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Singer S, Bergelt C, Tribius S, Laban S, Busch CJ. [Patient-reported outcomes in head and neck cancer treatment: relevance, challenges, and benefit]. HNO 2023; 71:592-598. [PMID: 37422597 DOI: 10.1007/s00106-023-01325-7] [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] [Accepted: 05/17/2023] [Indexed: 07/10/2023]
Abstract
Next to overall survival, quality of life is becoming more and more pivotal for cancer patients. The various domains of quality of life are complex and have different value to each patient. However, not only patients but also health care professionals, the pharmaceutical industry, and regulatory bodies ask: How can quality of life be reliably ascertained in clinical trials? For this purpose, carefully developed and validated specific questionnaires are needed: the patient-reported outcome measures (PROMs). A key challenge is to define how results based on PROMs can be used for shared decision-making. Next to clinical factors such as health and nutritional status, quality of life acts as a prognostic factor for overall survival in cancer. Thus, it is crucial to take quality of life into account in daily clinical practice.
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Affiliation(s)
- Susanne Singer
- Abteilung Epidemiologie und Versorgungsforschung, Institut für Medizinische Biometrie, Epidemiologie und Informatik, Universitätsmedizin Mainz, 55101, Mainz, Deutschland.
| | - Corinna Bergelt
- Institut für Medizinische Psychologie, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - Silke Tribius
- Hermann-Holthusen-Institut für Strahlentherapie, Asklepios-Klinik St. Georg, Hamburg, Deutschland
- Asklepios Tumorzentrum Hamburg, Hamburg, Deutschland
| | - Simon Laban
- Klinik und Poliklinik für Hals‑, Nasen‑, Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsmedizin Ulm, Ulm, Deutschland
| | - Chia-Jung Busch
- Klinik und Poliklinik für Hals‑, Nasen‑, Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsmedizin Greifswald, Greifswald, Deutschland
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2
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Thilges S, Mumby P, Sinacore J, Clark J, Czerlanis C. Implementing a cognitive behavioral intervention for patients with head and neck cancer. Support Care Cancer 2023; 31:476. [PMID: 37466682 DOI: 10.1007/s00520-023-07948-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 07/13/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE Sequelae of and therapies for head and neck cancers (HNC) are associated with physical and functional impairment as well as increased levels of psychological distress post treatment. Given the impact of HNC and treatment on functioning (i.e., eating and talking), health-related quality of life (HRQOL) is a significant area of survivorship concern within this population. Although prior research indicates that the incidence of anxiety and depression ranges from 15 to 50%, to date, there is a paucity of research on specific psychosocial interventions related to HNC treatment and completed studies have been limited by infrequent use of a randomized design and provision of non-standardized psychosocial interventions. This study aimed to address these gaps and utilize a brief cognitive behavioral intervention (CBI) to improve (1) self-efficacy for coping with cancer, (2) depressive symptoms, (3) other psychological symptoms, and (4) HRQOL among patients with HNC. METHODS In an effort to conduct a randomized clinical trial of those undergoing treatment for HNC, eighty-eight patients were assigned to receive either a standardized CBI or usual psychological care (N = 47 and 41, respectively) with a 1-year follow-up. The means of all variables for both groups, adjusted for baseline, were visually compared at 3, 6, and 12 months post treatment. RESULTS As has been a challenge in other longitudinal HNC studies, a high degree of attrition occurred, with a loss of 35 patients from the CBI group and 29 from the usual care group. Despite the high attrition, analysis of existing data indicated that the effect of CBI was discernable among the patients who completed the course of the study. Of the 38 comparisons, 34 showed that the CBI group had the favorable outcome. Important considerations for implementation of a structured psychotherapy intervention during active cancer treatment with multiple barriers including communication challenges and practical limitations were realized. CONCLUSIONS The impact of HNC treatment can be particularly distressing as it often results in functional impairment and markedly changed activities of daily living among survivors. However, engaging in therapeutic methods to cope and manage distress during treatment can influence QOL and mood into the survivorship phase.
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Affiliation(s)
- Sarah Thilges
- Department of Psychiatry and Behavioral Neurosciences, Loyola University Medical Center, 2160 South First Avenue, Maywood, IL, 60153, USA.
| | - Patricia Mumby
- Department of Psychiatry and Behavioral Neurosciences, Loyola University Medical Center, 2160 South First Avenue, Maywood, IL, 60153, USA
| | - James Sinacore
- Department of Public Health Sciences, Loyola University, 2160 South First Avenue, Maywood, IL, 60153, USA
| | - Joseph Clark
- Department of Hematology and Oncology, Loyola University Medical Center, 2160 South First Avenue, Maywood, IL, 60153, USA
| | - Cheryl Czerlanis
- Department of Hematology and Oncology, Loyola University Medical Center, 2160 South First Avenue, Maywood, IL, 60153, USA
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Rogers SN, Waylen AE, Thomas S, Penfold C, Pring M, Waterboer T, Pawlita M, Hurley K, Ness AR. Quality of life, cognitive, physical and emotional function at diagnosis predicts head and neck cancer survival: analysis of cases from the Head and Neck 5000 study. Eur Arch Otorhinolaryngol 2020; 277:1515-1523. [PMID: 32062743 PMCID: PMC7160091 DOI: 10.1007/s00405-020-05850-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 02/04/2020] [Indexed: 02/06/2023]
Abstract
Purpose The aim of this paper is to determine whether health-related quality of life (HRQOL) at diagnosis of head and neck cancer (HNC) is associated with overall survival following treatment with curative intent after adjusting for other factors. Methods Data were collected from 5511 participants of the Head and Neck 5000 study (HN5000). HRQOL was measured using the EORTC QLQ-C30. Questionnaire and covariate data were available from 2171 participants diagnosed as follows: oral cavity (655), oropharynx HPV+ (723) and HPV− (277), and larynx (516). On average, participants were followed up 3.2 years (SD 1.2) after diagnosis. Data were adjusted for age, gender, co-morbidity, intended treatment, education level, income from benefits, smoking status and alcohol consumption. Results There was a clinically meaningful difference between Global HRQOL scores at diagnosis and survival in an unadjusted and adjusted model: [HR = 0.86, CI 0.82–0.89, p < 0.001 (unadjusted) and HR = 0.90, CI 0.86–0.94, p < 0.001 (adjusted)]. In analyses stratified by tumour site and HPV status, this association was similarly noted before adjustment and persisted after. There were some tumour sub-site variations: improved survival for people with laryngeal cancer reporting higher levels of physical role or social functioning and people with oral cancer reporting higher levels of role or social functioning. Conclusion As survival is the main priority for most people diagnosed with cancer, pre-treatment HRQOL is an additional factor to be included in risk stratification and case-mix adjustments. There is merit in incorporating HRQOL into routine clinical care as this is a useful facet in patient-clinician decision making, prognostication and recovery.
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Affiliation(s)
- S N Rogers
- Evidence-Based Practice Research Centre (EPRC), Faculty of Health and Social Care, Edge Hill University, St Helens Road, Ormskirk, L39 4QP, UK. .,Regional Maxillofacial Unit, University Hospital Aintree, Liverpool, L9 1AE, UK.
| | - A E Waylen
- Bristol Dental School, University of Bristol, Lower Maudlin St, Bristol, BS1 2LY, UK
| | - S Thomas
- Bristol Dental School, University of Bristol, Lower Maudlin St, Bristol, BS1 2LY, UK
| | - C Penfold
- NIHR Bristol Biomedical Research Centre, University of Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - M Pring
- Bristol Dental School, University of Bristol, Lower Maudlin St, Bristol, BS1 2LY, UK
| | - T Waterboer
- Infections and Cancer Epidemiology, Infection, Inflammation and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - M Pawlita
- Infections and Cancer Epidemiology, Infection, Inflammation and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - K Hurley
- NIHR Bristol Biomedical Research Centre, University of Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - A R Ness
- NIHR Bristol Biomedical Research Centre, University of Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
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Bonzanini LIL, Soldera EB, Ortigara GB, Schulz RE, Knorst JK, Ardenghi TM, Ferrazzo KL. Effect of the sense of coherence and associated factors in the quality of life of head and neck cancer patients. Braz Oral Res 2020; 34:e009. [PMID: 32049110 DOI: 10.1590/1807-3107bor-2020.vol34.0009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 12/10/2019] [Indexed: 11/22/2022] Open
Abstract
The sense of coherence (SOC) is a measure of global orientation regarding the ability of individuals to cope with stressful situations. The aim of the present study was to evaluate the association between SOC and quality of life (QoL) and clinical and sociodemographic characteristics among survivors of oral, oropharynx, hypopharynx, or larynx cancer. A cross-sectional study was conducted with 90 cancer patients in follow up at the Santa Maria University Hospital in southern Brazil who had completed conformal 3D radiotherapy at least three months earlier. QoL was assessed using the University of Washington Quality of Life (UW-QOL) questionnaire and SOC was measured using the Brazilian version of the SOC-13 questionnaire. Data on socio-demographic characteristics and the disease were obtained from patients' charts. Oral clinical conditions were also evaluated. Associations between exploratory variables and mean UW-QOL scores were evaluated through Poisson regression and the results were presented as rate ratios (RR) and 95% confidence intervals (CI). The mean overall UW-QOL score was 67.90 (± 18.71). Moderate and high SOC scores were associated with higher mean UW-QOL scores, that is, individuals with a stronger SOC demonstrated better QoL, (p < 0.05). Regarding the clinical variables, individuals with advanced stage cancer and those with hyposalivation and trismus had poorer QoL (p < 0.05). Patients with a greater SOC reported a better quality of life. Our findings show the importance of focusing on psychosocial factors, which can alleviate the impact caused by the disease and improve the QoL of these patients.
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Affiliation(s)
- Laura Izabel Lampert Bonzanini
- Universidade Federal do Rio Grande do Sul (UFRGS), School of Dentistry, Department of Surgery and Orthopedics, Porto Alegre, RS, Brazil
| | - Eloisa Barbieri Soldera
- Universidade Federal de Santa Maria (UFSM), School of Dentistry, Department of Stomatology, Santa Maria, RS, Brazil
| | - Gabriela Barbieri Ortigara
- Universidade Federal de Santa Maria (UFSM), School of Dentistry, Department of Stomatology, Santa Maria, RS, Brazil
| | - Riéli Elis Schulz
- Universidade Federal de Santa Maria (UFSM), School of Dentistry, Department of Stomatology, Santa Maria, RS, Brazil
| | - Jessica Klöckner Knorst
- Universidade Federal de Santa Maria (UFSM), School of Dentistry, Department of Stomatology, Santa Maria, RS, Brazil
| | - Thiago Machado Ardenghi
- Universidade Federal de Santa Maria (UFSM), School of Dentistry, Department of Stomatology, Santa Maria, RS, Brazil
| | - Kívia Linhares Ferrazzo
- Universidade Federal de Santa Maria (UFSM), School of Dentistry, Department of Pathology, Santa Maria, RS, Brazil
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Abstract
The clinical manifestations of oral cancer and the effects of treatment can have a negative impact on a patient's quality of life. Physiologic functions, cosmetic appearance, and psychological well-being can become compromised during the diagnosis, treatment, and survivorship of patients with oral cancer. This article addresses the relationship of oral cancer and quality of life, as well as the different aspects affected by this condition.
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Affiliation(s)
- Jesus Amadeo Valdez
- Department of Oral Medicine, Carolinas Healthcare System, Carolinas Medical Center, PO Box 32861, Charlotte, NC 28232, USA
| | - Michael T Brennan
- Department of Oral Medicine, Carolinas Healthcare System, Carolinas Medical Center, PO Box 32861, Charlotte, NC 28232, USA.
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6
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Carrillo J, Carrillo L, Ramirez-Ortega M, Ochoa-Carrillo F, Oñate-Ocaña L. The impact of treatment on quality of life of patients with head and neck cancer and its association with prognosis. Eur J Surg Oncol 2016; 42:1614-21. [DOI: 10.1016/j.ejso.2016.05.037] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 03/25/2016] [Accepted: 05/26/2016] [Indexed: 01/17/2023] Open
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Dodson RM, McQuellon RP, Mogal HD, Duckworth KE, Russell GB, Votanopoulos KI, Shen P, Levine EA. Quality-of-Life Evaluation After Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy. Ann Surg Oncol 2016; 23:772-783. [PMID: 27638671 DOI: 10.1245/s10434-016-5547-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Indexed: 12/27/2022]
Abstract
BACKGROUND Cytoreductive surgery (CS) with hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal metastases can alleviate symptoms and prolong survival at the expense of morbidity and quality of life (QoL). This study aimed to monitor QoL and outcomes before and after HIPEC. METHODS A prospective QoL trial of patients who underwent HIPEC for peritoneal metastases from 2000 to 2015 was conducted. The patients completed the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), the Functional Assessment of Cancer Therapy + Colon Subscale (FACT-C), the Brief Pain Inventory, the Center for Epidemiologic Studies Depression scale, and the Eastern Cooperative Oncology Group (ECOG) performance status at baseline, then 3, 6, 12, and 24 months after HIPEC. The trial outcome index (TOI) was analyzed. Proportional hazards modeled the effect of baseline QoL on survival. RESULTS The 598 patients (53.8 % female) in the study had a mean age of 53.3 years. The overall 1-year survival rate was 76.8 %, and the median survival period was 2.9 years. The findings showed a minor morbidity rate of 29.3 %, a major morbidity rate of 21.7 %, and a 30-day mortality rate of 3.5 %. The BPI (p < 0.0001) and worst pain (p = 0.004) increased at 3 months but returned to baseline at 6 months. After CS + HIPEC, FACT-C emotional well-being, SF-36 mental component score, and emotional health improved (all p < 0.001). Higher baseline FACT-General (hazard ratio [HR], 0.92; 95 % confidence interval [CI], 0.09-0.96), FACT-C (HR, 0.73; 95 % CI 0.65-0.83), physical well-being (HR, 0.71; 95 % CI 0.64-0.78), TOI (HR, 0.87; 95 % CI 0.84-0.91), and SF-36 vitality (HR, 0.88; 95 % CI 0.83-0.92) were associated with improved survival (all p < 0.001). Higher baseline BPI (HR, 1.1; 95 % CI 1.05-1.14; p < 0.0001), worst pain (HR, 1.06; 95 % CI 1.01-1.10; p = 0.01), and ECOG (HR, 1.74; 95 % CI 1.50-2.01; p < 0.0001) were associated with worse survival. CONCLUSIONS Although HIPEC is associated with morbidity and detriments to QoL, recovery with good overall QoL typically occurs at or before 6 months. Baseline QoL is associated with morbidity, mortality, and survival after HIPEC.
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Affiliation(s)
- Rebecca M Dodson
- Department of Surgical Oncology, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Richard P McQuellon
- Department of Medical Oncology, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Harveshp D Mogal
- Department of Surgical Oncology, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | | | - Gregory B Russell
- Department of Biostatistical Sciences, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | | | - Perry Shen
- Department of Surgical Oncology, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Edward A Levine
- Department of Surgical Oncology, Wake Forest Baptist Health, Winston-Salem, NC, USA. .,Department of Surgical Oncology, Medical Center Boulevard, Wake Forest University, Winston-Salem, NC, USA.
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Parkar SM, Shah MN. A relationship between quality-of-life and head and neck cancer: A systemic review. South Asian J Cancer 2015; 4:179-82. [PMID: 26981509 PMCID: PMC4772395 DOI: 10.4103/2278-330x.175955] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
AIM The aim was to identify the literature and to assess the association between quality-of-life (QoL) and head and neck cancer (HNC) related outcomes systemically. MATERIALS AND METHODS The full articles published in English language bio-medical journals between 1992 and December 2014 were searched using Medline database. The keywords used for searching the articles include the combination of "health-related of QoL," "QoL," "HNC." The search limited only to the observational studies using questionnaires European Organization for Research and Treatment of Cancer (EORTC) QLQ C 30 and EORTC QLQ H and N 35. Purely psychological studies were excluded. RESULTS A total of 5055 articles were retrieved, and 16 articles were selected for this review. Of 16 observational studies, 13 (81.25%) were prospective cohort studies while remaining 3 (18.75%) were cross-sectional studies. The main findings of the studies revealed that the treatment of HNC had a statistically significant influence on QoL. Others associated factors like age, female sex, duration of treatment, advance tumor, and site of the tumor has also the impact on QoL on patients suffering from HNC. CONCLUSION This review provides evidence for a positive relationship between cancer-related outcomes and QoL. Assessment of QoL in relation to HNC with proper methodology and validated instruments is lacking hence there is a need for further evidence to support the relation between cancer and QoL.
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Affiliation(s)
- Sujal Mitul Parkar
- Department of Public Health Dentistry, Siddhpur Dental College and Hospital, Patan, Gujarat, India
- Correspondence to: Dr. Sujal Mitul Parkar, E-mail:
| | - Mihir N. Shah
- Department of Periodontology, Ahmedabad Dental College and Hospital, Ahmedabad, Gujarat, India
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9
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Kim SA, Roh JL, Lee SA, Lee SW, Kim SB, Choi SH, Nam SY, Kim SY. Pretreatment depression as a prognostic indicator of survival and nutritional status in patients with head and neck cancer. Cancer 2015; 122:131-40. [DOI: 10.1002/cncr.29693] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 08/19/2015] [Accepted: 08/25/2015] [Indexed: 01/06/2023]
Affiliation(s)
- Shin-Ae Kim
- Department of Otolaryngology, Asan Medical Center; University of Ulsan College of Medicine; Seoul Republic of Korea
| | - Jong-Lyel Roh
- Department of Otolaryngology, Asan Medical Center; University of Ulsan College of Medicine; Seoul Republic of Korea
| | - Sang-Ah Lee
- Department of Otolaryngology, Asan Medical Center; University of Ulsan College of Medicine; Seoul Republic of Korea
| | - Sang-wook Lee
- Department of Radiation Oncology, Asan Medical Center; University of Ulsan College of Medicine; Seoul Republic of Korea
| | - Sung-Bae Kim
- Department of Internal Medicine (Oncology), Asan Medical Center; University of Ulsan College of Medicine; Seoul Republic of Korea
| | - Seung-Ho Choi
- Department of Otolaryngology, Asan Medical Center; University of Ulsan College of Medicine; Seoul Republic of Korea
| | - Soon Yuhl Nam
- Department of Otolaryngology, Asan Medical Center; University of Ulsan College of Medicine; Seoul Republic of Korea
| | - Sang Yoon Kim
- Department of Otolaryngology, Asan Medical Center; University of Ulsan College of Medicine; Seoul Republic of Korea
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10
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Pretreatment quality of life as a prognostic factor for early survival and functional outcomes in patients with head and neck cancer. Qual Life Res 2015; 25:165-74. [DOI: 10.1007/s11136-015-1063-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2015] [Indexed: 10/23/2022]
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van Nieuwenhuizen AJ, Buffart LM, Brug J, Leemans CR, Verdonck-de Leeuw IM. The association between health related quality of life and survival in patients with head and neck cancer: a systematic review. Oral Oncol 2014; 51:1-11. [PMID: 25262163 DOI: 10.1016/j.oraloncology.2014.09.002] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 08/31/2014] [Accepted: 09/02/2014] [Indexed: 10/24/2022]
Abstract
The aim of this study was to systematically review available evidence on the association between health-related quality of life (HRQoL) and survival in patients with head and neck cancer (HNC), adjusted for important clinical, demographic and lifestyle-related factors. A systematic literature search in four electronic bibliographic databases was conducted in January 2014. We included studies that provided data on HRQoL, survival, and the association between HRQoL and survival among HNC patients. Two researchers independently rated the quality of the included studies. A best evidence synthesis was applied to draw conclusions. Nineteen studies were included, of which twelve focused on all subscales of a HRQoL questionnaire and seven focused on selected subscales. The mean (SD) quality score was 72 (17)% and 11 (58)% studies were of high quality. According to the best evidence synthesis, we found strong evidence for a positive association between pre-treatment physical functioning and survival and between change in global QoL from pre-treatment to 6 months after treatment and survival. Due to inconsistent findings, we found insufficient evidence for an association with survival of other HRQoL domains, including role, emotional, cognitive and social functioning, mental health and well-being. Future high quality studies with a longitudinal design are needed to examine the complex association between HRQoL and survival.
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Affiliation(s)
- Annette J van Nieuwenhuizen
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - Laurien M Buffart
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Johannes Brug
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - C René Leemans
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands.
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Verdonck-de Leeuw IM, Buffart LM, Heymans MW, Rietveld DH, Doornaert P, de Bree R, Buter J, Aaronson NK, Slotman BJ, Leemans CR, Langendijk JA. The course of health-related quality of life in head and neck cancer patients treated with chemoradiation: A prospective cohort study. Radiother Oncol 2014; 110:422-8. [DOI: 10.1016/j.radonc.2014.01.002] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Revised: 01/03/2014] [Accepted: 01/12/2014] [Indexed: 10/25/2022]
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13
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Fang CY, Egleston BL, Ridge JA, Lango MN, Bovbjerg DH, Studts JL, Burtness BA, Einarson MB, Klein-Szanto AJP. Psychosocial functioning and vascular endothelial growth factor in patients with head and neck cancer. Head Neck 2013; 36:1113-9. [PMID: 23804308 DOI: 10.1002/hed.23421] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Revised: 03/27/2013] [Accepted: 06/10/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Psychosocial functioning is associated with vascular endothelial growth factor (VEGF) in various patient populations. This study examined whether psychosocial functioning in patients with head and neck squamous cell carcinoma (HNSCC) is associated with tumor VEGF expression, a protein that stimulates angiogenesis and is associated with poor prognosis. METHODS Forty-two newly diagnosed patients completed assessments of psychosocial functioning (ie, depressive symptoms, perceived stress, anxiety, social support) before surgery. Tumor samples were obtained for VEGF analysis and human papillomavirus (HPV)-typing. RESULTS Poorer psychosocial functioning was associated with greater VEGF expression controlling for disease stage (odds ratio [OR], 4.55; 95% confidence interval [CI], 1.72-12.0; p < .01). When examined by HPV status, the association between psychosocial functioning and VEGF remained significant among patients who were HPV negative (OR, 5.50; 95% CI, 1.68-17.3; p < .01), but not among patients who were HPV positive. CONCLUSION These findings inform our understanding of the biobehavioral pathways that may contribute to poor outcomes in non-HPV-associated HNSCCs.
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Affiliation(s)
- Carolyn Y Fang
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania
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Montero-Miranda PH, Ganly I. Survivorship--competing mortalities, morbidities, and second malignancies. Otolaryngol Clin North Am 2013; 46:681-710. [PMID: 23910478 DOI: 10.1016/j.otc.2013.04.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Mortality of head and neck cancer has declined in the United States over the past 20 years. This improvement has been linked to use of multimodality treatment of advanced disease. Despite this improvement, disease-specific survival remains low. Patients who survive head and neck cancer are exposed to morbidity and mortality secondary to the same factors as the general population. Factors related to cancer and cancer treatment predispose them to increased risk of mortality. Improvements in head and neck cancer treatment have led to a scenario where an increasing proportion of patients die from causes other than the primary cancer, called competing mortalities.
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Affiliation(s)
- Pablo H Montero-Miranda
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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15
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Singer S, Danker H, Guntinas-Lichius O, Oeken J, Pabst F, Schock J, Vogel HJ, Meister EF, Wulke C, Dietz A. Quality of life before and after total laryngectomy: Results of a multicenter prospective cohort study. Head Neck 2013; 36:359-68. [DOI: 10.1002/hed.23305] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2013] [Indexed: 01/23/2023] Open
Affiliation(s)
- Susanne Singer
- University Medical Centre Mainz; Institute of Medical Biostatistics; Epidemiology and Informatics (IMBEI); Mainz Germany
- University of Leipzig; Division of Psychosocial Oncology; Leipzig Germany
| | - Helge Danker
- University of Leipzig; Department of Psychosomatic Medicine and Psychotherapy; Leipzig Germany
| | | | - Jens Oeken
- Hospital Chemnitz; Department of Otorhinolaryngology; Chemnitz Germany
| | - Friedemann Pabst
- Hospital Dresden-Friedrichstadt; Department of Otorhinolaryngology; Dresden Germany
| | - Juliane Schock
- Hospital Martha-Maria; Department of Otorhinolaryngology; Halle-Dölau Germany
| | - Hans-Joachim Vogel
- Hospital Elblandkliniken; Department of Otorhinolaryngology; Riesa Germany
| | - Eberhard F. Meister
- Community Hospital St. Georg; Department of Otorhinolaryngology; Leipzig Germany
| | - Cornelia Wulke
- Community Hospital St. Georg; Department of Otorhinolaryngology; Leipzig Germany
| | - Andreas Dietz
- University of Leipzig; Department of Otorhinolaryngology; Leipzig Germany
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Nishio A, Sumi T, Yamada M, Kuwahata Y. [Treatments for otorhinolaryngological patients with psychiatric disorders]. NIHON JIBIINKOKA GAKKAI KAIHO 2013; 116:97-102. [PMID: 23539958 DOI: 10.3950/jibiinkoka.116.97] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
There are few systems in place for patients with psychiatric disorders who need treatments for physical complications. In Tokyo, "The Tokyo metropolitan psychiatric emergency system" was established in 1981, and Ome Municipal General Hospital participated in it. Under this system, fifteen patients with psychiatric disorders were treated for otorhinolaryngological diseases in our department from April 2005 to March 2011. We reviewed the fifteen patients. The coexisting psychiatric disorders were schizophrenia in twelve patients, and mental retardation, Korsakoff's syndrome, and Alzheimer's dementia in one patient each, respectively. All the patients had been receiving psychiatric treatment. The otorhinolaryngological diseases were head and neck cancer in nine patients, chronic sinusitis in three patients, and benign salivary gland tumor, cholesteatoma, and epistaxis in one patient each, respectively. Among the fifteen patients, thirteen could complete their treatment, but two dropped out due to exacerbation of their psychiatric symptoms. The therapeutic course is uncertain in otorhinolaryngological diseases occurring concomitantly with psychiatric disorders, especially in head and neck cancer, because it may be difficult to prioritize the problem when determining the treatment options and delivering the treatment. Thus, we should treat patients with psychiatric disorders carefully on a case-by-case basis depending on their psychiatric symptoms. It is also important to cooperate with psychiatrists and patients' families.
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Affiliation(s)
- Ayako Nishio
- Department of Otorhinolaryngology, Ome Municipal General Hospital
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Bornbaum CC, Doyle PC, Skarakis-Doyle E, Theurer JA. A critical exploration of the International Classification of Functioning, Disability, and Health (ICF) framework from the perspective of oncology: recommendations for revision. J Multidiscip Healthc 2013; 6:75-86. [PMID: 23526147 PMCID: PMC3596126 DOI: 10.2147/jmdh.s40020] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND In 2001, the World Health Organization developed the International Classification of Functioning, Disability, and Health (ICF) framework in an effort to attend to the multidimensional health-related concerns of individuals. Historically, although the ICF has frequently been used in a rehabilitation-based context, the World Health Organization has positioned it as a universal framework of health and its related states. Consequently, the ICF has been utilized for a diverse array of purposes in the field of oncology, including: evaluating functioning in individuals with cancer, guiding assessment in oncology rehabilitation, assessing the comprehensiveness of outcome measures utilized in oncology research, assisting in health-related quality of life instrument selection, and comparing the primary concerns of health professionals with those of their patients. DISCUSSION Examination of the ICF through the lens of cancer care highlights the fact that this framework can be a valuable tool to facilitate comprehensive care in oncology, but it currently possesses some areas of limitation that require conceptual revision; to this end, several recommendations have been proposed. Specifically, these proposed recommendations center on the following three areas of the ICF framework: (1) the replacement of the term "health condition" with the more inclusive and dynamic term "health state;" (2) the continuing development and refinement of the personal factors component to ensure issues such as comorbidities can be accounted for appropriately; and (3) the inclusion of a mechanism to account for the subjective dimension of health and functioning (eg, quality of life). SUMMARY It is through the expansion of these conceptual parameters that the ICF may become more relevant and applicable to the field of oncology. With these important revisions, the ICF has the potential to provide a broader biopsychosocial perspective of care that captures the diverse range of concerns that arise throughout the continuum of care in oncology.
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Affiliation(s)
- Catherine C Bornbaum
- Graduate Program in Health and Rehabilitation Sciences, The University of Western Ontario, London, ON, Canada
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Tarsitano A, Pizzigallo A, Ballone E, Marchetti C. Health-related quality of life as a survival predictor for patients with oral cancer: is quality of life associated with long-term overall survival? Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114:756-63. [PMID: 23021925 DOI: 10.1016/j.oooo.2012.06.022] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Revised: 06/22/2012] [Accepted: 06/27/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of the present prospective study was to obtain further insight into health-related quality of life (HR-QoL) as a predictor of survival in a selected cohort of patients with oral cancer. STUDY DESIGN A total of 124 patients were treated with surgery or combined therapy. All of the recruited patients completed the European Organization for Research and Treatment of Cancer questionnaires QLQC30 and H&N35 on 4 occasions. Overall survival was assessed. Univariate and multivariate Cox proportional hazards regression models were conducted. RESULTS High baseline HR-QoL score and high pain symptom score were significantly associated with a better survival (HR 0.86 and 0.92 respectively). Swallowing (HR 0.94), and speech (HR 0.92) high baseline scores were also significantly associated with a better survival in the adjusted analyses. CONCLUSIONS Patients who reported a better HR-QoL at tumor diagnosis had a better survival than patients with a lower HR-QoL baseline score.
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Affiliation(s)
- Achille Tarsitano
- Maxillofacial Surgery Unit, S.Orsola-Malpighi Hospital, Alma Mater Studiorum University of Bologna, Bologna, Italy.
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Johansson M, Rydén A, Ahlberg K, Finizia C. “Setting boundaries” – Mental adjustment to cancer in laryngeal cancer patients: An interview study. Eur J Oncol Nurs 2012; 16:419-25. [DOI: 10.1016/j.ejon.2011.09.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Revised: 09/28/2011] [Accepted: 09/30/2011] [Indexed: 10/15/2022]
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Feasibility of EASE: a psychosocial program to improve symptom management in head and neck cancer patients. Support Care Cancer 2012; 21:191-200. [DOI: 10.1007/s00520-012-1510-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Accepted: 05/21/2012] [Indexed: 11/26/2022]
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Johansson M, Rydén A, Finizia C. Mental adjustment to cancer and its relation to anxiety, depression, HRQL and survival in patients with laryngeal cancer - a longitudinal study. BMC Cancer 2011; 11:283. [PMID: 21718478 PMCID: PMC3136424 DOI: 10.1186/1471-2407-11-283] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2010] [Accepted: 06/30/2011] [Indexed: 11/12/2022] Open
Abstract
Background Using a longitudinal design, aim of this study was to investigate the relation between mental adjustment to cancer and anxiety, depression, health-related quality of life (HRQL) and survival in patients treated for laryngeal cancer. Methods 95 patients with Tis-T4 laryngeal cancer were assessed at one and 12 months after start of treatment, respectively, using the Mini-Mental Adjustment to Cancer Scale (Mini-MAC), the European Organisation for Research and Treatment of Cancer (EORTC) Study Group on Quality of Life core questionnaire (EORTC QLQ-C30) supplemented with the Head and Neck cancer module (QLQ-H&N35) and the Hospital Anxiety and Depression (HAD) Scale. For survival analyses patients were followed up for a median time of 4.22 years from inclusion. Results The most commonly used adjustment response at both occasions was Fighting Spirit. The use of adjustment responses was relatively stable over time. Correlation analyses showed that patients using Helpless-Hopeless and Anxious Preoccupation responses reported more anxiety and depression, as well as decreased HRQL. Tumour site and stage showed no effect on adjustment response. Survival analysis indicated that use of a Helpless-Hopeless response was related to poorer survival (HR 1.17, p 0.001). Conclusion The relation between adjustment responses Helpless-Hopeless and Anxious Preoccupation and anxiety, depression, HRQL and possibly poorer survival indicate that assessment of mental adjustment should be considered when planning treatment and rehabilitation in laryngeal cancer patients.
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Affiliation(s)
- Mia Johansson
- Department of Otolaryngology, Sahlgrenska University Hospital, SE 431 80 Mölndal, Sweden.
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Quality of life as predictor of survival: A prospective study on patients treated with combined surgery and radiotherapy for advanced oral and oropharyngeal cancer. Radiother Oncol 2010; 97:258-62. [DOI: 10.1016/j.radonc.2010.02.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2008] [Revised: 02/08/2010] [Accepted: 02/08/2010] [Indexed: 11/21/2022]
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Ledeboer QCP, van der Schroeff MP, Pruyn JFA, de Boer MF, Baatenburg de Jong RJ, van der Velden LA. Survival of patients with palliative head and neck cancer. Head Neck 2010; 33:1021-6. [DOI: 10.1002/hed.21572] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2010] [Revised: 05/18/2010] [Accepted: 07/09/2010] [Indexed: 11/07/2022] Open
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Vilela LD, Allison PJ. An investigation of the correlates of sense of coherence in a sample of Brazilians with head and neck cancer. Oral Oncol 2010; 46:360-5. [DOI: 10.1016/j.oraloncology.2010.02.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Revised: 02/16/2010] [Accepted: 02/16/2010] [Indexed: 10/19/2022]
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Montazeri A. Quality of life data as prognostic indicators of survival in cancer patients: an overview of the literature from 1982 to 2008. Health Qual Life Outcomes 2009; 7:102. [PMID: 20030832 PMCID: PMC2805623 DOI: 10.1186/1477-7525-7-102] [Citation(s) in RCA: 372] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2009] [Accepted: 12/23/2009] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Health-related quality of life and survival are two important outcome measures in cancer research and practice. The aim of this paper is to examine the relationship between quality of life data and survival time in cancer patients. METHODS A review was undertaken of all the full publications in the English language biomedical journals between 1982 and 2008. The search was limited to cancer, and included the combination of keywords 'quality of life', 'patient reported-outcomes' 'prognostic', 'predictor', 'predictive' and 'survival' that appeared in the titles of the publications. In addition, each study was examined to ensure that it used multivariate analysis. Purely psychological studies were excluded. A manual search was also performed to include additional papers of potential interest. RESULTS A total of 451 citations were identified in this rapid and systematic review of the literature. Of these, 104 citations on the relationship between quality of life and survival were found to be relevant and were further examined. The findings are summarized under different headings: heterogeneous samples of cancer patients, lung cancer, breast cancer, gastro-oesophageal cancers, colorectal cancer, head and neck cancer, melanoma and other cancers. With few exceptions, the findings showed that quality of life data or some aspects of quality of life measures were significant independent predictors of survival duration. Global quality of life, functioning domains and symptom scores - such as appetite loss, fatigue and pain - were the most important indicators, individually or in combination, for predicting survival times in cancer patients after adjusting for one or more demographic and known clinical prognostic factors. CONCLUSION This review provides evidence for a positive relationship between quality of life data or some quality of life measures and the survival duration of cancer patients. Pre-treatment (baseline) quality of life data appeared to provide the most reliable information for helping clinicians to establish prognostic criteria for treating their cancer patients. It is recommended that future studies should use valid instruments, apply sound methodological approaches and adequate multivariate statistical analyses adjusted for socio-demographic characteristics and known clinical prognostic factors with a satisfactory validation strategy. This strategy is likely to yield more accurate and specific quality of life-related prognostic variables for specific cancers.
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Affiliation(s)
- Ali Montazeri
- Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran.
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Brunello A, Sandri R, Extermann M. Multidimensional geriatric evaluation for older cancer patients as a clinical and research tool. Cancer Treat Rev 2009; 35:487-92. [DOI: 10.1016/j.ctrv.2009.04.005] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Risberg-Berlin B, Rydén A, Möller RY, Finizia C. Effects of total laryngectomy on olfactory function, health-related quality of life, and communication: a 3-year follow-up study. BMC EAR, NOSE, AND THROAT DISORDERS 2009; 9:8. [PMID: 19640307 PMCID: PMC2727487 DOI: 10.1186/1472-6815-9-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/11/2009] [Accepted: 07/29/2009] [Indexed: 11/12/2022]
Abstract
Background As total laryngectomy results in loss of airflow through the nose, one of the adverse effects for a majority of patients is the reduced or complete loss of olfactory function. However, with the introduction of a new method, the Nasal Airflow-Inducing Maneuver (NAIM), an important technique is available for laryngectomized patients to regain the ability to smell. The purpose of the present study was to assess changes in olfaction, health-related quality of life (HRQL) and communication 3 years after NAIM rehabilitation. Methods 18 patients (15 men and 3 women; mean age, 71 years) who had undergone laryngectomy and NAIM rehabilitation were followed longitudinally for 3 years. For comparison an age and gender matched control group with laryngeal cancer treated with radical radiotherapy was included. Olfactory function was assessed using the Questionnaire on Odor, Taste and Appetite and the Scandinavian Odor Identification Test. HRQL was assessed by: 1) the European Organization for Research and Treatment for cancer quality of life questionnaires; and 2) the Hospital Anxiety and Depression Scale. Communication was assessed by the Swedish Self-Evaluation of Communication Experiences after Laryngeal Cancer. Descriptive statistics with 95% confidence interval were calculated according to standard procedure. Changes over time as well as tests between pairs of study patients and control patients were analyzed with the Fisher nonparametric permutation test for matched pairs. Results Thirty-six months after rehabilitation 14 of 18 laryngectomized patients (78%) were smellers. There were, with one exception (sleep disturbances), no clinically or statistically significant differences between the study and the control group considering HRQL and mental distress. However, statistical differences (p < 0.001) were found between the study and the control group concerning changes in communication. Conclusion Olfactory training with NAIM should be integrated into the multidisciplinary rehabilitation program after total laryngectomy. Our study shows that patients who were successfully rehabilitated concerning olfaction and communication had an overall good HRQL and no mental distress. Moreover, the EORTC questionnaires should be complemented with more specific questionnaires when evaluating olfaction and communication in laryngectomized patients.
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Affiliation(s)
- Birgit Risberg-Berlin
- Division of Logopedics and Phoniatrics, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden.
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Abstract
PURPOSE OF REVIEW Nurses can play an essential role in the treatment of head and neck cancer and the care of patients and their families. The role and influence of nursing is dependent on available evidence to fulfill that role and on the sociopolitical and organizational factors that shape the context for nursing and interdisciplinary practice. RECENT FINDINGS Nurses influence treatment for head and neck cancer through symptom management and tobacco cessation to improve quality of life and patient-reported outcomes. Nurses and interdisciplinary teams in the United States and Europe report successful, novel nurse-led care models that optimize influence on management. SUMMARY Current research suggests that nurses can influence head and neck cancer treatment through emphasis on symptom management, tobacco and alcohol cessation, and on patient and family education and care coordination. Nonetheless, evidence for practice remains scant. Only continued research, employing qualitative and quantitative approaches, conducted by nurse and interdisciplinary investigator teams will advance head and neck cancer management and optimize influence of nursing within it. Novel models for nursing care that are well fit into the organizations and society in which care is delivered may further improve care and patient outcomes. Evaluation of such models is further required to document improvements.
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