Long-term Quality-of-Life Evaluation After Head and Neck Cancer Treatment in a Developing Country
To evaluate the long-term quality of life of patients treated for head and neck cancer at a single institution in a developing country.
Cross-sectional analysis of a consecutive series of patients.
Tertiary cancer center hospital in Brazil.
Eligible subjects included patients treated between 1974 and 1999 for head and neck carcinoma who had a minimum disease-free survival of 2 years and who completed a Portuguese version of the University of Washington Quality of Life (UW-QOL) questionnaire.
Descriptive analyses of the results and comparisons of the scores for each UW-QOL domain, stratified by tumor site, were performed using nonparametric tests.
Findings from 344 patients were analyzed. Of the study population, 140 (41%) had survived 2 to 5 years, 125 (36%) had survived 5 to 10 years, and 79 (23%) had survived more than 10 years since treatment. Primary tumor sites were in the oral cavity in 43.3% of cases, the oropharynx in 20.9%, the larynx in 32.0%, and the hypopharynx in 3.8%. In terms of treatment, 33.1% underwent surgery alone; 16.9%, radiotherapy alone; and 50% underwent combined treatment. Overall, 78.5% of the patients classified their own health as good or excellent. Stratified analysis showed that impairment in chewing and swallowing was more common in patients with oral and oropharyngeal tumors than in those with larynx and hypopharynx tumors, and speech impairment was more frequently related to patients with larynx and hypopharynx tumors than to those with oral and oropharynx tumors. In all tumor sites, the composite scores were significantly worse in advanced tumors than early stage tumors, but the use of combined treatment had the greatest negative impact on quality-of-life scores, after we adjusted for T and N stage with multivariable analyses (P<.001).
The Portuguese version of the UW-QOL questionnaire was an effective tool to evaluate quality of life in a Brazilian population. Although many patients reported some limitations, most reported a good to excellent long-term quality of life.
Available from: PubMed Central
- "Functional results of the combination of radiotherapy and chemotherapy for tumors in the head and neck area can preserve the organ and work to maintain functionality (2-6). However, radiotherapy can cause other disorders in different degrees of severity, notably: edema and fibrosis of the exposed region, trismus, mucositis, xerostomia, odynophagia, actinic dermatitis, substantial weight loss, and the need to use alternative feeding routes (7). "
[Show abstract] [Hide abstract]
ABSTRACT: The aim of this study is to analyze subjectively, using the SWAL-QOL questionnaire, swallowing dysfunction and associated factors after treatment with radiotherapy and chemotherapy in patients treated for head and neck cancer.
This is a cross-sectional study, based on the selection of patients with tumors of the head and neck area, treated with radiotherapy with or without chemotherapy during the years 2000 to 2006 at the Oncology Institute of Juiz de Fora. The data were analyzed using SPSS 15.0 software, and were evaluated using the chi-square test to compare differences in proportions between groups. The statistical significance level was set at 5%.
It was observed that with respect to foods of solid consistency, there was a statistically significant difference for mouth tumors (p<0.01), with a tendency in this group to use softer foods, easier to chew (stews, boiled vegetables, creamy soups, canned fruit). With reference to the domains of the SWAL-QOL, the location of the tumor in the mouth was statistically associated with the lowest quality of life in the symptoms domain (p<0.05). The female gender variable was associated with the lowest perceived quality of life in several domains, namely swallowing (p=0.02); fatigue (p=0.008); symptoms (p=0.009). Age (split below and above 60 years) was not associated with differences in perceived quality of life in any domain.
Tumor in the mouth and the total dose of radiation in the superior fossa were associated with the lowest quality of life in the symptoms domain. The female gender variable was associated with the lowest perceived quality of life in several domains This study shows that speech therapy should maintain a presence in the teams, to then guide the rehabilitation of organic dysphonia and mechanical dysphagia possibly afflicting patients after cancer treatment with radiation therapy and chemotherapy. Key words:Quality of life, dysphagia, head and neck neoplasms, rehabilitation.
Journal of Clinical and Experimental Dentistry 07/2013; 5(3):e122-7. DOI:10.4317/jced.51092
Available from: Prathamesh Pai
- "In developing countries like India, head and neck cancer (HNC) is a major health problem constituting 10% to 25% of all cancers . A large proportion of these patients are diagnosed with advanced disease and are treated with aggressive multimodality treatments that are associated with higher morbidity, worse quality of life (QOL) outcomes , and poor survival . This pattern of disease presentation can be explained by a high incidence coupled with other synergistic conditions such as low socioeconomic status, lack of cancer awareness, and difficulties in accessing the health care system. "
[Show abstract] [Hide abstract]
ABSTRACT: Head and neck cancer (HNC) survivors have substantial psychological distress in addition to treatment-related side effects. This study examines the long-term quality of life (QOL) of HNC survivors in a busy tertiary care center.
A prospective, cross-sectional survey was conducted studying 212 HNC survivors 1 year after completion of their treatment at a tertiary cancer center. Quality of life assessments were performed using the 2 standardized health-related QOL questionnaires: The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 and The Quality of Life Questionnaire Head and Neck Cancer Module.
The overall global QOL rating for the study cohort was satisfactory. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 scores showed that the domains where most patients faired poorly included financial difficulties (54%), appetite loss (36%), fatigue (33%), and cough (30%). The Quality of Life Questionnaire Head and Neck Cancer Module scale identified the domains with poor scores to be dry mouth (64%), dental problems (42%), sticky saliva (40%), cough (39%), and problems with mouth opening (32%). Patients with early-stage tumors and those treated with surgery alone had significantly better QOL scores when compared with advanced stage tumors and patients receiving either radiation alone or multimodality treatment, respectively.
Quality of life questionnaires provide a medium for patients to effectively communicate with their physician in a busy tertiary care facility and provide an insight into the physical, psychological, and social problems affecting our patients which can then direct future interventions.
American journal of otolaryngology 05/2009; 30(3):176-80. DOI:10.1016/j.amjoto.2008.05.001 · 0.98 Impact Factor
Available from: Riccardo De Gaudenzi
[Show abstract] [Hide abstract]
ABSTRACT: The authors propose an innovative code division multiple access
(CDMA)-based mobile system for voice (and data) services. The system
makes use of voice activation in order to increase the CDMA efficiency
(useful transmitted information vs. occupied bandwidth). The
synchronization problems are solved by distributing a master code in the
forward link and using forced link activation in the return when no
speech activity is detected. The blocking probability is minimized by
means of multirate speech coding associated with a centralized network
control. Bit error rate calculations show all the advantages of
operating in a synchronous mode
Global Telecommunications Conference, 1989, and Exhibition. Communications Technology for the 1990s and Beyond. GLOBECOM '89., IEEE; 12/1989
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.