and Treatment (EORTC) QoL questionnaire and the General Health Questionnaire (GHQ) (distress measure) were answered. Levels of neuroticism and the Theoretically Originated Measure of the Cognitive Activation Theory of Stress (TOMCATS) coping expectancy were determined. Results Hearing disability was determined by PTA (better ear) and level of neuroticism. Distress and QoL were determined by neuroticism and coping. Conclusion More neuroticism was associated with worse outcome for the variables hearing disability, distress, and QoL. Helplessness and hopelessness were associated with worse hearing disability, increased distress, and lowered QoL. Patient reported hearing disability was also associated with PTA (better ear). There is a need to investigate further the associations between hearing disability and QoL to psychosocial parameters.
Collapse
Affiliation(s)
- Øyvind Nordvik
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.,Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway
| | - Peder O Laugen Heggdal
- Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway
| | - K Jonas Brännström
- Department of Clinical Science, Section of Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
| | - Anne Kari Aarstad
- Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway.,Faculty of Health, VID Specialized University, Bergen, Norway
| | - Hans Jørgen Aarstad
- Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway. .,Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway.
| |
Collapse
|
21
|
Ventura TMO, Santos PSS, Ribeiro NR, de Lima Leite A, Taira EA, Dionizio A, Rubira CMF, Buzalaf MAR. Is there difference in the comparative and quantitative salivary proteome between stimulated and unstimulated saliva in head and neck cancer patients treated by radiotherapy? Oral Oncol 2021; 118:105315. [PMID: 33985911 DOI: 10.1016/j.oraloncology.2021.105315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 04/12/2021] [Accepted: 04/20/2021] [Indexed: 12/24/2022]
Abstract
Stimulation of saliva production is an alternative to improve the quality of life of patients treated by radiotherapy. However, there is no information about changes in the salivary proteome of stimulated and unstimulated saliva in these patients. OBJECTIVES Thus, we evaluated the difference in the proteomic profile of stimulated and unstimulated saliva in patients with head and neck cancer (HNC) treated by radiotherapy. METHODS Stimulated and unstimulated saliva were collected from 9 patients with HNC before (BRT), during (DRT; 2-5 weeks) and after (ART; 3-4 months) treatment. Healthy patients paired by age and gender also had their saliva collected (C; control group). The stimulated and unstimulated salivary flow were evaluated (p < 0.05). Salivary proteins were extracted and processed for shotgun proteomic analysis. RESULTS Significant differences were observed between stimulated and unstimulated salivary flows for C and BRT (p greater than 0.001), but not for DRT and ART. Proteins involved with apoptosis, antibacterial and acid-resistance were decreased in stimulated saliva in comparison to unstimulated saliva DRT and ART. Isoforms of keratins were not identified in control and BRT. CONCLUSION there is a marked difference in the protein profile of stimulated and unstimulated salivary flows in HNC patients treated by radiotherapy. In addition, saliva stimulation in patients with HNC decreases important proteins involved with dental protection. The unstimulated salivary flow seems to be the best alternative to search for biomarkers. Our results contribute in an unprecedented way to understand the changes in the salivary proteome of different flows in HNC patients undergoing radiotherapy treatment.
Collapse
Affiliation(s)
- Talita Mendes Oliveira Ventura
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil, Al. Octávio Pinheiro Brisolla, 9-75, Bauru, SP 17012-90, Brazil
| | - Paulo Sérgio Silva Santos
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, SP, Brazil, Al. Octávio Pinheiro Brisolla, 9-75, Bauru, S2P 17012-90, Brazil
| | - Nathalia Regina Ribeiro
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil, Al. Octávio Pinheiro Brisolla, 9-75, Bauru, SP 17012-90, Brazil
| | - Aline de Lima Leite
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil, Al. Octávio Pinheiro Brisolla, 9-75, Bauru, SP 17012-90, Brazil
| | - Even Akemi Taira
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil, Al. Octávio Pinheiro Brisolla, 9-75, Bauru, SP 17012-90, Brazil
| | - Aline Dionizio
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil, Al. Octávio Pinheiro Brisolla, 9-75, Bauru, SP 17012-90, Brazil
| | - Cássia Maria Fischer Rubira
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, SP, Brazil, Al. Octávio Pinheiro Brisolla, 9-75, Bauru, S2P 17012-90, Brazil
| | - Marília Afonso Rabelo Buzalaf
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil, Al. Octávio Pinheiro Brisolla, 9-75, Bauru, SP 17012-90, Brazil.
| |
Collapse
|
22
|
Elumalai T, Mukherji A, Vijayaprabhu N, Periasamy K, Yadala A. The patient-reported outcome measures in oropharyngeal, laryngeal and hypopharyngeal cancer patients treated with Volumetric Modulated Arc based simultaneous integrated boost radiotherapy. Tech Innov Patient Support Radiat Oncol 2021; 18:1-7. [PMID: 33817354 PMCID: PMC8010266 DOI: 10.1016/j.tipsro.2021.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 01/30/2021] [Accepted: 02/12/2021] [Indexed: 11/27/2022] Open
Abstract
The patient-reported outcomes are as vital as the physician documented toxicities. The QOL scores return back to normal in most scales similar to baseline value by 3 months. VMAT based SIB is a feasible and safe strategy in terms of toxicity profile.
Objective To assess the change in the quality of life (QOL) in head and neck cancer patients treated with Simultaneous Integrated Boost (SIB) by Volumetric Modulated Arc Therapy (VMAT) technique. Methods Thirty patients with localised head and neck cancers (Stage II- IVa) were treated with VMAT and SIB technique. The three-dose levels prescribed were 68.2 Gy at 2.2 Gy/fraction, 62 Gy at 2 Gy/fraction and 55.8 Gy at 1.8 Gy/fraction to the high, intermediate and low-risk volumes respectively. Concurrent chemotherapy with cisplatin 100 mg/m2 was administered once in three weeks. Acute toxicities were evaluated and scored according to the RTOG grading system. Quality of life (QOL) was assessed using European Organization of Research and Treatment of Cancer (EORTC) QLQC30 and HN35 questionnaires at baseline and in three instances (immediately, one month and three months after the radiotherapy). Results Out of the total 30, 80% patients had a complete response (CR) at the median follow up of 12 months, while three patients died because of progression, and the remaining 3 had stable disease. All planning objectives were achieved for organs at risk and planning target volume(PTV). There was a statiscally significant(p value < 0.001) reduction in global quality of life scores at the end of treatment when compared to baseline scores, but by three months, there was the return in the QOL scores in most scales similar to the baseline value. Conclusion VMAT based Simultaneous boost radiotherapy is a feasible and safe strategy in terms of toxicity profile with an acceptable transient change in the quality of life and allows a faster return to baseline quality of life.
Collapse
Affiliation(s)
- Thiraviyam Elumalai
- Department of Radiotherapy, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.,Department of Clinical Oncology, The Christie NHS Foundation Trust, UK
| | - Ashutosh Mukherji
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - N Vijayaprabhu
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Kannan Periasamy
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Amdedkar Yadala
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| |
Collapse
|
23
|
Ogino N, Funayama A, Niimi K, Mikami T, Inoue M, Kobayashi T. Evaluation of factors affecting health-related quality of life in patients treated for oral cancer. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2021. [DOI: 10.1016/j.adoms.2021.100057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
24
|
Seferin MR, Pinto FR, Leite AKN, Dedivitis RA, Kulcsar MAV, Cernea CR, Matos LLD. The impact of sentinel lymph node biopsy on the quality of life in patients with oral cavity squamous cell carcinoma. Braz J Otorhinolaryngol 2020; 88:434-438. [PMID: 33422480 PMCID: PMC9422623 DOI: 10.1016/j.bjorl.2020.11.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/09/2020] [Accepted: 11/17/2020] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION Sentinel lymph node biopsy is a proven method for staging the neck in patients with early oral cavity squamous cell carcinoma because it results in less comorbidity than the traditional method of selective neck dissection, with the same oncological results. However, the real effect of that method on the quality of life of such patients remains unknown. OBJECTIVE The present study aimed to evaluate the quality of life of patients with oral cavity squamous cell carcinoma T1/T2N0 submitted to sentinel lymph node biopsy compared to those that received selective neck dissection. METHODS Cross-sectional study including 24 patients, after a 36 month follow-up, 15 of them submitted to the sentinel lymph node biopsy and 9 to selective neck dissection. All patients answered the University of Washington quality of life questionnaire. RESULTS The evaluation of the questionnaires showed a late worsening of the domains appearance (p=0.035) and chewing (p=0.041), as well as a decrease of about 10% of general quality of life (p=0.025) in patients undergoing selective neck dissection in comparison to those undergoing sentinel lymph node biopsy. CONCLUSION Patients with early-stage oral cavity squamous cell carcinoma undergoing sentinel lymph node biopsy presented better late results of general quality of life, mainly regarding appearance and chewing, when compared to patients submitted to selective neck dissection.
Collapse
Affiliation(s)
- Marco Roberto Seferin
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil.
| | - Fábio Roberto Pinto
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| | - Ana Kober Nogueira Leite
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| | - Rogerio Aparecido Dedivitis
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| | | | - Claudio Roberto Cernea
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| | - Leandro Luongo de Matos
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| |
Collapse
|
25
|
van Nieuwenhuizen AJ, Buffart LM, Langendijk JA, Vergeer MR, Voortman J, Leemans CR, Verdonck-de Leeuw IM. Health-related quality of life and overall survival: a prospective study in patients with head and neck cancer treated with radiotherapy. Qual Life Res 2020; 30:1145-1153. [PMID: 33289866 PMCID: PMC8004520 DOI: 10.1007/s11136-020-02716-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2020] [Indexed: 01/06/2023]
Abstract
Purpose We aimed to examine whether pre-treatment, post-treatment and change in health-related quality of Life (HRQoL) is associated with survival, in patients with head and neck cancer (HNC). Methods We included 948 newly diagnosed HNC patients treated with primary or adjuvant (chemo)radiotherapy with curative intent. The EORTC QLQ-C30 questionnaire was assessed pre-treatment and at 6 weeks, 6 months and 12 months post-treatment. Multivariable Cox regression analyses were performed to examine whether HRQoL at all time points and changes in HRQoL over time were associated with survival, after adjusting for demographic, clinical and lifestyle-related variables. Results Higher HRQoL scores were significantly associated with improved 5-year overall survival at all time points, except for the subscale global QoL at 6 weeks. Changes in HRQoL at 6 weeks post-treatment compared to pre-treatment were not significantly associated with survival. Changes in physical (HR: 0.88 95% CI: 0.82–0.96) and emotional functioning (HR: 0.90 95% CI: 0.85–0.96) from pre-treatment to 6 months post-treatment and changes in global QOL, and physical, emotional, and social functioning from pre-treatment to 12 months post-treatment were significantly associated with survival. Conclusion Higher HRQoL reported pre-treatment and post-treatment (6 weeks, 6 months and 12 months) are significantly associated with improved survival, as well as changes in HRQoL at 6 and 12 months compared to pre-treatment. Our results highlight the value of monitoring HRQoL and to identify those patients that report decreased or deteriorated HRQOL. This may help to further improve cancer care in a timely and efficient manner.
Collapse
Affiliation(s)
- A J van Nieuwenhuizen
- Amsterdam University Medical Centers, Department of Otolaryngology-Head and Neck Surgery, Amsterdam, The Netherlands
| | - L M Buffart
- Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, department of Epidemiology and Biostatistics, Amsterdam Public Health, Amsterdam, The Netherlands.,Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, department of Medical Oncology, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - J A Langendijk
- University Medical Center Groningen, Department of Radiation Oncology, University of Groningen, Groningen, The Netherlands
| | - M R Vergeer
- Amsterdam University Medical Centers, Department of Radiation Oncology, Amsterdam, The Netherlands
| | - J Voortman
- Amsterdam University Medical Centers, Department of Medical Oncology, Amsterdam, The Netherlands
| | - C R Leemans
- Amsterdam University Medical Centers, Department of Otolaryngology-Head and Neck Surgery, Amsterdam, The Netherlands
| | - I M Verdonck-de Leeuw
- Amsterdam University Medical Centers, Department of Otolaryngology-Head and Neck Surgery, Amsterdam, The Netherlands.
| |
Collapse
|
26
|
Traditional Herbal Medicine Mediated Regulations during Head and Neck Carcinogenesis. Biomolecules 2020; 10:biom10091321. [PMID: 32942674 PMCID: PMC7565208 DOI: 10.3390/biom10091321] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/13/2020] [Accepted: 09/14/2020] [Indexed: 01/31/2023] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) is one of the most prevalent neoplasms worldwide. It is well recognized that environmental challenges such as smoking, viral infection and alcohol consumption are key factors underlying HNSCC pathogenesis. Other than major clinical interventions (e.g., surgical resection, chemical and radiotherapy) that have been routinely practiced over years, adjuvant anticancer agents from Traditional Herbal Medicine (THM) are proposed, either alone or together with conventional therapies, to be experimentally effective for improving treatment efficacy in different cancers including HNSCCs. At a cellular and molecular basis, THM extracts could modulate different malignant indices via distinct signaling pathways and provide better control in HNSCC malignancy and its clinical complications such as radiotherapy-induced xerostomia/oral mucositis. In this article, we aim to systemically review the impacts of THM in regulating HNSCC tumorous identities and its potential perspective for clinical use.
Collapse
|
27
|
Hospital Based Quality of Life in Oral Cancer Surgery. Cancers (Basel) 2020; 12:cancers12082152. [PMID: 32759640 PMCID: PMC7464423 DOI: 10.3390/cancers12082152] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 07/27/2020] [Accepted: 07/29/2020] [Indexed: 01/26/2023] Open
Abstract
The diagnosis of cancer and its treatment have an incomparable impact on a patient's life. In the early postoperative stages after the surgical treatment of oral squamous cell carcinoma (OSCC), functions and well-being are limited, which leads to a fundamental decline of the quality of life (QoL). To date, no studies have been performed that focus on the development of special aspects during the time of the in-patient stay of OSCC patients. With the results of this cross-sectional study, we are able to identify those patients who tend to require special support. This cross-sectional study determined the postoperative QoL with a questionnaire (QU) that was handed out twice to OSCC patients after surgery during their inpatient stay. The questions were based on the European Organisation for Research and Treatment of Cancer (EORTC)'s Quality of Life Questionnaire (QLQ)-C30 and QLQ-H&N35. In our study, we found that for postoperative OSCC patients, eating, swallowing and speech were influenced the most. After decannulation, tracheotomy showed no impact on functions. Social contact was impaired at both timepoints. Especially female patients consider themselves to be more impaired on the scale of social contact. QoL should be checked with a standardized QU as an established tool during hospitalization in every oncology department. Only this procedure can pinpoint those patients who have struggles with their surgical outcome and need more assistance.
Collapse
|
28
|
Schorn L, Lommen J, Sproll C, Krüskemper G, Handschel J, Nitschke J, Prokein B, Gellrich NC, Holtmann H. Evaluation of patient specific care needs during treatment for head and neck cancer. Oral Oncol 2020; 110:104898. [PMID: 32674039 DOI: 10.1016/j.oraloncology.2020.104898] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/19/2020] [Accepted: 07/04/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Tumorous diseases of the head and neck region annually occur in more than 550.000 cases worldwide. Little is known about patient specific care needs and potential relationships between non-fulfillment of those following therapeutic and especially surgical treatment of head and neck cancer (HNC). OBJECTIVES This study aimed to evaluate potential correlations between patient specific care needs, regarding physiological rehabilitation, family/social support, economic needs, and their impact on health-related quality of life (HRQoL). METHODS A total of 1359 patients were included in this retrospective analysis. Data derived from the exploratory international multicenter rehabilitation study of the German-Austrian-Swiss Cooperative Group on Tumors of the Maxillofacial Region (DÖSAK), including 43 oral and maxillofacial departments in Germany, Austria, and Switzerland using the Bochum patient questionnaire on rehabilitation and a questionnaire on tumor and treatment related data. RESULTS Results showed a significant correlation of a patient's social bonds and depression, coping with depression, and anxiety. Patients' needs for speech therapy, physiotherapy or respiratory training were hardly ever met and patients had to compensate for financial losses during hospitalization for acute treatment. CONCLUSION In conclusion, this study describes social, physical, and socio-economic care needs. A multidisciplinary approach managing cancer and treatment related side effects is necessary, as well as enhanced awareness of care needs of practitioners during early recovery after surgery.
Collapse
Affiliation(s)
- Lara Schorn
- Department of Oral-, Maxillo- and Plastic Facial Surgery, University Clinic Düsseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany
| | - Julian Lommen
- Department of Oral-, Maxillo- and Plastic Facial Surgery, University Clinic Düsseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany.
| | - Christoph Sproll
- Department of Oral-, Maxillo- and Plastic Facial Surgery, University Clinic Düsseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany
| | - Gertrud Krüskemper
- Department of Medical Psychology, Ruhr University of Bochum, Universitätsstr. 150, Building MA 0/145, 44780 Bochum, Germany
| | - Jörg Handschel
- Department of Oral-, Maxillo- and Plastic Facial Surgery, Kaiserteich Medical Center, Reichstr. 59, 40217 Duesseldorf, Germany; Medical School, Heinrich-Heine-University, Universitätsstr. 1, 40225 Düsseldorf, Germany
| | - Julia Nitschke
- Department of Neurosurgery, University Clinic Düsseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany
| | - Benjamin Prokein
- Department of Oral-, Maxillo- and Plastic Facial Surgery, University Medicine Rostock, Schillingallee 35, 18057 Rostock, Germany
| | - Nils-Claudius Gellrich
- Department for Oral-, Maxillo- and Plastic Facial Surgery, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Henrik Holtmann
- Department of Oral-, Maxillo- and Plastic Facial Surgery, Malteser Clinic St. Johannes, Johannisstraße 21, 47198 Duisburg, Germany
| |
Collapse
|
29
|
Sumita Y, Iwamoto N, Seki M, Yoshida T, Honma R, Iwatake M, Ohba S, Takashi I, Hotokezaka Y, Harada H, Kuroshima S, Nagai K, Asahara T, Atsushi Kawakam I, Asahina I. Phase 1 clinical study of cell therapy with effective-mononuclear cells (E-MNC) for radiogenic xerostomia (first-in-human study) (FIH study on E-MNC therapy for radiogenic xerostomia). Medicine (Baltimore) 2020; 99:e20788. [PMID: 32590759 PMCID: PMC7328916 DOI: 10.1097/md.0000000000020788] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 05/21/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Treatment for most patients with head and neck cancers includes ionizing radiation with or without chemotherapy. This treatment causes irreversible damage to salivary glands in the irradiation field accompanied by a loss of fluid-secreting acinar cells and a considerable decrease of saliva secretion. There is currently no adequate conventional treatment for this condition. In recent years, we developed an effective culture method to enhance the anti-inflammatory and vasculogenic phenotypes of peripheral blood mononuclear cells (PBMNCs), and such effectively conditioned PBMNC (E-MNC) therapy has shown promising improvements to the function of radiation-injured salivary glands in preclinical studies. However, the safety and effect of E-NMC therapy have yet assessed in human. The objective of this ongoing first-in-man study is to assess the safety, tolerability, and in part the efficacy of E-MNC therapy for treating radiation-induced xerostomia. METHODS/DESIGN This phase 1 first-in-man study is an open-label, single-center, two-step dose escalation study. A total of 6 patients, who had no recurrence of head and neck cancer over 5 years following radiation therapy and suffered from radiation-induced xerostomia, will receive a transplantation of E-NMCs derived from autologous PBMNCs to a submandibular gland. The duration of the intervention will be 1 year. To analyze the recovery of salivary secretion, a gum test will be performed. To analyze the recovery of atrophic salivary glands, computed tomography (CT), and magnetic resonance imaging (MRI) of salivary glands will be conducted. The primary endpoint is the safety of the protocol. The secondary endpoints are the changes from baseline in whole saliva secretion and salivary gland atrophy. DISCUSSION This will be the first clinical study of regenerative therapy using E-MNCs for patients with severe radiation-induced xerostomia. The results of this study are expected to contribute to developing the low-invasive cell-based therapy for radiation-induced xerostomia. TRIAL REGISTRATION This study was registered with the Japan Registry of Clinical Trials (http://jrct.niph.go.jp) as jRCTb070190057.
Collapse
Affiliation(s)
| | - Naoki Iwamoto
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | | | - Takako Yoshida
- Basic and Translational Research Center for Hard Tissue Disease
| | - Ryo Honma
- Basic and Translational Research Center for Hard Tissue Disease
- Department of Regenerative Oral Surgery, Unit of Translational Medicine
| | - Mayumi Iwatake
- Basic and Translational Research Center for Hard Tissue Disease
| | - Seigo Ohba
- Department of Regenerative Oral Surgery, Unit of Translational Medicine
| | - I. Takashi
- Department of Regenerative Oral Surgery, Unit of Translational Medicine
| | - Yuka Hotokezaka
- Department of Radiology and Cancer Biology, Nagasaki University Graduate School of Biomedical Sciences
| | | | - Shinichiro Kuroshima
- Department of Applied Prosthodontics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | | | - Takayuki Asahara
- Department of Regenerative Medicine Science, Tokai University School of Medicine, Isehara, Japan
| | - I Atsushi Kawakam
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Izumi Asahina
- Department of Regenerative Oral Surgery, Unit of Translational Medicine
| |
Collapse
|
30
|
Chen R, Gao Y, Qiu X, Hong P, Zhou D, Chen Q. Acupuncture for the treatment of radiation-induced xerostomia among patients with cancer: A protocol for a systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e20658. [PMID: 32541507 PMCID: PMC7302672 DOI: 10.1097/md.0000000000020658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND With the number of cancer patients growing, radiotherapy and chemotherapy have been a necessary treatment. Unfortunately, there are many side effects after radiation and chemotherapy, one of which is xerostomia that always harasses patients. Although there are many ways of treatment of xerostomia, they have many disadvantages. With the rare side effects and the excellent effect, acupuncture has been widely applied to dry mouth after radiotherapy, but it has not been recognized as the standard treatment. Because acupuncture prescription is mostly different and the sample size of studies is small, we need more high-quality meta-analysis to provide relatively reliable evidence for the treatment of radiation-induced xerostomia. The objective of this study is to assess the curative effect of acupuncture treatment of cancer patients after radiotherapy and provide more reliable evidence for acupuncture treatment of xerostomia after radiotherapy for cancer patients. METHODS We will search the following databases: CENTRAL (The Cochrane Central Register of Controlled Trials), MEDLINE, EMBASE, PubMed, CNKI (China National Knowledge Infrastructure), VIP (China Science and Technology Journal Database), Wan Fang Data Knowledge Service Platform. At any rate, 2 review authors will assess all randomized controlled trials (RCTs), seemingly conformance to the inclusion criteria, to confirm qualification, determine the risk of bias and extract data using a running data extraction form. The revolution of disagreements is a discussion. We will use the approach recommended by Cochrane reviews to assess the bias in studies. Risk ratios (RR) and 95% confidence intervals (CIs) will be used to assess the treatment effects of an intervention for dichotomous results. We will use mean differences (MD) and standard deviation (SD) to aggregate the data of every trial for continuous results. The heterogeneity test of Cochran and quantification of the I statistic will be used to assess the variation of treatment effects. Only if there are studies of semblable comparisons reporting the same results, we will conduct a meta-analysis. RESULTS From the study, we will evaluate the efficacy of acupuncture for xerostomia patients who has cancer and been treated by radiation. CONCLUSION The conclusion of this study will be the evidence, which can ensure the efficacy of acupuncture for cancer patients with radiation-evoked xerostomia among and provide guidance for the treatment of xerostomia. INPLASY REGISTRATION NUMBER INPLASY202040211.
Collapse
|
31
|
Mulasi U, Vock DM, Jager-Wittenaar H, Teigen L, Kuchnia AJ, Jha G, Fujioka N, Rudrapatna V, Patel MR, Earthman CP. Nutrition Status and Health-Related Quality of Life Among Outpatients With Advanced Head and Neck Cancer. Nutr Clin Pract 2020; 35:1129-1137. [PMID: 32141121 DOI: 10.1002/ncp.10476] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
This pilot study evaluated nutrition status and health-related quality of life (HRQOL) outcomes among outpatients with head and neck cancer (HNC). Data were collected from 19 patients (18 males, 1 female) during 3 time points: once before chemoradiotherapy (CRT) initiation and 1 and 3 months after CRT. Nutrition status was evaluated using the Scored Patient-Generated Subjective Global Assessment (PG-SGA). Malnutrition was defined as PG-SGA stage B (moderate/suspected malnutrition) or stage C (severely malnourished). HRQOL was assessed through the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and its HNC-specific module (QLQ-H&N35). We found that well-nourished patients reported having fewer issues with pain, fatigue, appetite loss, chewing, sticky saliva, coughing, and social eating than those categorized as malnourished (P < .05). The association between the global quality-of-life score and PG-SGA score was statistically significant but weak in strength (r = -0.37, P = .012). Although PG-SGA identified 70% as either moderately or severely malnourished before treatment initiation, the mean body mass index was in the overweight category (29 ± 5 kg/m2 ). Compared with pretreatment, patients reported more severe problems with chewing, swallowing, sticky saliva, dry mouth, speech, social eating, and taste and smell sensations at 1-month follow-up, although issues with dry mouth persisted 3 months post treatment (P = .003). In conclusion, malnourished patients reported having worse HRQOL symptoms compared with well-nourished patients. Routine nutrition and psychosocial assessment through PG-SGA and EORTC tools might help identify patients in need of nutrition and psychosocial care.
Collapse
Affiliation(s)
- Urvashi Mulasi
- Department of Family & Consumer Sciences (Nutrition and Food/Dietetics), California State University, Sacramento, California, USA
| | - David M Vock
- School of Public Health, Division of Biostatistics, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA
| | - Harriët Jager-Wittenaar
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, the Netherlands.,Department of Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Levi Teigen
- Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA
| | - Adam J Kuchnia
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Gautam Jha
- Division of Hematology, Oncology and Transplantation, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA
| | - Naomi Fujioka
- Division of Hematology, Oncology and Transplantation, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA
| | | | - Manish R Patel
- Division of Hematology, Oncology and Transplantation, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA
| | - Carrie P Earthman
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware, USA
| |
Collapse
|
32
|
Understanding Functional Communication in Head and Neck Cancer Survivors Using a Mixed Methods Design. Cancer Nurs 2020; 42:119-128. [PMID: 29489478 DOI: 10.1097/ncc.0000000000000569] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Functional communication, defined as everyday communication with family and friends, at work, and in the community, is an important but understudied concept in the head and neck cancer (HNC) survivor population. OBJECTIVE The aim of this study was to better understand functional communication by using a mixed methods approach. METHODS Head and neck cancer survivors participated in semistructured interviews and completed self-report questionnaires assessing multiple aspects of well-being and health-related quality of life (HRQOL). These qualitative and quantitative data were collected concurrently, analyzed separately, and then integrated. RESULTS Survivors' perceptions of functional communication ranged from "Communication is good" to "Communication has changed" to "Communication is difficult." Using these qualitative results, survivors were categorized into 3 mutually exclusive groups. Clinically meaningful cut points were exceeded on measures of depressive symptoms (18%), state (40%) and trait (54%) anxiety, and pain (18%). Health-related quality of life scores were moderate to high for the sample as a whole. Statistically significant group differences were found only on the HNC-specific measure of HRQOL. A surprising finding was that the lowest mean score on social function was in the "Communication has changed" group. This group perceived changes in speech and voice that bothered them when communicating in social situations, although their speech was clear to a listener. CONCLUSION An underrecognized subpopulation of HNC survivors may exist, whose day-to-day functional communication has changed in ways that impact their relationships and sense of self. IMPLICATIONS FOR PRACTICE Clinical identification of this subpopulation and provision of appropriate interventions are essential to facilitate optimal HRQOL after HNC treatment.
Collapse
|
33
|
Dawson C, Adams J, Fenlon D. Liminality and head and neck cancer: core concepts and applications for clinical practice. Ecancermedicalscience 2020; 13:986. [PMID: 32010210 PMCID: PMC6974377 DOI: 10.3332/ecancer.2019.986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Indexed: 12/14/2022] Open
Abstract
This article explores the concept of liminality and its potential application to understand the experience of being diagnosed and receiving treatment for head and neck cancer.The article describes how we identified liminality in people who had received surgical treatment of head and neck cancer and why it is important that the clinical team understand and consider liminality in their interventions, to improve outcomes.
Collapse
Affiliation(s)
- Camilla Dawson
- Queen Elizabeth Hospital Birmingham, Birmingham B15 2TH, UK
| | - Jo Adams
- University of Southampton, Southampton B15 2TH, UK
| | | |
Collapse
|
34
|
Rajendra A, Noronha V, Joshi A, Patil VM, Menon N, Prabhash K. Palliative chemotherapy in head and neck cancer: balancing between beneficial and adverse effects. Expert Rev Anticancer Ther 2020; 20:17-29. [PMID: 31899993 DOI: 10.1080/14737140.2020.1708197] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Introduction: Head and neck squamous cell cancer (HNSCC) is the sixth most common cancer in the world. Almost 2/3rds of patients have recurrent or metastatic (R/M) HNSCC. Treatment options for R/M HNSCC have evolved, with relatively little change in survival. Thus, it is imperative that management decisions must balance efficacy with toxicity and emphasize the importance of maintaining the patient's quality of life (QOL).Areas covered: We cover the various chemotherapeutic options available for R/M HNSCC including single agent chemotherapy, platinum-based doublets and triplet options. The role of cetuximab, immunotherapy and oral metronomic chemotherapy (OMCT) is also reviewed. We discuss the management of patients with platinum-refractory disease.Expert opinion: In all patients with R/M HNSCC, we recommend assessment of extent of disease, patient symptomatology, performance status, affordability and availability of logistic and social support. In patients with PD-L1 CPS =/> 20, pembrolizumab is an option. In patients with PD-L1 CPS < 20, pembrolizumab/cisplatin/5FU or cisplatin/5FU/cetuximab (EXTREME) may be considered based on affordability and availability. Options available that have a lower toxicity and can help to maintain the patient's QOL include; single agent chemotherapy, carboplatin/paclitaxel combination chemotherapy, sequential combination chemotherapy followed by cetuximab, replacing 5FU with docetaxel (TPEx regime) and OMCT.
Collapse
Affiliation(s)
- Akhil Rajendra
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Vanita Noronha
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Amit Joshi
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Vijay Maruti Patil
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Nandini Menon
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Kumar Prabhash
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| |
Collapse
|
35
|
Zhou X, Zhang SE, Nueangkhota P, Liang YJ, Su YX, Liao GQ. Assessment of the contralateral facial artery pedicle nasolabial island flap for buccal defect repair. Int J Oral Maxillofac Surg 2019; 49:862-866. [PMID: 31852586 DOI: 10.1016/j.ijom.2019.01.033] [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: 10/09/2018] [Revised: 01/16/2019] [Accepted: 01/29/2019] [Indexed: 11/19/2022]
Abstract
The facial artery pedicle nasolabial island flap (FAPNIF) is widely used for oral and maxillofacial reconstruction. However, its use in reconstruction after malignant tumour resection is limited by the possibility of ipsilateral cervical lymph node metastasis along the facial artery. Through fine dissection, it was found that the contralateral FAPNIF can be used to repair the defect after buccal carcinoma resection. The aim of this study was to evaluate the clinical outcomes of the contralateral FAPNIF for buccal defect repair. From 2013 to 2016, 30 patients underwent the repair of a buccal defect with a contralateral FAPNIF after tumour resection. Clinical outcomes and complications were recorded and quality of life was evaluated preoperatively and at 3, 6, and 12 months postoperative. The flaps survived in all 30 cases. Mean mouth opening was 2.50±0.14cm at 1 month, 3.22±0.25cm at 6 months, and 3.35±0.23cm at 12 months postoperative. With regard to patient quality of life, adverse effects included impaired aesthetics, pain, and difficulty eating; these usually subsided within 1year after surgery. The contralateral FAPNIF is easily harvested and is a safe and effective option for the repair of medium-sized buccal defects after the resection of carcinoma.
Collapse
Affiliation(s)
- X Zhou
- Discipline of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - S-E Zhang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory, Sun Yat-sen University, Guangzhou, China
| | - P Nueangkhota
- Oral and Maxillofacial Surgical Oncology, Oral and Maxillofacial Surgery Unit, Maharat Nakhon Ratchasima Hospital, Thailand
| | - Y-J Liang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory, Sun Yat-sen University, Guangzhou, China
| | - Y-X Su
- Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, the University of Hong Kong, Hong Kong, China
| | - G-Q Liao
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory, Sun Yat-sen University, Guangzhou, China.
| |
Collapse
|
36
|
Maddalo M, Buglione M, Pasinetti N, Triggiani L, Costa L, Magrini SM, Murphy BA. The linguistic validation process of the Vanderbilt Head and Neck Symptom Survey - Italian Version (VHNSS-IT). Radiol Med 2019; 125:228-235. [PMID: 31784925 DOI: 10.1007/s11547-019-01105-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 11/13/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE To linguistically validate the Italian translation of the Vanderbilt Head and Neck Symptom Survey (VHNSS), there is a patient-reported outcome measure to screen for symptoms in the head and neck cancer (HNC) patients population. The goal was to ensure conceptually equivalence with the original version and maintain clarity, ease of use and understanding. METHODS We conducted a multi-step linguistic process (forward translation, backward translation and patient testing) to generate and validate an Italian translation of the VHNSS. RESULTS Two intermediate Italian versions were created: The first Italian version was derived from a reconciliation of the three forward translations, and the second Italian version was derived from changes in the first version after the backward translation step. All investigators involved actively discussed possible solutions to produce a translated instrument that maintained a reading and comprehension level accessible by most respondents, without altering the meaning and content of the original source. During the patient testing step, only two patients reported problems with items comprehension and the rate of comprehension problems per single item was lower than expected. This phase allowed patients to give suggestion in order to make items clearer and easier to understand: 43% of patients proposed a revision of the survey during the face-to-face interview, and most of these suggestions were retained. CONCLUSIONS A valid multi-step process leads to the creation of the final version of the VHNSS-IT, a suitable instrument to screen for symptoms in the Italian HNC patients population and an official measurement tool that can be used in cooperative research group.
Collapse
Affiliation(s)
- Marta Maddalo
- Department of Radiation Oncology, ASST Spedali Civili di Brescia - Brescia University, Piazzale Spedali Civili 1, 25123, Brescia, Italy.
| | - Michela Buglione
- Department of Radiation Oncology, ASST Spedali Civili di Brescia - Brescia University, Piazzale Spedali Civili 1, 25123, Brescia, Italy
| | - Nadia Pasinetti
- Department of Radiation Oncology, Ospedale di Esine - ASL Vallecamonica-Sebino, Esine, Italy
| | - Luca Triggiani
- Department of Radiation Oncology, ASST Spedali Civili di Brescia - Brescia University, Piazzale Spedali Civili 1, 25123, Brescia, Italy
| | - Loredana Costa
- Department of Radiation Oncology, ASST Spedali Civili di Brescia - Brescia University, Piazzale Spedali Civili 1, 25123, Brescia, Italy
| | - Stefano M Magrini
- Department of Radiation Oncology, ASST Spedali Civili di Brescia - Brescia University, Piazzale Spedali Civili 1, 25123, Brescia, Italy
| | - Barbara A Murphy
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| |
Collapse
|
37
|
Karimi AM, Gairola M, Ahlawat P, Tandon S, Pal M, Sachdeva N, Sharief MI, Dobriyal K. Health-related quality of life assessment for head-and-neck cancer patients during and at 3 months after radiotherapy - A prospective, analytical questionnaire-based study. Natl J Maxillofac Surg 2019; 10:134-140. [PMID: 31798246 PMCID: PMC6883888 DOI: 10.4103/njms.njms_92_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 02/18/2019] [Accepted: 03/06/2019] [Indexed: 11/04/2022] Open
Abstract
Introduction Health-related quality of life (HRQoL) is a more specific area of QoL that deals with the evaluation and assessment of the impact of the disease and its treatment-related morbidities on a patient's physical, psychological, and social aspects. The aim of the present study was to assess the HRQoL of patients with head-and-neck cancer (HNCs) during and at 3 months after completion of radiotherapy (RT) by intensity-modulated RT. Materials and Methods This study was a prospective, longitudinal, observational, and self-completed questionnaire-based study that included 120 patients with HNC who underwent intensity-modulated RT. The questionnaire had adequate internal consistency. The questionnaires were given to each patient at the beginning of treatment (pretreatment), weekly visits during the course of RT (at the end of 1st, 2nd, 3rd, 4th, 5th, and 6th week), on the day of completion of RT, and then finally at 3 months after completion of RT. Thus, a total of successive nine time points were assessed. Results and Conclusions One hundred and eleven patients completed the questionnaires at all nine time points. HRQoL usually decreases during treatment and then increases to pretreatment levels by 3 months after treatment. The Quality of Life Questionnaire, Core Module and Quality of Life Questionnaire, Head and Neck Module were found to be both valid and reliable. There was a significant QoL reduction for the patients throughout treatment in relation to functions and symptoms in the treatment of HNC. However, all the functions and most of the symptoms returned to baseline at the 3-month follow-up.
Collapse
Affiliation(s)
| | - Munish Gairola
- Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, New Delhi, India
| | - Parveen Ahlawat
- Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, New Delhi, India
| | - Sarthak Tandon
- Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, New Delhi, India
| | - Manoj Pal
- Department of Medical Oncology, Millennium Cancer Center, Gurugram, Haryana, India
| | - Nishtha Sachdeva
- Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, New Delhi, India
| | - Muhammed Ismail Sharief
- Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, New Delhi, India
| | - Kiran Dobriyal
- Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, New Delhi, India
| |
Collapse
|
38
|
Kainulainen S, Koivusalo AM, Roine RP, Wilkman T, Sintonen H, Törnwall J, Thorén H, Lassus P. Long-term quality of life after surgery of head and neck cancer with microvascular reconstruction: a prospective study with 4.9-years follow-up. Oral Maxillofac Surg 2019; 24:11-17. [PMID: 31691048 PMCID: PMC7010629 DOI: 10.1007/s10006-019-00806-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 09/11/2019] [Indexed: 11/26/2022]
Abstract
Purpose The aim of this study was to evaluate the long-term health-related quality of life (HRQoL) of head and neck cancer patients with microvascular surgery. Surgical treatment causes great changes in patient HRQoL. Studies focusing on long-term HRQoL after microvascular reconstruction for head and neck cancer patients are scarce. Methods We conducted a prospective study of 93 patients with head and neck cancer and microvascular reconstruction in Helsinki University Hospital Finland. HRQoL was measured using the 15D instrument at baseline and after a mean 4.9-years follow up. Results were compared with those of an age-standardized general population. Results Of the 93 patients, 61 (66%) were alive after follow-up; of these, 42 (69%) answered the follow-up questionnaire. The median time between surgery and HRQoL assessment was 4.9 years (range 3.7–7.8 years). The mean 15D score of all patients (n = 42) at the 4.9-years follow up was statistically significantly (p = 0.010) and clinically importantly lower than at baseline. The dimensions of “speech” and “usual activities” were significantly impaired at the end of follow up. There was a significant difference at the 4.9-years follow-up in the mean 15D score between patients and the general population (p = 0.014). After follow up, patients were significantly (p < 0.05) worse off on the dimensions of “speech,” “eating,” and “usual activities.” Conclusions Long-term HRQoL was significantly reduced in the whole patient cohort. Speech and usual activities were the most affected dimensions in head and neck cancer patients with microvascular reconstruction at the end of the 4.9-years follow up.
Collapse
Affiliation(s)
- Satu Kainulainen
- Department of Oral and Maxillofacial Surgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
- Department of Oral and Maxillofacial Surgery, Helsinki University Hospital, P.O. Box 220, FI-00029 HUS, Helsinki, Finland.
| | - A M Koivusalo
- Department of Anesthesia and Intensive Care Unit, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - R P Roine
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
- Group Administration, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - T Wilkman
- Department of Oral and Maxillofacial Surgery, Helsinki University Hospital, P.O. Box 220, FI-00029 HUS, Helsinki, Finland
| | - H Sintonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - J Törnwall
- University of Helsinki, Helsinki, Finland
| | - H Thorén
- Department of Oral and Maxillofacial Diseases, Institute of Dentistry, University of Turku and Turku University Hospital, Turku, Finland
| | - P Lassus
- Department of Plastic Surgery, Helsinki University Hospital, Helsinki, Finland
| |
Collapse
|
39
|
Buccal adhesive chitosan conjugate comprising pilocarpine for xerostomia. Int J Biol Macromol 2019; 135:1043-1051. [PMID: 31158424 DOI: 10.1016/j.ijbiomac.2019.05.219] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 05/27/2019] [Accepted: 05/30/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND Xerostomia is caused by different factors such as side effects of medication, radiotherapy by head and neck cancer as well as Sjögren syndrome. AIM The goal was to synthesize novel preactivated chitosan conjugates and to design adhesive dosage forms comprising sialagogue pilocarpine. METHODS Unmodified chitosan (CH) was covalently linked to sulfhydryl possessing mercaptonicotinic acid (MNA) via amide bond formation. In a second step, preactivation occurred via disulfide bond establishment between sulfhydryl linked chitosan and preactivation ligand MNA. Mucoadhesive and mucoprotective properties were scrutinized on buccal mucosa. Safety assessment was performed on head and neck squamous cells. Histology assay was conducted on buccal tissue. Pilocarpine was scrutinized in terms of controlled release behavior. RESULTS Novel preactivated CH was successfully synthesized and considered as not harmful to the cells at all. Furthermore, mucoadhesion was 1.3-fold improved in the presence of preactivated chitosan as compared to respective unmodified one. Pilocarpine exhibited a 3.1-fold controlled release in presence of novel synthesized chitosan as in comparison to unmodified CH. CONCLUSION The novelty of this promising polymeric carrier lies in the synthesis procedure leading to a pronounced mucoadhesive, mucoprotecting and controlled release encouraging dosage form in the management of xerostomia.
Collapse
|
40
|
Evaluation of the information given to patients undergoing total pharyngolaryngectomy and quality of life: a prospective multicentric study. Eur Arch Otorhinolaryngol 2019; 276:2531-2539. [DOI: 10.1007/s00405-019-05513-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 06/10/2019] [Indexed: 11/26/2022]
|
41
|
Fingerhut PE, DaLomba EJ, Li CY. Responsiveness of Life Participation for Parents (LPP ®): A Tool for Family-Centered Rehabilitation. Phys Occup Ther Pediatr 2019; 39:543-552. [PMID: 31144561 DOI: 10.1080/01942638.2019.1566194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 11/27/2018] [Accepted: 12/23/2018] [Indexed: 10/26/2022]
Abstract
Aims:The Life Participation for Parents (LPP®) is a Quality of Life assessment designed to measure family-centered practice outcomes. Previous studies of the LPP have established its internal consistency (Cronbach's alpha = .85), test-retest reliability (r = .89), construct validity, and concurrent validity. This study examined the responsiveness of the LPP, hypothesizing change scores after 3 months of intervention would exceed that explained by standard error. Methods: Thirty-two parents of children with disabilities completed the LPP to identify family-centered issues. The LPP was completed a second time after 3 months of intervention. Wilcoxon Signed Rank test was used to compare the median differences between two administrations. Minimal clinically important differences (MCID) were calculated for the total and two LPP subscales (efficiency and effectiveness). Cohen's effect size was calculated using the standardized response mean (SRM) to quantify the change. Results: The age range of the parents was 31-50 (72%), including 31 mothers (96.9%). Median differences between the two administrations were significantly different (p < .05). The MCID were 11.34, 9.82, and 4.48; the SRM were 0.42, 0.54, and 0.04, for the LPP total score, efficiency subscale and effectiveness subscale, respectively. Conclusions: The LPP is responsive to detect a change larger than measurement error in parental ability of participating in life occupations while raising a child with disabilities.
Collapse
Affiliation(s)
- Patricia E Fingerhut
- a Department of Occupational Therapy, University of Texas Medical Branch , Galveston , TX , USA
| | - Elaina J DaLomba
- b Department of Occupational Therapy, Samuel Merritt University , Oakland , CA , USA
| | - Chih-Ying Li
- a Department of Occupational Therapy, University of Texas Medical Branch , Galveston , TX , USA
| |
Collapse
|
42
|
Guimarães I, Torrejano G, Aires R, Gonçalves F, Freitas SV, Correia P, Romeiro C, Silvestre I, Bom R, Martins P, Santos AR. Self-evaluation of communication experiences after laryngectomy (SECEL): translation and psychometric properties in European Portuguese. LOGOP PHONIATR VOCO 2019; 45:66-72. [DOI: 10.1080/14015439.2019.1615544] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Isabel Guimarães
- Speech Therapy Department, Alcoitão School of Health Sciences, Clinical and Therapeutics Pharmacological Unit, Faculty of Medicine, Instituto de Medicina Molecular, University of Lisbon, Lisbon, Portugal
| | | | - Raquel Aires
- ENT department, Hospital of Santa Maria, Lisbon, Portugal
| | | | | | - Paula Correia
- ENT department, Hospital Garcia de Orta, Almada, Portugal
| | - Cláudia Romeiro
- ENT department, Hospital of the Divino Espírito Santo, Ponta Delgada, Azores, Portugal
| | - Inês Silvestre
- ENT department, Coimbra University Hospital, Coimbra, Portugal
| | - Rita Bom
- ENT department, Hospital do Espírito Santo de Évora, EPE, Évora, Portugal
| | - Paulo Martins
- ENT department, Hospital of Santa Maria, Lisbon, Portugal
| | - Ana R. Santos
- ENT department, Hospital of Santa Maria, Lisbon, Portugal
| |
Collapse
|
43
|
Association between coffee intake and the risk of oral cavity cancer: a meta-analysis of observational studies. Eur J Cancer Prev 2019; 29:80-88. [PMID: 31021885 DOI: 10.1097/cej.0000000000000515] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The association between coffee intake and the risk of oral cavity cancer has been inconsistent in previous studies. Therefore, we conducted a meta-analysis to summarize the evidence regarding the strength of association between coffee intake and oral cavity cancer. PubMed, Embase, and Cochrane Library were searched to select studies on the relationship between coffee intake and oral cavity cancer conducted up to September 2018. Case-control or cohort studies and those that have reported about the effect estimates with 95% confidence intervals (CIs) of oral cavity cancer according to the different categories of coffee intake were included. The odds ratio (OR) and its corresponding 95% CI were calculated using the random-effects model. Fourteen case-control and five cohort studies that recruited 6456 patients with oral cavity cancer were included in the final quantitative meta-analysis. High versus low coffee intake was associated with a reduced risk of oral cavity cancer (OR: 0.68; 95% CI: 0.56-0.82; P < 0.001) in case-control studies (OR: 0.70; 95% CI: 0.55-0.90; P = 0.006) and cohort studies (OR: 0.65; 95% CI: 0.48-0.87; P = 0.004). Moreover, intermediate coffee intake was significantly associated with a reduced risk of oral cavity cancer (OR: 0.85; 95% CI: 0.77-0.94; P = 0.002), and such associations were mainly observed in case-control studies (OR: 0.86; 95% CI: 0.76-0.98; P = 0.021) but not in cohort studies (OR: 0.83; 95% CI: 0.67-1.02; P = 0.071). High or intermediate coffee intake might have protective effects against oral cavity cancer. However, the underlying mechanisms must be further evaluated in large-scale prospective cohort studies.
Collapse
|
44
|
Badr H, Sobrero M, Chen J, Kotz T, Genden E, Sikora AG, Miles B. Associations between pre-, post-, and peri-operative variables and health resource use following surgery for head and neck cancer. Oral Oncol 2019; 90:102-108. [PMID: 30846167 DOI: 10.1016/j.oraloncology.2019.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 01/31/2019] [Accepted: 02/04/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVE We examined associations between pre-, post-, and peri-operative variables and health resource use in head and neck cancer patients. METHODS Patients (N = 183) who were seen for a pre-surgical consult between January 2012 and December 2014 completed surveys that assessed medical history, a patient-reported outcome measure (PROM) of dysphagia, and quality of life (QOL). After surgery, peri-operative (e.g., tracheostomy, feeding tube) and post-operative (e.g., complications) variables were abstracted from patients' medical records. RESULTS Multivariate regression models using backward elimination showed that pre-surgical University of Washington Quality of Life (UW-QOL) Inventory and M.D. Anderson Dysphagia Inventory (MDADI) composite scores, documented surgical complications, and having a tracheostomy, were all significant predictors of hospital length of stay, explaining 57% of the total variance (F(5, 160) = 18.71, p < .001). Male gender, psychiatric history, and lower pre-surgical MDADI scores significantly predicted thirty-day unplanned readmissions (30dUR). Pre-surgical MDADI composite scores also significantly predicted emergencey department (ED) visits within 30 days of initial hospital discharge (p = .02). CONCLUSIONS Assessment of PROMs and QOL in the pre-surgical setting may assist providers in identifying patients at risk for prolonged LOS and increased health resource use after hospital discharge.
Collapse
Affiliation(s)
- Hoda Badr
- Department of Medicine, Section of Health Services Research, Baylor College of Medicine, Houston, TX, USA.
| | | | - Joshua Chen
- Department of Medicine, Section of Health Services Research, Baylor College of Medicine, Houston, TX, USA; Department of Psychology, University of St Thomas, Houston, TX, USA
| | - Tamar Kotz
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Eric Genden
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Andrew G Sikora
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Brett Miles
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| |
Collapse
|
45
|
Pateman KA, Weerakoon AT, Batstone MD, Ford PJ. A culture shock in dental hygiene: Exploring the management of oral health after head and neck cancer. Int J Dent Hyg 2018; 17:183-191. [PMID: 30506841 DOI: 10.1111/idh.12376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 11/02/2018] [Accepted: 11/27/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Managing oral health after the treatment for head and neck cancer requires meticulous daily oral hygiene practices and regular professional dental care; however, the individual factors and health system structures required to achieve oral health are often not well considered. This study aimed to explore how oral health was understood and managed after head and neck cancer treatment and identify factors that influenced oral health behaviours and dental service utilization. METHODS A qualitative, inductive approach was used for data collection and analysis. Sampling of participants was purposive, using a maximum variation approach, and data were analysed using thematic analysis. Participants were recruited from the maxillofacial clinic at a tertiary facility in Brisbane, Queensland, Australia. RESULTS Twenty-one participants took part in the study. Findings described individual and structural factors that influenced the management of oral health post-treatment. Individual determinants of oral health behaviours included a cognitive shift towards lifelong oral health; management of unexpected barriers; and management of competing priorities. Structural factors included availability, accessibility of services, and continuity of care. The ability to fund oral health emerged as a salient theme that influenced both individual and structural factors. CONCLUSIONS Strong self-efficacy and financial and spousal support enhanced the management of oral health, whereas difficulty managing competing issues post-treatment, such as psychological and financial stress, limited participants' capacity to prioritize and manage oral health. Policy initiatives are needed to address the structural barriers caused by a lack of timely access to general and preventive dental care post-treatment.
Collapse
Affiliation(s)
- Kelsey A Pateman
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Arosha T Weerakoon
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Martin D Batstone
- Royal Brisbane and Women's Hospital, Herston, Brisbane, Queensland, Australia.,School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Pauline J Ford
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
46
|
Mobadder ME, Farhat F, Mobadder WE, Nammour S. Photobiomodulation Therapy in the Treatment of Oral Mucositis, Dysgeusia and Oral Dryness as Side-Effects of Head and Neck Radiotherapy in a Cancer Patient: A Case Report. Dent J (Basel) 2018; 6:dj6040064. [PMID: 30423851 PMCID: PMC6313426 DOI: 10.3390/dj6040064] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 11/05/2018] [Accepted: 11/07/2018] [Indexed: 01/04/2023] Open
Abstract
Successful management of oral mucositis, dysgeusia and oral dryness was made with five sessions of photobiomodulation. The severity of oral mucositis was measured according to the World Health Organization scale for the assessment of oral mucositis. Dysgeusia testing was performed according to the International Standards Organization (ISO). For the assessment of oral dryness or hyposalivation, quantity of the total resting and stimulated saliva (Q-sal, mL/min) was measured. Photobiomodulation parameters, applications, and treatment protocol used were suggested by an international multidisciplinary panel of clinicians and researchers with expertise in the area of supportive care in cancer and/or PBM clinical application and dosimetry. This case report confirms the effectiveness of photobiomodulation therapy in the management of oral mucositis, dysgeusia, and oral dryness.
Collapse
Affiliation(s)
- Marwan El Mobadder
- Department of Dental Science, Faculty of Medicine, University of Liège, 4000Liège, Belgium.
| | - Fadi Farhat
- Department of Hematology and Oncology, Hammoud Hospital University Medical Centre,652Saida, Lebanon.
| | - Wassim El Mobadder
- Department of Endodontics, Faculty of dental medicine, University Saint Joseph, Beirut 1107 2050, Lebanon.
| | - Samir Nammour
- Department of Dental Science, Faculty of Medicine, University of Liège, 4000Liège, Belgium.
| |
Collapse
|
47
|
Aoki T, Ota Y, Sasaki M, Aoyama KI, Akiba T, Shirasugi Y, Naito M, Shiroiwa T. To what extent does the EQ-5D-3L correlate with the FACT-H&N of patients with oral cancer during the perioperative period? Int J Clin Oncol 2018; 24:350-358. [DOI: 10.1007/s10147-018-1364-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 10/29/2018] [Indexed: 12/19/2022]
|
48
|
Palin CL, Huryn JM, Golden M, Booth PR, Randazzo JD. Three-dimensional printed definitive cast for a silicone obturator prosthesis: A clinical report. J Prosthet Dent 2018; 121:353-357. [PMID: 30392749 DOI: 10.1016/j.prosdent.2018.04.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 04/15/2018] [Accepted: 04/16/2018] [Indexed: 11/29/2022]
Abstract
For patients with head and neck cancer requiring a maxillectomy, obturator prostheses help with quality of life. These patients routinely require adjuvant oncologic treatments with significant adverse effects. Treatment sequelae can leave patients with difficulty speaking and swallowing, reduced salivary function, reduction in maximal incisal opening, and at risk of osteoradionecrosis. A 55-year-old African-American woman presented with significant trismus and reduction in maximal incisal opening after treatment for squamous cell carcinoma of the left maxillary sinus. She had received a left total maxillectomy with adjuvant chemotherapy and radiation treatments. With her reduced opening, she was no longer able to insert her interim obturator prosthesis, which caused difficulty speaking and nasal regurgitation. A cone beam computed tomography scan was made of the patient's maxillectomy defect. From the Digital Imaging and Communications in Medicine file, a definitive cast was 3-dimensionally printed to fabricate a flexible silicone obturator prosthesis. This treatment has allowed the patient to return to a functional quality of life and could help other patients in similar situations.
Collapse
Affiliation(s)
- Charles L Palin
- Maxillofacial Prosthetics Fellow, Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Joseph M Huryn
- Chief, Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Marjorie Golden
- Maxillofacial Prosthetics Technician, Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Paul R Booth
- Supervisor, Biomedical Systems Section, Biomedical Engineering, Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Joseph D Randazzo
- Maxillofacial Prosthetics Director, Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
| |
Collapse
|
49
|
Ong KJ, Checchi M, Burns L, Pavitt C, Postma MJ, Jit M. Systematic review and evidence synthesis of non-cervical human papillomavirus-related disease health system costs and quality of life estimates. Sex Transm Infect 2018; 95:28-35. [PMID: 30674687 DOI: 10.1136/sextrans-2018-053606] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 07/06/2018] [Accepted: 08/07/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Many economic evaluations of human papillomavirus vaccination should ideally consider multiple disease outcomes, including anogenital warts, respiratory papillomatosis and non-cervical cancers (eg, anal, oropharyngeal, penile, vulvar and vaginal cancers). However, published economic evaluations largely relied on estimates from single studies or informal rapid literature reviews. METHODS We conducted a systematic review of articles up to June 2016 to identify costs and utility estimates admissible for an economic evaluation from a single-payer healthcare provider's perspective. Meta-analyses were performed for studies that used same utility elicitation tools for similar diseases. Costs were adjusted to 2016/2017 US$. RESULTS Sixty-one papers (35 costs; 24 utilities; 2 costs and utilities) were selected from 10 742 initial records. Cost per case ranges were US$124-US$883 (anogenital warts), US$6912-US$52 579 (head and neck cancers), US$12 936-US$51 571 (anal cancer), US$17 524-34 258 (vaginal cancer), US$14 686-US$28 502 (vulvar cancer) and US$9975-US$27 629 (penile cancer). The total cost for 14 adult patients with recurrent respiratory papillomatosis was US$137 601 (one paper).Utility per warts episode ranged from 0.651 to 1 (12 papers, various utility elicitation methods), with pooled mean EQ-5D and EQ-VAS of 0.86 (95% CI 0.85 to 0.87) and 0.74 (95% CI 0.74 to 0.75), respectively. Fifteen papers reported utilities in head and neck cancers with range 0.29 (95% CI 0.0 to 0.76) to 0.94 (95% CI 0.3 to 1.0). Mean utility reported ranged from 0.5 (95% CI 0.4 to 0.61) to 0.65 (95% CI 0.45 to 0.75) (anal cancer), 0.59 (95% CI 0.54 to 0.64) (vaginal cancer), 0.65 (95% CI 0.60 to 0.70) (vulvar cancer) and 0.79 (95% CI 0.74 to 0.84) (penile cancer). CONCLUSIONS Differences in values reported from each paper reflect variations in cancer site, disease stages, study population, treatment modality/setting and utility elicitation methods used. As patient management changes over time, corresponding effects on both costs and utility need to be considered to ensure health economic assumptions are up-to-date and closely reflect the case mix of patients.
Collapse
Affiliation(s)
- Koh Jun Ong
- National Infection Service, Public Health England, London, UK
| | - Marta Checchi
- National Infection Service, Public Health England, London, UK
| | - Lorna Burns
- Faculty of Medicine and Dentistry, University of Plymouth, Devon, UK
| | | | - Maarten J Postma
- Department of Pharmacy, University of Groningen, Groningen, The Netherlands.,Department of Health Sciences, University Medical Center Groningen, Groningen, The Netherlands.,Department of Economics, Econometrics & Finance, University of Groningen, Groningen, The Netherlands
| | - Mark Jit
- National Infection Service, Public Health England, London, UK .,Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
50
|
Correlation between Psychosocial Distress and Quality of Life in Patients with Nasopharyngeal Carcinoma following Radiotherapy. JOURNAL OF ONCOLOGY 2018; 2018:3625302. [PMID: 30174692 PMCID: PMC6106906 DOI: 10.1155/2018/3625302] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 05/15/2018] [Accepted: 06/27/2018] [Indexed: 11/23/2022]
Abstract
The aim of this study was to investigate the relationship between psychosocial distress and quality of life (QOL) in patients with nasopharyngeal carcinoma (NPC) after radiotherapy. Fifty-three patients with an initial diagnosis of NPC were enrolled in this study. The psychological Distress Thermometer (DT) and Functional Assessment of Cancer Therapy-Head & Neck (FACT-H&N) were conducted before and after radiotherapy in NPC patients. We compared the differences in psychological distress and QOL before and after radiotherapy and analyzed the correlation between psychological distress and QOL after radiotherapy. The performance on the DT was 6.60 ± 1.42 and 2.81 ± 1.43 before and after chemotherapy, respectively, with a significant difference between the time points (t = -13.73, P < 0.01). The performance on the FACT-H&N was 68.30 ± 6.14 and 39.84 ± 6.14 before and after chemotherapy, respectively, with a significant difference between the time points (t = -19.9, P< 0.01). There was a significant negative correlation between the DT score and the FACT-H&N score (r = -3.64, P< 0.01). Patients with NPC experience different degrees of psychological distress, an important factor that affects quality of life, after radiotherapy.
Collapse
|