Quality of Life of Patients With Recurrent Nasopharyngeal Carcinoma Treated With Nasopharyngectomy Using the Maxillary Swing Approach

Division of Head and Neck Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China.
Archives of Otolaryngology - Head and Neck Surgery (Impact Factor: 2.33). 03/2006; 132(3):309-16. DOI: 10.1001/archotol.132.3.309
Source: PubMed


To investigate factors affecting the quality of life (QOL) of patients with recurrent nasopharyngeal carcinoma who underwent a nasopharyngectomy using the maxillary swing approach.
Cross-sectional study using self-administered questionnaire data and medical chart review.
Tertiary cancer referral center.
Patients with recurrent nasopharyngeal carcinoma who underwent a nasopharyngectomy using the maxillary swing approach between January 1998 and December 2003, had a minimal follow-up of 3 months, and completed the questionnaire.
We measured QOL using the validated traditional Chinese version of the European Organization for Research and Treatment of Cancer core questionnaire and head and neck module.
Descriptive analysis of the results and comparison of scores for each QOL domain, stratified by presence of postoperative trismus, presence of postoperative palatal fistula, sex, age (< or = 45 years and > 45 years), duration of treatment (< or = 1 year and > 1 year), and disease status at follow-up, were performed using nonparametric tests.
Of the 50 eligible patients, 41 (32 men and 9 women; mean [SD] age, 51.5 [10.4] years) participated in the study. The mean +/- SD global QOL scale score of the participants was 68.7 +/- 24.2. Social functioning score was the lowest (64.6 +/- 25.9) of the 5 functioning scales. Fatigue and financial difficulties were the most common general concerns. Dryness of mouth, sticky saliva, and limited mouth opening were the most common head and neck problems. Women were found to have significantly lower QOL scores in the fatigue (P = .03), diarrhea (P = .03), and emotional functioning (P = .05) domains than men. The presence of severe trismus after the maxillary swing approach was significantly associated with a low QOL score in the mouth opening (P = .001), sticky saliva (P = .006), mouth dryness (P = .02), and social eating (P = .05) domains. However, the presence of palatal fistula, age, duration of treatment, and disease status at follow-up did not result in any significant differences on the QOL scores.
The QOL of patients treated with nasopharyngectomy using the maxillary swing approach to treat recurrent nasopharyngeal carcinoma was good. Female sex and the presence of postoperative trismus were factors significantly related to some of the QOL domain differences after surgery.

30 Reads
  • Source
    • "Cantonese (?) Ng 2006 Combined H&N scale only: 0.79 [39] "
    [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: The EORTC QLQ-H&N35 (H&N35) is widely used to measure quality of life in head and neck cancer patients. The aims of this study were to obtain insight into a) the languages in which the H&N35 has been used and the psychometric properties in those languages, b) the study designs, and c) its acceptance by patients and investigators. Methods: A systematic literature review was performed searching for all original papers that had used at least one item of the H&N35. Identified papers were read and the information about methodological issues abstracted statistically analysed. Results: A total of 136 papers were identified. The H&N35 was administered in 19 different languages in 27 countries. The study design was cross-sectional in the majority of studies (53 %), prospective cohort studies (31 %), phase-II-trials (7 %), phase-III-trials (6 %) and case-control studies (1 %). The scales with the highest percentages of missing values were Sexuality (11.5 %) and Speech (7 %). The median Cronbach's alpha of the multi-item scales ranged from 0.61 (Senses) to 0.93 (Sexuality). Construct validity was rarely investigated. On average, 12 scales (range 0-18) of the instrument were used by the investigators. The scale most often used was swallowing (in 85 % of studies) and least often used was Weight Gain (39 %). Conclusion: The H&N35 is widely used throughout the world, mainly in observational studies, and has demonstrated robust psychometric features in different languages. However, some methodological problems reported imply that the instrument can be improved in some areas.
    Quality of Life Research 11/2012; 22(8). DOI:10.1007/s11136-012-0325-1 · 2.49 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Orofacial pain and altered nerve sensation may be the initial sign of oropharyngeal or nasopharyngeal cancer. This article focuses on the most common orofacial pain conditions and neurosensory alterations that affect cancer patients, such as neuropathic pain, muscle spasm or contractures, mucositis, and increased or decreased sensory discrimination in the affected area. The various pharmacotherapeutic modalities for cancer pain management ranging from non steroidal anti-inflammatory drugs (NSAIDs) for mild pain to opioids for severe pain are discussed in detail.
    Dental Clinics of North America 02/2008; 52(1):183-202, ix-x. DOI:10.1016/j.cden.2007.09.003
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Our aim was to assess the correlation between the radiation therapy (RT) dose to the mastication apparatus and trismus of oropharyngeal cancer patients. Eighty-one patients treated with RT were analyzed. The masseter, pterygoid, and temporalis muscles and the coronoid and condyl were delineated on axial CT slices. The mean dose in these structures was correlated with outcome of quality of life questionnaires. Fifty-six (88%) patients responded; 16% of the patients scored grade 3/4 on the Head & Neck 35 "opening mouth" question. A significant correlation was observed between dose in masseter and pterygoid muscles and trismus (p= .02). Patients treated with brachytherapy received a lower dose in masticatory muscles. A steep dose-effect relationship between mean dose in masseter muscle and pterygoid muscles and the probability of having trismus complaints was observed; with every additional 10 Gy to the pterygoid muscle, an increase of the probability of trismus of 24% was observed.
    Head & Neck 05/2008; 30(5):622-30. DOI:10.1002/hed.20760 · 2.64 Impact Factor
Show more