Functional Outcomes of Chemoradiation in Patients with Head and Neck Cancer

Tulunay‐Ugur, Ozlem E.; McClinton, Christopher; Young, Zachary; Peñagarícano, José; Maddox, Anne Marie; Vural, Emre

doi:10.1177/0194599812459325

Cited by 35 publications

(33 citation statements)

References 23 publications

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“…The affected domains were ''speech'' and emotional domains, but the change of these domains during recovery were not assessed. Another study evaluated the dependence on tracheotomy tube and showed that the average time of dependence was 11 months [25]. They did not measure QoL but speculated that tracheotomy tube may influence it.…”

Section: Discussionmentioning

confidence: 99%

Trends in the 15D health-related quality of life over the first year following diagnosis of head and neck cancer

Aro

Bäck

Loimu

et al. 2015

Eur Arch Otorhinolaryngol

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Management of head and neck cancer influences both physical and mental wellbeing. Measuring the health-related quality of life (HRQoL) is important, as various treatment modalities are associated with significant morbidity and mortality. In this prospective cohort study, we tested the feasibility of the generic 15D HRQoL instrument in 214 head and neck cancer patients managed with surgery, definitive (chemo)radiotherapy, or with combined modality treatment. HRQoL was assessed at baseline and three times after treatment onset during 1 year, and compared with that of general population standardized for age and sex. At baseline, the patients' mean 15D score was significantly worse compared with general population. Overall HRQoL was at lowest at 3 months after treatment onset, it gradually improved towards 12 months but never reached baseline levels. The dimensions "vitality", "distress", "depression" and "sexual activity" showed marked deterioration at 3 months after the treatment onset, but improved gradually during 12 months. The 15D instrument seems useful for evaluation of HRQoL of head and neck cancer patients. Dimensions reflecting mental wellbeing improved gradually after 3 months, but they seldom reached baseline levels. The support for patients at the time of diagnosis, during treatment, and recovery is emphasized.

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Section: Discussionmentioning

confidence: 99%

Trends in the 15D health-related quality of life over the first year following diagnosis of head and neck cancer

Aro

Bäck

Loimu

et al. 2015

Eur Arch Otorhinolaryngol

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“…Recent literature continues to show that XRT/CRT have a negative impact on QOL and swallowing function 52 with xerostomia-related complications being the most prominent obstacles for patients to overcome. 53 Minimizing and focusing XRT, while avoiding chemotherapy lead to less treatment toxicity and improved outcomes. 53–55 Patients with early stage disease treated with surgery alone, demonstrate superior outcomes by avoiding the toxicity of XRT.…”

Section: Commentmentioning

confidence: 99%

“…53 Minimizing and focusing XRT, while avoiding chemotherapy lead to less treatment toxicity and improved outcomes. 53–55 Patients with early stage disease treated with surgery alone, demonstrate superior outcomes by avoiding the toxicity of XRT. 27,54,56 Although this data is still in its infancy, TORS is showing promise as an optimal treatment strategy in early stage disease.…”

Section: Commentmentioning

confidence: 99%

Transoral Robotic Surgery for Oropharyngeal Cancer

Dziegielewski

Teknos

Durmuş

et al. 2013

JAMA Otolaryngol Head Neck Surg

198

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Objective To determine swallowing, speech and quality of life (QOL) outcomes following transoral robotic surgery (TORS) for oropharyngeal squamous cell carcinoma (OPSCC). Design Prospective cohort study. Setting Tertiary care academic comprehensive cancer center. Patients 81 patients with previously untreated OPSCC. Intervention Primary surgical resection via TORS and neck dissection as indicated. Main Outcome Measures Patients were asked to complete the Head and Neck Cancer Inventory (HNCI) pre-operatively and at 3 weeks as well as 3, 6 and 12 months post-operatively. Swallowing ability was assessed by independence from a gastrostomy tube (G-Tube). Clinicopathological and follow-up data were also collected. Results Mean follow-up time was 22.7 months. HNCI response rates at 3 weeks and 3, 6, and 12 months were 79%, 60%, 63%, 67% respectively. There were overall declines in speech, eating, aesthetic, social and overall QOL domains in the early post-operative periods. However, at 1 year post-TORS scores for aesthetic, social and overall QOL remained high. Radiation therapy was negatively correlated with multiple QOL domains (p<0.05), while age > 55 years correlated with lower speech and aesthetic scores (p<0.05). HPV status did not correlate with any QOL domain. G-Tube rates at 6 and 12 months were 24% and 9%, respectively. The extent of TORS (> 1 oropharyngeal site resected) and age > 55 years predicted the need for a G-Tube at any point after TORS (p<0.05). Conclusions Patients with OPSCC treated with TORS maintain a high QOL at 1 year after surgery. Adjuvant treatment and advanced age tend to decrease QOL.

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“…The risks for tracheostomy dependence may have multifactorial etiology, including poor laryngeal function prior to treatment as well as radiation toxicity after treatment, leading to laryngeal edema and laryngeal inflexibility as well as chondronecrosis . Some have attempted to identify factors that predict poor laryngeal function, as measured by long‐term tracheostomy . By identifying factors that predict poor functional outcomes after organ preservation therapy, we may better select for patients who would derive the most benefit from toxic chemoradiation regimens.…”

Section: Introductionmentioning

confidence: 99%

Predictors and outcomes for chronic tracheostomy after chemoradiation for advanced laryngohypopharyngeal cancer

2015

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Functional Outcomes of Chemoradiation in Patients with Head and Neck Cancer

Abstract: Despite major improvement in locoregional control rates, CCRT has a significant negative impact on the functional outcomes of head and neck cancer patients, with a high number of patients remaining PEG and tracheotomy dependent.

Cited by 35 publications

References 23 publications

Trends in the 15D health-related quality of life over the first year following diagnosis of head and neck cancer

Trends in the 15D health-related quality of life over the first year following diagnosis of head and neck cancer

Transoral Robotic Surgery for Oropharyngeal Cancer

Predictors and outcomes for chronic tracheostomy after chemoradiation for advanced laryngohypopharyngeal cancer

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