Long‐Term Quality of Life After Total Laryngectomy and Postoperative Radiotherapy Versus Concurrent Chemoradiotherapy for Laryngeal Preservation

Boscolo‐Rizzo, Paolo; Maronato, Francesca; Marchiori, Carlo; Gava, Alessandro; Mosto, Maria Cristina Da

doi:10.1097/mlg.0b013e31815a9ed3

Cited by 126 publications

(105 citation statements)

References 25 publications

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“…21 However, this group found chemoradiation to be superior in terms of global QOL, speech and social contact compared to those undergoing surgical treatment.…”

Section: Discussionmentioning

confidence: 99%

Quality of life after treatment of laryngeal carcinoma: a single centre cross-sectional study

Williamson

Ingrams

Jones

2011

annals

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The mainstays of treatment for head and neck cancers include surgery, chemotherapy and radiotherapy given alone or in combination. However, the side effects of these treatments are multifactorial in nature, causing substantial physical as well as psychosocial morbidity.1,2 Their location inherently affects life's basic and vital functions including breathing, feeding and oral communication. Furthermore, altered appearance, difficulty in swallowing and pain as a result of treatment can cause problems with social function and have a further effect on a patient's quality of life (QOL). 3A number of studies have revealed QOL is affected by T and N stage, 4,5 time after treatment and treatment modality. [5][6][7] Investigation into the effect of these factors on specific aspects of QOL such as saliva production and swallowing has yielded varying conclusions. 7-10The aim of this study was to identify whether factors including patient age, treatment modality, tumour stage and nodal status significantly affect quality of life in patients treated for laryngeal cancer. It was hypothesised that patients with advanced T stage and nodal disease would experience poorer QOL. Furthermore, patients undergoing surgical treatment with or without chemoradiotherapy would experience poorer QOL than those undergoing primary radiotherapy.We aimed to identify those aspects of QOL that are significantly affected in order to counsel patients regarding the significant risks and benefits of treatment with uncertain curative outcomes. Furthermore, we aimed to identify patients at risk of significant side effects before treatment in order to effectively prepare them for their treatment experience and focus support from health professionals on the appropriate patients. MethodsThe University of Washington Quality of Life (UW-QOL) questionnaire is a validated tool for determining QOL outcomes in patients treated for head and neck cancer.9,11,12 We used version 3 of the questionnaire (the most current at the time), which consists of ten domain specific questions that ask patients regarding their experiences of pain, appearance, activity level, recreation, swallowing, chewing, speech, shoulder function, taste and saliva production in the last seven days, compared to the month before they de- . We aimed to identify which aspects of QOL and which patients are most affected by the various treatment options. METHODS The University of Washington Quality of Life (UW-QOL) questionnaire was administered to all patients with laryngeal cancer treated at a single institution over a seven-year period (2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010). RESULTS In total, 41 patients responded. All had been treated for squamous cell carcinoma of the larynx. Questionnaires were completed at a median of 18.5 months after treatment. The overall quality of life was 81.1/100 as assessed by the UW-QOL scale, with only 4.9% reporting 'poor' or worse QOL. Neither patient age nor time after treatment significantly affected any aspect of QOL. Patients undergoing primary r...

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“…21 However, this group found chemoradiation to be superior in terms of global QOL, speech and social contact compared to those undergoing surgical treatment.…”

Section: Discussionmentioning

confidence: 99%

Quality of life after treatment of laryngeal carcinoma: a single centre cross-sectional study

Williamson

Ingrams

Jones

2011

annals

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“…Patients for whom the presence of a prescription for opioids indicated they had not stopped using opioids at 3 months after the completion of radiation therapy were considered to be "nonstoppers." The 3-month cutoff time was based on the findings of previous studies indicating that a majority of patients return to their baseline level of pain and function within 3 months after treatment [6,7,[22][23][24]. In addition, we also conducted an analysis of stoppers versus nonstoppers at the 6-month period to determine if identified risk factors at 3 months are persistent at 6 months, as well as to determine duration of treatment among those patients who ultimately succeeded becoming stoppers.…”

Section: Methodsmentioning

confidence: 99%

Predictors of Long-Term Opioid Treatment Among Patients Who Receive Chemoradiation for Head and Neck Cancer

et al. 2013

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Introduction. The factors associated with successful opioid discontinuation after cancer treatment are not well‐known. We determined the proportion of patients with advanced head and neck cancer who continued using opioids 3 months after the completion of radiation therapy with or without chemotherapy. Methods. We included 70 patients with head and neck cancer referred to our institution's supportive care center between January 1, 2008, and December 31, 2010. Patients who no longer used opioids 3 months after the completion of radiation therapy were classified as stoppers; patients who continued using opioids were considered nonstoppers. We compared demographics, cancer‐related characteristics, alcoholism, substance abuse history, use of psychoactive drugs, and opioid‐related factors between stoppers and nonstoppers. Results. In all, 44 of 70 patients (63%) and 23 of 70 patients (33%) continued opioids 3 months and 6 months after the completion of radiation therapy, respectively. A total of 18 of 44 nonstoppers (41%) and 3 of 26 stoppers (12%) were positive for alcoholism based on the CAGE questionnaire (i.e., Cut down, Annoying, Guilty, Eye opener; odds ratio: 5.3). Demographic and clinical characteristics did not differ between stoppers and nonstoppers. The median duration of any type of opioid use of CAGE‐positive patients was significantly longer than that of CAGE‐negative patients (median: 261 days vs. 93 days; hazard ratio: 2.5). Conclusion. CAGE positivity is a risk factor for opioid use beyond 3 months after the completion of radiation therapy and for duration of opioid treatment. Routine CAGE screening and meticulous follow‐up are needed for these patients.

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“…The only studies that examined voice self-assessment in relation with psychological states studied populations with severe voice disabilities and voice pathologies. They observed that negative voice self-assessment and speech in patients who suffered partial or total laryngectomies was associated with higher levels of depression and anxiety and withdrawal from social activities (Devins et al 1994;Nalbadian et al 2001;Birkhaug et al 2002;de Maddalena 2002;Hanna et al 2004;Boscolo-Rizzo et al 2008;Danker et al 2010). Our results demonstrate that the relationship between voice self-assessment and psychological states also holds in the normal population.…”

Section: Connected Speechmentioning

confidence: 99%

Effects of age on the amplitude, frequency and perceived quality of voice

Lortie

Thibeault

Guitton

et al. 2015

AGE

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The manner and extent to which voice amplitude and frequency control mechanisms change with age is not well understood. The related question of whether the assessment of one's own voice evolves with age, concomitant with the acoustical changes that the voice undergoes, also remains unanswered. In the present study, we characterized the aging of voice production mechanisms (amplitude, frequency), compared the aging voice in different experimental contexts (vowel utterance, connected speech) and examined the relationship between voice self-assessment and age-related voice acoustical changes. Eighty healthy adults (20 to 75 years old) participated in the study, which involved computation of several acoustical measures of voice (including measures of fundamental frequency, voice amplitude, and stability) as well as self-assessments of voice. Because depression is frequent in older adults, depression and anxiety scores were also measured. As was expected, analyses revealed age effects on most acoustical measures. However, there was no interaction between age and the ability to produce high/low voice amplitude/frequency, suggesting that voice amplitude and frequency control mechanisms are preserved in aging. Multiple mediation analyses demonstrated that the relationship between age and voice self-assessment was moderated by depression and anxiety scores. Taken together, these results reveal that while voice production undergoes important changes throughout aging, the ability to increase/decrease the amplitude and frequency of voice are preserved, at least within the age range studied, and that depression and anxiety scores have a stronger impact on perceived voice quality than acoustical changes themselves.

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Long‐Term Quality of Life After Total Laryngectomy and Postoperative Radiotherapy Versus Concurrent Chemoradiotherapy for Laryngeal Preservation

Abstract: We found better long-term QoL scores in patients undergoing concurrent chemoradiation. This appears to be mainly because of better physical functioning, social functioning, and social contact and smaller problems with pain, respiration, speech, the senses, and sleep disturbances.

Cited by 126 publications

References 25 publications

Quality of life after treatment of laryngeal carcinoma: a single centre cross-sectional study

Quality of life after treatment of laryngeal carcinoma: a single centre cross-sectional study

Predictors of Long-Term Opioid Treatment Among Patients Who Receive Chemoradiation for Head and Neck Cancer

Effects of age on the amplitude, frequency and perceived quality of voice

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