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Unmet needs, quality of life and psychological distress: insights regarding head and neck cancer patients in a rural setting. J Laryngol Otol 2023; 137:89-95. [PMID: 36128616 DOI: 10.1017/s0022215121001699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE This study aimed to evaluate the perceived quality of life, unmet needs and psychological distress in patients with head and neck cancer in a rural setting in New Zealand. METHOD Patients presenting with head and neck cancer in Northland, New Zealand, were asked to complete questionnaires on quality of life, unmet needs, and anxiety or depression together with a free-text option. RESULTS About one quarter of respondents (27 per cent) scored high in the anxiety and depression scale, with corresponding diminished quality of life scores and increased needs. Over half of respondents (54 per cent) found it challenging to travel for treatment. Financial difficulties were encountered more frequently with indigenous patients. Rurality alone does not lead to significant differences in quality of life or needs. CONCLUSION After treatment for head and neck cancer, it is important to monitor and manage patients' psychological distress and ease of access to health services to improve quality of life.
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Getting back on track: a group psychoeducational intervention for patients and families living with head and neck cancer. Support Care Cancer 2022; 30:3259-3268. [PMID: 34984551 DOI: 10.1007/s00520-021-06771-z] [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: 06/29/2021] [Accepted: 12/14/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Head and neck cancer survivors are increasing in prevalence, and 60-70% still experience at least one unmet emotional and/or physical need after treatment has ended. The purpose of this study was to determine the efficacy of a brief post-treatment psychoeducational intervention on perceived preparedness for coping with recovery using post-session evaluations. METHODS Between August 2013 and May 2018, a two-session, multidisciplinary "getting back on track" class was delivered to head and neck cancer patients approximately 2 months following radiation treatment at Princess Margaret Cancer Centre in Toronto, Canada. Three hundred and fifty attendees completed evaluations. Statistical analyses of the 310 patients surveyed measured change in level of preparedness to cope with recovery using the b-prepared scale. Qualitative analyses provided insight into potential benefits for future patients. RESULTS Almost two-thirds (58%) of patients reported an increase in level of preparedness in post-intervention surveys. Comparing self-reported level of preparedness among patients from before to after the class showed an increase in feeling prepared from 50 to 58%, and of those feeling very prepared, from 6 to 34%. The proportion of patients who reported feeling unprepared (11%) or neutral (33%) before the class decreased post-intervention, with 0% feeling unprepared and 7% feeling neutral. There were statistically significant differences in the ideal timing of the class, but overall attendees agreed that the class is an essential part of their recovery. CONCLUSION Results confirm the efficacy of this brief psychoeducational intervention to improve preparedness in head and neck cancer survivors following radiation treatment.
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Chambergo-Michilot D, Corcuera-Ciudad R, Runzer-Colmenares FM, Navarrete-Reyes AP, Parodi JF. Pain management, activities of daily living and the assessment of the WHOQOL-OLD module: results of a cross-sectional analysis of a cohort of older men with oncological diagnoses. JOURNAL OF GERONTOLOGY AND GERIATRICS 2022. [DOI: 10.36150/2499-6564-n395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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4
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Ronen O, Robbins KT, de Bree R, Guntinas-Lichius O, Hartl DM, Homma A, Khafif A, Kowalski LP, López F, Mäkitie AA, Ng WT, Rinaldo A, Rodrigo JP, Sanabria A, Ferlito A. Standardization for oncologic head and neck surgery. Eur Arch Otorhinolaryngol 2021; 278:4663-4669. [PMID: 33982178 DOI: 10.1007/s00405-021-06867-6] [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: 03/15/2021] [Accepted: 05/03/2021] [Indexed: 12/01/2022]
Abstract
The inherent variability in performing specific surgical procedures for head and neck cancer remains a barrier for accurately assessing treatment outcomes, particularly in clinical trials. While non-surgical modalities for cancer therapeutics have evolved to become far more uniform, there remains the challenge to standardize surgery. The purpose of this review is to identify the barriers in achieving uniformity and to highlight efforts by surgical groups to standardize selected operations and nomenclature. While further improvements in standardization will remain a challenge, we must encourage surgical groups to focus on strategies that provide such a level.
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Affiliation(s)
- Ohad Ronen
- Department of Otolaryngology-Head and Neck Surgery, Galilee Medical Center, Affiliated with Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.
| | - K Thomas Robbins
- Department of Otolaryngology Head and Neck Surgery, Southern Illinois University Medical School, Springfield, IL, USA
| | - Remco de Bree
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Orlando Guntinas-Lichius
- Department of Otorhinolaryngology, Institute of Phoniatry/Pedaudiology, Jena University Hospital, Jena, Germany
| | - Dana M Hartl
- Head and Neck Oncology Service, Gustave Roussy, Villejuif, France
| | - Akihiro Homma
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Avi Khafif
- Head and Neck Surgery and Oncology Unit, A.R.M. Center for Advanced Otolaryngology Head and Neck Surgery, Assuta Medical Center, Tel Aviv, Israel
| | - Luiz P Kowalski
- Department of Otorhinolaryngology-Head and Neck Surgery, A.C. Camargo Cancer Center, São Paulo, Brazil.,Department of Head and Neck Surgery, University of São Paulo Medical School, São Paulo, Brazil
| | - Fernando López
- Department of Otolaryngology, Hospital Universitario Central de Asturias-ISPA, Oviedo, Spain.,University of Oviedo-IUOPA, Oviedo, Spain.,Head and Neck Cancer Unit, CIBERONC, Madrid, Spain
| | - Antti A Mäkitie
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Wai Tong Ng
- Department of Clinical Oncology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | | | - Juan P Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias-ISPA, Oviedo, Spain.,University of Oviedo-IUOPA, Oviedo, Spain.,Head and Neck Cancer Unit, CIBERONC, Madrid, Spain
| | - Alvaro Sanabria
- Department of Surgery, School of Medicine, Universidad de Antioquia/Hospital Universitario San Vicente Fundación, Medellín, Colombia.,CEXCA Centro de Excelencia en Enfermedades de Cabeza Y Cuello, Medellín, Colombia
| | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group, Padua, Italy
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5
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Crowder SL, Najam N, Sarma KP, Fiese BH, Arthur AE. Quality of life, coping strategies, and supportive care needs in head and neck cancer survivors: a qualitative study. Support Care Cancer 2021; 29:4349-4356. [PMID: 33415365 DOI: 10.1007/s00520-020-05981-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 12/29/2020] [Indexed: 01/24/2023]
Abstract
PURPOSE The purpose of this qualitative study was to better understand the lived experience of head and neck cancer (HNC) survivors between 6 months to 9 years post-radiation. Quality of life, coping strategies, concerns for the future, and preferences for supportive care were explored. METHODS Semi-structured interviews were conducted in 31 HNC survivors from a Midwestern hospital. Interviews were recorded, transcribed verbatim and analyzed using qualitative thematic analysis. RESULTS Survivors described restrictions on daily living, social eating, and financial concerns. Despite these restrictions, survivors reported an overall high mentality and enjoyment of life. Coping considerations included adapting to a new normal and increased involvement in cancer support and faith groups. Preferences for supportive care included receiving more information about and being more involved in the treatment care plan, referrals to therapy and support groups, and more comprehensive follow-up in survivorship. CONCLUSIONS While long-term HNC survivors adapt to daily living restrictions, a high proportion continue to have unmet needs. This data can guide the development of HNC survivorship interventions to inform optimal clinical guidelines based on patients' perceived needs. This qualitative study uncovered distinct perceived needs of HNC survivors which can inform future service development. Incorporating referrals to supportive care services including speech language pathologist, physical therapists, and dietitians into the standard of care before, during, and after treatment would assist survivors in adapting to life after treatment and managing long-term health consequences of their disease.
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Affiliation(s)
- Sylvia L Crowder
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, 386 Bevier Hall 905 S Goodwin Ave, Urbana, IL, 61801, USA.,Department of Health Outcomes and Behavior, Moffitt Cancer Center, 4117 E Fowler Ave., Tampa, FL, 33617, USA
| | - Natasha Najam
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, 386 Bevier Hall 905 S Goodwin Ave, Urbana, IL, 61801, USA
| | - Kalika P Sarma
- Carle Cancer Center, Carle Foundation Hospital, 602 W University Ave., Urbana, IL, 61801, USA
| | - Barbara H Fiese
- Family Resiliency Center and Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign, 1016B Doris Kelley Christopher Hall. 904 West Nevada Street., Urbana, IL, 61801, USA
| | - Anna E Arthur
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, 386 Bevier Hall 905 S Goodwin Ave, Urbana, IL, 61801, USA.
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6
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Rangabashyam MS, Lee SY, Tan SY, Mueller S, Sultana R, Ho J, Skanthakumar T, Tan NC, Tan HK, Soo KC, Iyer NG. Adherence of head and neck squamous cell carcinoma patients to tumor board recommendations. Cancer Med 2020; 9:5124-5133. [PMID: 32472749 PMCID: PMC7367636 DOI: 10.1002/cam4.3097] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 04/15/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Multidisciplinary team (MDT) meetings or tumor boards (TBs) are fundamental components of cancer treatment. Although their primary function is improved outcomes, this aspect is often underreported. The main objective of this study was to analyze the outcomes of patients with head and neck squamous cell carcinoma (HNSCC) discussed at TBs, and to compare the effect of adherence and nonadherence to recommended treatment plans on outcomes. METHODS Retrospective data analysis was conducted of HNSCC patients those who were adherent and nonadherent to TB therapy recommendations during 2008-2009 at a comprehensive cancer center. Fisher's exact test and t test were used for group-wise comparison, and Kaplan-Meier and logistic regression models, for survival analysis and determination of the contributing factors to nonadherence. RESULTS Comprehensive Treatment plans were recommended by TBs in 293 HNSCC patients with curative intent. Seventy-two patients were excluded based on the selection criteria. Among the remaining 221 patients, 172 (77.9%) were adherent to TB recommendations, while 49 (22.1%) failed to comply. Patient (n = 36; 73.5%), clinician (n = 2; 4.1%), and disease-related (n = 11; 22.4%) factors were significant contributors to nonadherence. Mean (±standard deviation (SD)) survival time was 55.6 ± 2.32 and 29.1 ± 4 months in the adherent and nonadherent groups, (P < .0001, respectively). Multivariate analyses showed that gender, ethnicity, higher T-stage, and multimodal treatment were associated with nonadherence. CONCLUSION Adherence to TB recommendations improved overall survival, reflecting the importance of interdisciplinary expertise in contemporary cancer treatment. Early identification and intervention is crucial in "at risk" patients to prevent subsequent drop-out from optimal cancer care.
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Affiliation(s)
- Mahalakshmi S Rangabashyam
- Department of Head & Neck Surgery, National Cancer Centre Singapore, Singapore.,SingHealth Duke-NUS Head and Neck Centre, Singapore
| | - Shi Yan Lee
- Department of Head & Neck Surgery, National Cancer Centre Singapore, Singapore
| | - Sher Yin Tan
- Department of Head & Neck Surgery, National Cancer Centre Singapore, Singapore
| | - Stefan Mueller
- Department of Head & Neck Surgery, National Cancer Centre Singapore, Singapore
| | - Rehena Sultana
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore
| | - Johnatton Ho
- Department of Head & Neck Surgery, National Cancer Centre Singapore, Singapore
| | | | - Ngian Chye Tan
- Department of Head & Neck Surgery, National Cancer Centre Singapore, Singapore.,SingHealth Duke-NUS Head and Neck Centre, Singapore.,Duke-NUS Medical School, Singapore
| | - Hiang Khoon Tan
- Department of Head & Neck Surgery, National Cancer Centre Singapore, Singapore.,SingHealth Duke-NUS Head and Neck Centre, Singapore.,Duke-NUS Medical School, Singapore
| | - Khee Chee Soo
- Department of Head & Neck Surgery, National Cancer Centre Singapore, Singapore.,Duke-NUS Medical School, Singapore
| | - N Gopalakrishna Iyer
- Department of Head & Neck Surgery, National Cancer Centre Singapore, Singapore.,SingHealth Duke-NUS Head and Neck Centre, Singapore.,Duke-NUS Medical School, Singapore
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Calver L, Tickle A, Moghaddam N, Biswas S. The effect of psychological interventions on quality of life in patients with head and neck cancer: A systematic review and meta-analysis. Eur J Cancer Care (Engl) 2017; 27. [PMID: 29094780 DOI: 10.1111/ecc.12789] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2017] [Indexed: 12/01/2022]
Abstract
This systematic review and meta-analysis aimed to evaluate the effectiveness of psychological interventions in improving quality of life for head and neck cancer patients. Five databases were systematically searched in July 2016. Studies were included if they reported original empirical data from intervention studies utilising psychological approaches (excluding psychoeducational-only interventions) and provided data on quality of life outcomes. Six studies, involving 185 participants, fulfilled eligibility criteria. Study designs included a case study, single-group designs, non-randomised controlled trials and one randomised controlled trial. Meta-analysis of two studies did not provide support for the effectiveness of psychological intervention improving total quality of life scores (or subscales) compared to control groups at end of intervention. Intervention studies evaluating psychological interventions for patients with head and neck cancer have produced insufficient data to support their effectiveness for improving quality of life. This review further highlights the limited evidence base within this area. Existing studies are based on small samples and are inconsistent regarding: intervention type, duration and intensity; follow-up measurement periods; and methodological quality. Further research, addressing these limitations, is required for more definitive conclusions to be drawn about the effectiveness of psychological interventions with this population.
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Affiliation(s)
- L Calver
- Division of Psychiatry & Applied Psychology, University of Nottingham, Nottingham, UK
| | - A Tickle
- Division of Psychiatry & Applied Psychology, University of Nottingham, Nottingham, UK
| | - N Moghaddam
- Trent DClinPsy Programme, University of Lincoln, Lincoln, UK
| | - S Biswas
- King's Mill Hospital, Nottinghamshire Healthcare NHS Foundation Trust, Sutton-in-Ashfield, UK
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8
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Partner's survivorship care needs: An analysis in head and neck cancer patients. Oral Oncol 2017; 71:113-121. [PMID: 28688678 DOI: 10.1016/j.oraloncology.2017.06.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 06/05/2017] [Accepted: 06/15/2017] [Indexed: 11/22/2022]
Abstract
PURPOSE To determine the number, type and predictors of unmet needs for head and neck cancer (HNC) survivors' partner's. METHODS Partners of HNC patients were invited to complete the Cancer Survivors' Partners Unmet Needs Survey (CaSPUN). Analysis determined number, proportion and factors associated with greater unmet needs using linear regression. Agreement between the unmet needs of patients and their partners was determined. RESULTS Among the 44 partners participated 29 reported ≥1 unmet need and 4 had a very high number of needs (31-35). The most common unmet needs were related to concerns about cancer returning, coping with supporting someone with cancer, and the changes cancer has caused. The highest reported needs were in the Relationships domain. Increasing patient unmet needs was significantly associated with increasing partner unmet needs (p<0.01). CONCLUSIONS A significant proportion of head and neck cancer partners experience unmet needs, which often differ from the patient's needs.
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9
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Heineman T, St John MA, Wein RO, Weber RS. It Takes a Village: The Importance of Multidisciplinary Care. Otolaryngol Clin North Am 2017; 50:679-687. [PMID: 28606602 DOI: 10.1016/j.otc.2017.03.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
This article explores the evolving world of cancer care that requires increasing collaboration and is focused on value, quality, and efficiency, while placing the utmost importance on patient autonomy and individualized care plans. The expanding membership of the multidisciplinary team and the role of integrated patient care units are reviewed in the context of care for the patient with head and neck cancer.
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Affiliation(s)
- Thomas Heineman
- Department of Otolaryngology-Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
| | - Maie A St John
- UCLA Head and Neck Cancer Program, Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
| | - Richard O Wein
- Department of Otolaryngology-Head and Neck Surgery, Tufts Medical Center, 800 Washington Street, Box 850, Boston, MA 02111, USA.
| | - Randal S Weber
- Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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10
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Giuliani M, McQuestion M, Jones J, Papadakos J, Le LW, Alkazaz N, Cheng T, Waldron J, Catton P, Ringash J. Prevalence and nature of survivorship needs in patients with head and neck cancer. Head Neck 2016; 38:1097-103. [PMID: 26894614 DOI: 10.1002/hed.24411] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 12/08/2015] [Accepted: 12/29/2015] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The purpose of this study was to determine the number, type, and predictors of patients with head and neck cancer unmet survivorship needs. METHODS This study accrued patients with head and neck cancer at any time point in their survivorship course, and they completed a survey, including demographic information and the Cancer Survivors' Unmet Needs Measure (CaSUN). RESULTS The median age of the 158 participants was 64 years. Ninety-six patients (61%) reported at least one unmet need on the CaSUN and 6 patients had a very high number of needs between 31 and 35. The mean number of unmet needs was 5.8 ± 8.9. Comprehensive Cancer Care was the most common domain of unmet need (n = 69; 45%). Younger age, earlier survivorship phase, and worse quality of life were associated with increased survivorship unmet needs on multivariable analysis. CONCLUSION A high proportion of patients with head and neck cancer have unmet needs. These data can guide the development of head and neck survivorship programs. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1097-1103, 2016.
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Affiliation(s)
- Meredith Giuliani
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Maurene McQuestion
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Jennifer Jones
- Cancer Survivorship Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Janet Papadakos
- Patient and Survivorship Education, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Lisa W Le
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Nour Alkazaz
- Cancer Survivorship Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Terry Cheng
- Psychosocial Oncology and Palliative Care, Princess Margaret Cancer Center, Toronto, Ontario, Canada
| | - John Waldron
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Pamela Catton
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Jolie Ringash
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
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11
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Individualised quality of life as a measure to guide treatment choices in squamous cell carcinoma of the head and neck. Oral Oncol 2016; 52:18-23. [DOI: 10.1016/j.oraloncology.2015.10.020] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 10/19/2015] [Accepted: 10/26/2015] [Indexed: 11/30/2022]
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12
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A systematic review of quality of life in head and neck cancer treated with surgery with or without adjuvant treatment. Oral Oncol 2015. [PMID: 26209066 DOI: 10.1016/j.oraloncology.2015.07.002] [Citation(s) in RCA: 114] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Quality of life (QoL) is an important consideration in the management of head and neck cancers (HNC). We systematically reviewed the literature to assess the impact of curative surgical resection (+/- adjuvant therapy) of HNC on QoL. Eligible studies (participants>age 18 years, reported fully in English, and prospectively assessed QoL) were filtered using quality criteria, and classified according to the added value, using a published taxonomy. MEDLINE and EMBASE searching yielded 302 distinct reports, 49 met eligibility, and 26 met quality criteria. Among the eligible studies, achievement of certain quality criteria was poor: a priori hypothesis (8%), statistical accounting of missing data (8%), reporting of assessment interval (35%) and rationale for chosen measure (53%). The most frequent ways QoL added value were: understanding of treatment benefit and risk (100%), comparing treatments for QoL effect (92%) and advancing QoL research methodology (50%). QoL (physical/social functioning and various symptom domains) deteriorated with treatment, gradually recovering to baseline (cancer diagnosis) level. Swallowing, chewing, saliva, taste, eating disruption, and aesthetic deficits may persist. Advanced tumors, extensive surgical resection, need for flap reconstruction, neck dissection, and postoperative radiation are associated with worse QoL outcomes. Knowledge of these trends can be applied in shared decision making, identification of commonly faced QoL issues, and to develop and provide survivorship resources. Future research should focus on routinely incorporating QoL in randomized studies, reporting the result according to guidelines, and following knowledge translation principles to maximize the clinician's and patient's ability to use QoL data.
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Szuecs M, Kuhnt T, Punke C, Witt G, Klautke G, Kramp B, Hildebrandt G. Subjective voice quality, communicative ability and swallowing after definitive radio(chemo)therapy, laryngectomy plus radio(chemo)therapy, or organ conservation surgery plus radio(chemo)therapy for laryngeal and hypopharyngeal cancer. JOURNAL OF RADIATION RESEARCH 2015; 56:159-168. [PMID: 25348250 PMCID: PMC4572584 DOI: 10.1093/jrr/rru093] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Revised: 09/06/2014] [Accepted: 09/10/2014] [Indexed: 06/04/2023]
Abstract
This retrospective analysis focusses on the impact of therapy on perceived long-term post-cancer treatment function. A validated questionnaire including items and components for the assessment of communicative ability, quality of voice and swallowing was sent to 129 patients. All patients were treated between 1998 and 2007. A total of 76 patients (58.9%) with carcinoma of the larynx or hypopharynx replied to the questionnaire. Data was evaluated retrospectively. Therapy delivered was definitive radio(chemo)therapy (defchRT/RT) (21/76, 28%), laryngectomy + radio(chemo)therapy (LE + chRT/RT) (28/76, 37%), or larynx conservation surgery + radio(chemo)therapy (LCS + chRT/RT) (27/76, 36%). Radiotherapy was administered using 2D- or 3D-conformal planning. The most common concomitant chemotherapy delivered was cisplatin + 5FU. For statistical analyses of the components, averages were calculated and tested using the Kruskal-Wallis test and the U-test of Mann and Whitney. Differences were assessed by the Monte Carlo method or Fisher's exact test. The single item rates were compared with Fisher's exact test. Mean follow-up was 56.7 months (range, 8-130 months). After defchRT/RT, patients trended towards more substantial-strong hoarseness compared with LCS + chRT/RT (P = 0.2). After LE, patients were dissatisfied with their artificial larynx/electrolarynx and the tone of their voice (P = 0.3, P = 0.07) and communicative ability (P = 0.005, P = 0.008) compared with those treated with defchRT/RT and LCS + chRT/RT, respectively. Dysphagia and additional percutaneous endoscopic gastrostomy (PEG) feeding were more frequent after defchRT/RT in comparison with the other two groups (P < 0.05). Voice quality and communicative ability were slightly worse after defchRT/RT and LE + chRT/RT, but satisfying with all treatment modalities. Further development of the therapy approach is necessary to reduce long-term side effects, with measures of post-treatment function as important endpoints.
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Affiliation(s)
- Marcella Szuecs
- Department of Radiotherapy, University of Rostock, Südring 75, 18059 Rostock, Germany
| | - Thomas Kuhnt
- Department of Radiotherapy, University of Leipzig, Stephanstraße 9a, 04103 Leipzig, Germany
| | - Christoph Punke
- Department of Otolaryngology, Head and Neck Surgery 'Otto Körner', University of Rostock, Doberaner Straße 137-139, 18057 Rostock, Germany
| | - Gabriele Witt
- Department of Otolaryngology, Head and Neck Surgery 'Otto Körner', University of Rostock, Doberaner Straße 137-139, 18057 Rostock, Germany
| | - Gunther Klautke
- Department of Radiation Oncology, Hospital Chemnitz, Bürgerstraße 2, 09113 Chemnitz, Germany
| | - Burkhard Kramp
- Department of Otolaryngology, Head and Neck Surgery 'Otto Körner', University of Rostock, Doberaner Straße 137-139, 18057 Rostock, Germany
| | - Guido Hildebrandt
- Department of Radiotherapy, University of Rostock, Südring 75, 18059 Rostock, Germany
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Moore K, Ford P, Farah C. “I have quality of life…but…”: Exploring support needs important to quality of life in head and neck cancer. Eur J Oncol Nurs 2014; 18:192-200. [DOI: 10.1016/j.ejon.2013.10.010] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 09/30/2013] [Accepted: 10/10/2013] [Indexed: 12/01/2022]
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15
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Golusiński W, Sówka M, Uczułka R, Golusińska E, Kardach H, Wegner A, Pazdrowski J. Rola zespołu interdyscyplinarnego w diagnostyce i leczeniu chorych z nowotworami krtani i gardła dolnego. Otolaryngol Pol 2013; 67:198-203. [DOI: 10.1016/j.otpol.2013.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 03/22/2013] [Accepted: 03/27/2013] [Indexed: 11/26/2022]
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16
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Bradley PJ. Multidisciplinary clinical approach to the management of head and neck cancer. Eur Arch Otorhinolaryngol 2012; 269:2451-4. [DOI: 10.1007/s00405-012-2209-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Accepted: 09/19/2012] [Indexed: 12/24/2022]
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