scholarly journals Quality of Life in Electrochemotherapy for Cutaneous and Mucosal Head and Neck Tumors

2021 ◽  
Vol 10 (19) ◽  
pp. 4366
Author(s):  
Giuseppe Riva ◽  
Laura Salonia ◽  
Elisabetta Fassone ◽  
Silvia Sapino ◽  
Fabrizio Piano ◽  
...  

Background: Primary or recurrent head and neck cancer of skin or mucosa represents a challenge for clinicians and could be debilitating for the patient. Electrochemotherapy (ECT) emerged as a local ablative procedure for cutaneous and mucosal head and neck tumors. The aim of this observational study was the evaluation of quality of life (QoL) after ECT in patients without other surgical or radiation options as curative treatment. Materials and methods: The procedure was performed according the ESOPE (European Standard Operating procedure of Electrochemotherapy) protocol. Twenty-seven patients were evaluated before ECT (T0) and 1 (T1), 3 (T2), and 6 (T3) months after the procedure. QoL was assessed by means of the EORTC QLQ-C30 and EORTC QLQ-H&N35 questionnaires. Results: The objective tumor response rate was 48% (11% CR, 37% PR). Bleeding control was achieved in 7/7 patients who experienced bleeding prior to ECT. QoL improvement was observed after the procedure. In particular, global health status and social functioning were higher after ECT (p 0.026 and 0.043), while pain, pain-killers use and appetite loss decreased (p 0.045, 0.025 and 0.002). Conclusion: ECT represents a safe and effective treatment for skin and mucosal head and neck tumors without other curative options. It ensures a good pain and bleeding control without worsening of QoL.

2010 ◽  
Vol 97 (2) ◽  
pp. 270-275 ◽  
Author(s):  
Kean Fatt Ho ◽  
Damien J.J. Farnell ◽  
Jacqueline A. Routledge ◽  
Meriel P. Burns ◽  
Andrew J. Sykes ◽  
...  

2009 ◽  
Vol 27 (18) ◽  
pp. 2970-2976 ◽  
Author(s):  
François Meyer ◽  
André Fortin ◽  
Michel Gélinas ◽  
Abdenour Nabid ◽  
François Brochet ◽  
...  

Purpose To assess the added prognostic value for overall survival (OS) of baseline health-related quality of life (HRQOL) and of early changes in HRQOL among patients with localized head and neck cancer (HNC) treated with radiation therapy. Patients and Methods All 540 patients with HNC who participated in a randomized trial completed two HRQOL instruments before radiation therapy: the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) and the Head and Neck Radiotherapy Questionnaire. Six months after the end of radiation therapy, 497 trial participants again completed the two HRQOL instruments. During the follow-up, 179 deaths were observed. Multivariate Cox proportional hazards models were used to test whether HRQOL variables, baseline and change, provided additional prognostic value beyond recognized prognostic factors. Results The baseline EORTC QLQ-C30 physical functioning (PF) score was an independent predictor of OS. The hazard ratio (HR) associated with a 10-point increment in baseline PF was 0.87 (95% CI, 0.81 to 0.94). In multivariate models, the change in HRQOL was significantly associated with OS for most HRQOL dimensions. Among these, PF change was the strongest predictor. The magnitude of the association between PF change and survival decreased over time. At 1 year, the HR associated with a positive PF change of 10 points was 0.75 (95% CI, 0.68 to 0.83). After PF is taken into account, no other HRQOL variable was associated with survival. Conclusion Our findings indicate that both baseline PF and PF change provide added prognostic value for OS beyond established predictors in patients with HNC. Assessing HRQOL could help better predict survival of cancer patients.


1997 ◽  
Vol 116 (6) ◽  
pp. 666-673 ◽  
Author(s):  
Eva Hammerlid ◽  
Kristin Bjordal ◽  
Marianne Ahlner-ELMQVIST ◽  
Magnus Jannert ◽  
Stein Kaasa ◽  
...  

Despite modern advances in the treatment of head and neck cancer, the survival rate fails to improve. Considering the different treatment modalities involved, quality of life has been thought of as an additional end point criterion for use in clinical trials. A Nordic protocol to measure the quality of life of head and neck cancer patients before, during, and after treatment was established. Before the study, a pilot study was done with this protocol. The main purpose of this pilot study was to find out whether this cancer population would answer quality-pf-life questionnaires repeatedly (six times) over a 1-year period and whether the chosen questionnaires—a core questionnaire (European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30)), a tumor-specific questionnaire, and a psychological distress measure (Hospital Anxiety and Depression scale (HAD))—were sensitive for changes to functions and symptoms during the study year. The results presented in this article all refer to the pilot study. Forty-eight consecutive patients agreed to participate in the study. The most common tumor locations were the oral cavity (17) and the larynx (12). Almost all patients received combined treatment: 45 of 48 radiation therapy, 18 of 48 chemotherapy, and 17 of 48 surgery. After the primary treatment, 40 patients had complete tumor remission. Four of the 48 patients did not answer any questionnaires and were therefore excluded from the study. Of the remaining 44 patients, 3 died during the study year, and another 6 withdrew for various reasons. Thirty-five (85%) of the 41 patients alive at the 1-year follow-up answered all six questionnaires and thus completed the study. Mailed questionnaires were used throughout the study. All questionnaires were well accepted and found to be sensitive to changes during the study year. The greatest variability was found for symptoms and functions related specifically to head and neck cancer. The symptoms were swallowing difficulties, hoarse voice, sore mouth, dry mouth, and problems with taste. They all showed the same pattern, with an increase of symptoms during and just after finishing the treatment. The HAD scale revealed a high level of psychological distress, with 21% probable cases of psychiatric morbidity at diagnosis. In conclusion, it was shown that the study design and questionnaires were feasible for the forthcoming prospective quality-of-life assessment of Swedish and Norwegian head and neck cancer patients.


Author(s):  
Vipul Nautiyal ◽  
Viney Kumar ◽  
Anshika Arora ◽  
Meenu Gupta ◽  
Shivani Mehra ◽  
...  

Introduction: Most of the Recurrent or Metastatic (R/M) Head and Neck Squamous Cell Carcinomas (HNSCC) patients are treated only by palliative treatment. Metronomic Chemotherapy (MC) low doses is an emerging therapeutic option in these patients. It exerts tumour angiogenesis, stimulate anticancer immune response, induces tumour dormancy and offers a significant improvement in Quality of Life (QoL) with minimal toxicity. Aim: To assess the changes in QoL in patients with Metastatic, Recurrent (M/R) HNSCC receiving MC. Materials and Methods: This was a prospective interventional hospital-based study from February 2015 to September 2018, conducted at Cancer Research Institute, Himalayan Institute of Medical Sciences, SRHU University, Dehradun, Uttarakhand, India. A total of 175 patients more than 18 years, with Eastern Cooperative Oncology Group (ECOG) performance status score <2, with M/R HNSCC, not amenable to any radical treatment, were equally distributed by lottery method in three arms, in those receiving Capecitabine (Arm A, n: 59), Celecoxib and Methotrexate (Arm B, n: 62); and placebo with best supportive care (Arm C, n: 54). In addition to demographic and baseline clinical characteristics, patients were assessed for physical examination and questioned to score their QoL by European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) at presentation and followed every month for two months. Results: A total of 175 patients enrolled for the study, the mean age of study population was 56.73±6.84 years with male preponderance 77.71%. A 60% suffered from carcinoma oral cavity (n=105), followed by carcinoma oropharynx (24%) (n=42), carcinoma larynx and carcinoma hypopharynx consisted rest 16% (n=28). Altogether the QoL was quite divergent amongst the three arms. Symptom score for fatigue, dyspnoea, loss of appetite, nausea and vomiting showed rise representing worsening in Arm A and Arm C; whilst these symptoms also showed fall in symptom score in Arm B (fatigue: p-value=0.007; dyspnoea; p-value=0.042; Appetite loss: p-value=0.008 Nausea: p-value=0.02; Vomiting: p-value=0.03). There was a statistically significant improvement in overall EORTC QLQ-C30 score from baseline in the Methotrexate and Celecoxib arm (Arm B) compared with Capecitabine and with placebo. Conclusion: Metronomic Chemotherapy (MC) with Methotrexate and Celecoxib seems promising and well tolerated in patients with metastatic or advanced HNSCC as compared to Capecitabine or keeping on symptomatic treatment solely.


2019 ◽  
Vol 8 (4) ◽  
pp. 39-47
Author(s):  
A. V. Karpenko ◽  
R. R. Sibgatullin ◽  
A. A. Boyko ◽  
M. G. Kostova ◽  
O. M. Nikolayeva ◽  
...  

The study objective is to evaluate the quality of life as one of the main parameters that determines the effectiveness of treatment of patients with head and neck squamous cell carcinoma.Materials and methods. Thirty-three stage III—IV oral cancer patients aged between 39 and 70 years were asked to fill EORTC QLQ-C30 (European Organisation for Research and Treatment of Cancer quality of life questionnaire core 30-questions) and QLQ-H&N35 (head and neck cancer-specific module) before and 12—18 months after completion of the treatment that consisted of surgery followed by radiation with or without chemotherapy. Surgery included neck dissection with removal of the primary tumor via transoral (n = 5) or combined (n = 28) approach. Reconstruction was performed by primary closure (n = 5), with pedicled (n = 8) or free (n = 20) flaps.Results. According to EORTC QLQ-C30 questionnaire only positive shifts turned out to be statistically significant: general health, emotional function, pain, insomnia and diarrhea. Site-specific EORTC QLQ-H&N35 questionnaire revealed several positive (pain in the head and neck, feeling ill, use of painkillers and weight gain) and negative (public eating, problems with taste and smell, sticky saliva and dry mouth) changes. Applying algorithms for determining clinical significance changed the number and value of several scales and domains. Changes in general health, emotional function, pain, insomnia, pain in the head and neck, taste and smell disorders, mouth opening, sticky saliva, dry mouth, painkillers and weight gain were found to have some clinical relevance. Moreover, for one of them (mouth opening) statistical significance was not reached.Conclusions. Further research of clinical significance of changes and differences in scales and domains that determine and affect quality of life are needed. They will allow to understand more fully problems that every patient with oral cavity cancer tries to cope with.


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