Aspiration Prevention Surgery under Local Anesthesia for Palliative Care in Patients with Head and Neck Cancer: A Report of Two Cases

ORL ◽  
2020 ◽  
pp. 1-7
Author(s):  
Misaki Sekiguchi Koyama ◽  
Rumi Ueha ◽  
Takao Goto ◽  
Taku Sato ◽  
Akane Tachibana ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Local Anesthesia ◽  
Neck Cancer ◽  
Respiratory Impairment ◽  
Severe Dysphagia ◽  
Type Of Surgery

Aspiration prevention (AP) surgery may improve the quality of life (QOL) of patients with severe dysphagia. However, not all patients can endure this type of surgery under general anesthesia because of their poor status. Herein, we describe the cases of 2 patients with head and neck cancer (HNC) who underwent AP surgery for palliative care. Although both patients had tracheostomy due to severe dysphagia and respiratory impairment and frequently needed suction, they were successfully managed with AP surgery under local anesthesia. A tracheostoma was reshaped to be sufficiently large for an airway to be secured without a cannula. Their respiratory failure gradually improved, and suction frequency markedly decreased after surgery; thus, they could receive medical treatment at home. When patients with HNC under palliative care have a tracheal cannula and cannot vocalize, AP surgery under local anesthesia is an option to improve their QOL.

Effect of Early Palliative Care on Quality of Life of Advanced Head and Neck Cancer Patients: A Phase III Trial

2021 ◽  
Author(s):  
Vijay Maruti Patil ◽  
Pankaj Singhai ◽  
Vanita Noronha ◽  
Atanu Bhattacharjee ◽  
Jayita Deodhar ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Overall Survival ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Phase Iii ◽  
Early Palliative Care

Abstract Background Early palliative care (EPC) is an important aspect of cancer management but has never been evaluated in patients with head and neck cancer. Hence, we performed this study to determine whether the addition of EPC to standard therapy leads to an improvement in the quality of life (QOL), decrease in symptom burden and improvement in overall survival. Methods Adult patients with squamous cell carcinoma of the head and neck region planned for palliative systemic therapy, were allocated 1:1 to either standard systemic therapy without (STD arm) or with comprehensive EPC service referral (EPC arm). Patients were administered the revised Edmonton Symptom Assessment Scale (ESAS-r) and the Functional Assessment of Cancer Therapy for head and neck cancer (FACIT HN) questionnaire at baseline and every 1 month thereafter for 3 months. The primary endpoint was a change in the QOL measured at 3 months after random assignment. All statistical tests were 2-sided. Results Ninety patients were randomly assigned to each arm. There was no statistical difference in the change in the FACT-H&N total score (P = .94), FACT-H&N Trial Outcome Index (P = .95), FACT- G (general) total (P = .84) and ESAS-r scores at 3 months between the two arms. The median overall survival was similar between the two arms (Hazard ratio for death = 1.01, 95% CI = 0.74–1.35). There were 5 in-hospital deaths in both arms (5.6% for both, P = .99). Conclusions In this phase III study, the integration of EPC in head and neck cancer patients did not lead to an improvement in the QOL or survival.

Effect of early integration of specialized palliative care into standard oncologic treatment on the quality of life of patients with advanced head and neck cancers: A phase III randomized controlled trial.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 12013-12013
Author(s):  
Pankaj Singhai ◽  
Vijay Maruti Patil ◽  
Mary Ann Muckaden ◽  
Jayita Deodhar ◽  
Naveen Salins ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Overall Survival ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Systemic Therapy ◽  
Phase 3 ◽  
Early Palliative Care

12013 Background: Early palliative care is an important aspect of palliative treatment but has never been evaluated in head and neck cancer. Hence we performed this study. Methods: This was an open-label phase 3 randomised study which enrolled adult patients with squamous cell carcinoma of the head and neck region which warranted palliative systemic therapy. They were 1:1 allocated to either systemic therapy with (EPC arm) or without the addition of early palliative care service (STD arm). Patients were administered the Edmonton Symptom Assessment Scale (ESAS-r) and FACIT HN questionnaire at baseline and 4 weekly thereafter for 12 weeks. The primary endpoint was change in the quality of life (QOL) measured using FACIT HN 12 weeks after randomization. The secondary endpoints were changed in symptom burden at 12 weeks in ESAS-r and overall survival. A repeated-measures analysis of covariance (ANCOVA) was performed to examine the effects of arm and stratum on change in QOL (or symptom score), after controlling for baseline score. Results: Ninety patients were randomised in each arm between 1st June 2016 to 14th August 2017. The compliance with the questionnaires was 100% at baseline. In EPC arm the 70 patients were alive at 3 months and 67 (95.7%) completed the FACIT HN and 64 (91.4%) completed ESAS-r questionnaires. While in the STD arm out of 69 alive the corresponding figures were 61(88.4%) and 59 (85.5%) respectively. There was no statistical difference in change in QOL scores and ΔESAS-r at 12 weeks between the 2 arms (Table). The median overall survival was similar between the 2 arms. (Hazard ratio for death-1.006 (95%CI 0.7347-1.346)). Conclusion: In this phase 3 study, integration of early palliative care in head and neck cancer patients did not result in improvement in the quality of life scores, symptom scores or overall survival. Clinical trial information: CTRI/2016/03/006693 . [Table: see text]

Mapping the University of Washington Quality of life questionnaire onto EQ‐5D and HUI‐3 indices in patients with head and neck cancer

Head & Neck ◽  
2019 ◽  
Vol 42 (3) ◽  
pp. 513-521 ◽  
Author(s):  
Robert F. Stephens ◽  
Christopher W. Noel ◽  
Jie (Susie) Su ◽  
Wei Xu ◽  
Murray Krahn ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Life Questionnaire ◽  
University Of Washington ◽  
Quality Of Life Questionnaire ◽  
The University
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