Quality of life of patients with recurrent nasopharyngeal carcinoma treated with nasopharyngectomy using the maxillary swing approach.
ABSTRACT 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.
- SourceAvailable from: Chuangzhen Chen[Show abstract] [Hide abstract]
ABSTRACT: BACKGROUND:: It is important to determine the outcomes of retreatment in patients with locally recurrent nasopharyngeal carcinoma. METHODS:: We reviewed the records of patients treated for local recurrence at Stanford and Shantou Universities. The end points were local relapse-free survival (LRFS) and overall survival after retreatment. RESULTS:: Fifty-six patients from Stanford and 98 from Shantou qualified. For the Stanford patients, 33 had surgery alone (S group), 12 had surgery plus radiotherapy±chemotherapy (CMT group), and 22 had radiotherapy±chemotherapy (RT Stanford group). All Shantou patients received radiotherapy±chemotherapy (RT Shantou group). The 5-year LRFS rates were: 57% for S group, 25% for CMT group, 53% for RT Stanford group, and 41% for RT Shantou group (P>0.05) for rT1-2 tumors; they were 29% for S group, 25% for CMT group, 39% for RT Stanford group, and 9% for RT Shantou group for rT3-4 tumors (P>0.05). For RT patients, 5-year overall survival rates were 49% for Stanford and 25% for Shantou patients (P=0.026). CONCLUSIONS:: Similar and durable LRFS rates were attained for both S and RT groups when stratified by rT-stage.American journal of clinical oncology 12/2012; 37(4). DOI:10.1097/COC.0b013e318277d804 · 2.21 Impact Factor
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ABSTRACT: OBJECTIVES/HYPOTHESIS: The use of myringotomy with ventilation tube insertion after maxillary swing nasopharyngectomy was originally described to prevent the occurrence of otitis media with effusion. The outcome of this otologic procedure has never been reviewed and discussed. The purpose of this study is to examine the role of myringotomy with ventilation tube insertion in this group of patients. STUDY DESIGN: Retrospective review. METHODS: One hundred forty-two patients with maxillary swing nasopharyngectomy were recruited from 1999 to 2008. The otologic status was evaluated using otoscopy, pure tone audiogram, and tympanogram at 3 months, 6 months, and then yearly after the operation. The results were reviewed periodically during that 10-year period. During this period, there were three groups; the first group had myringotomy with ventilation tube inserted, the second group had myringotomy alone, and the third group had no myringotomy performed. RESULTS: There were significantly (P < .0001) more patients in the myringotomy with ventilation tube insertion group who suffered from adverse otologic complications such as discharging grommet, discharging chronic suppurative otitis media, and perforated eardrum when compared with patients with myringotomy alone and patients without myringotomy at 3 months, 6 months, and 12 months. There were no differences in the incidence of acute otitis media among all three groups of patients. CONCLUSIONS: Patients who underwent maxillary swing nasopharyngectomy and myringotomy with ventilation tube insertions suffered from more otologic complications. The routine use of myringotomy with or without ventilation tube insertion for this group of patients is not recommended.The Laryngoscope 09/2012; 123(2). DOI:10.1002/lary.23684 · 2.03 Impact Factor
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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 · 2.86 Impact Factor