Treatment expectations and quality of life outcomes of patients with laryngeal cancer based on different treatment methods

Abstract

The treatment expectations of patients with laryngeal carcinoma and their quality of life after treatment were evaluated. We enrolled patients who were receiving treatment for epidermoid carcinoma of the larynx between January 2011 and January 2012. Their expectations from the treatment were evaluated using the visual analog scale (VAS) prior to and at the end of the treatment. Quality of life was assessed using the EORTC QLQ C 30 and EORTC H&N 35 questionnaires 3 months after completion of the treatment. In addition, the Beck Depression Inventory was used for mood assessment of the patients after treatment. As per the VAS scores pre-treatment, no differences were found between treatment expectations of early and advanced-stage tumors groups in pre-treatment expectations, but post-treatment evaluation statistically found difference between two groups in terms of average VAS score. Emotional, cognitive, and social functions of the EORTC QLQ C 30 questionnaire were the most affected items in the advanced-stage tumor group. Sense and speech problems in the symptom scales of the EORTC H&N 35 questionnaire were found to be significantly higher in patients with advanced-stage tumors than in those with early stage tumors. The present study is the first to assess the treatment expectations of patients with laryngeal carcinoma by using the VAS. Although the treatment expectations of the patients with early and advanced-stage tumors did not differ according to VAS scores in pre-treatment evaluation, early stage groups had better score than advanced-stage group. VAS was an easy and a simple applicable method for evaluating treatment expectations.

Laringectomias supracricóides: revisão de literatura em protocolos de qualidade de vida

“…Another aspect quoted by authors is the disease stage, once in early stages treatments are more conservative, increasing the satisfaction level with the treatment method 12,13,27 . By applying the Beck Depression Inventory, used to assess patients' mood after treatment, some authors could conclude that patients with tumors in more advanced stages are more willing to develop depression than patients in early HN-QOL The HNQOL questionnaire was developed by the Otorhinolaryngology department of Michigan University.…”

“…Early decanulated patients are more satisfied with their quality of life than those who remained with the tracheostomy for a long period of time 11,13,26,38 , since besides affecting directly the feeding and increasing the permanence in hospital 35 , the presence of the tracheal cannula affects significantly the voice, contributing for a difficulty in the speech intelligibility with a consequent prejudice in social communication¹. Thus, patients tend to have a better self-assessment of quality of life when they are without the nasogastric tube, decanulated and with the possibility of social eating 7,8,26,37 .…”

“…It important to stress that the assessment of quality of life of patients in early stages is different than those in more advanced stages of the disease. That is because a more conservative approach changes significantly the patient's expectations towards the treatment, diminishing the physical and emotional distress, and consequently improving the quality of life scores 13 . In this study, it was possible to verify that the most commonly used general protocol to asses voice related quality of life in individuals submitted to SCPL was the VHI.…”

“…Several literature reports show local control, low recurrence rate 5,[7][8][9][10] and survival rates similar to TL [1][2][3] , besides allowing the nonuse of permanent tracheostomy, which enables the oral feeding, voice preservation and social functions, providing a better quality of life 5,6,[11][12][13][14] . Thus, the SPL justifies itself as an alternative of great value once it allows the maintenance of voice without the use of any device and without training 15 .…”

Desvantagem vocal e estratégias de enfrentamento nas disfonias após laringectomias

“…Survival rates of SCPL are similar to the TL ones (6,8) , although it may benefit the patient by not using permanent tracheostomy. The vocal quality after SCPL is characterized as hoarse and breathy (2) , however intelligible, allowing the patient to keep an effective voice for his communication (1) and has low impact on social activities, contributing for a better quality of life (1,3,4,5,9,10) . The TL, however, is still one of the main procedures in the treatment of laryngeal cancer and the patient needs to learn a new way of verbal communication and deal with breathing and swallowing changes, which will certainly interfere in his life (11) .…”