QOL – Oral Cancer News

Reducing RT toxicity in head and neck cancer: recent research context

Source: www.medpagetoday.com Author: Kristin Jenkins, contributing writer, MedPage Today In patients with head and neck malignancies, studies show that the significant acute and long-term toxicities and poor quality of life (QOL) associated with postoperative radiation therapy (PORT) can be improved by selectively reducing larger radiotherapy volumes. This includes treating just one side of the neck. In patients with locally advanced head and neck squamous cell carcinoma (HNSCC), however, locoregional failure rates with the omission of PORT to the pathologically uninvolved neck (PN0) have been less clear. As a result, PORT has historically been delivered to the PN0 neck, with several studies showing high rates of regional control ranging from 95% to 100%. Notably, consensus clinical practice guidelines continue to recommend the use of bilateral irradiation of node-negative necks. However, results from a prospective phase II study in 72 patients with primary HNSCC and high-risk pathology features now suggest that PORT to the PNo neck can be eliminated without sacrificing excellent disease control or QOL. At a median follow-up of 53 months, absolute regional control in the unirradiated neck was 97%, even though 67 patients (93%) had stage III/IV disease and 71% of tumors involved or crossed midline. No patient received contralateral neck PORT, and 17 patients (24%) were treated for the primary neck tumor only, said Wade Thorstad, MD, of Washington University in St. Louis, and colleagues. The 5-year rates of local control, regional control, progression-free survival, and overall survival (OS) were 84%, 93%, 60%, and 64%, respectively, they reported [...]

Oral Cancer Foundation News Team - A2019-11-21T12:57:43-07:00November, 2019|Oral Cancer News|

Improving QOL in head and neck cancer as survival improves

Source: www.medscape.com Author: Zosia Chustecka In patients undergoing radiation treatment for head and neck cancer, reducing the radiation to organs not affected by cancer is key to improving quality of life post-treatment. Several studies presented here at the 2014 Multidisciplinary Head and Neck Cancer Symposium described new approaches to sparing radiation delivered to the salivary glands and to the voice box, without any loss of cancer control, but with a reported reduction in adverse effects, such as xerostomia (dry mouth), and an anticipated reduction in loss of voice and speech quality. Improvements in such outcomes are becoming increasingly important as the epidemiology of head and neck cancer is changing, and the increase in human papillomavirus-positive disease means that patients are being diagnosed their 50s and will, in many cases, go on to live for decades after their definitive cancer treatment, researchers commented at a press briefing. Xerostomia can make it difficult to speak, as well as chew and swallow, and can lead to dental problems. "Dry mouth might seem trivial, but it actually has a significant effect on quality of life," commented Tyler Robin, PhD, an MD candidate in his final year at the University of Colorado Medical School in Denver. To reduce this adverse effect, intensity-modulated radiation techniques are already directing the beam away from the parotid gland, which is responsible for stimulated saliva production, for example during eating. But for the rest of the time, saliva is produced unstimulated from the submandibular gland. "This gland actually produces the [...]

Oral Cancer Foundation News Team - A2014-02-28T14:23:04-07:00February, 2014|Oral Cancer News|

Influences and predictors of long-term quality of life in head and neck cancer survivors

Source: Arch Otolaryngol Head Neck Surg. 2009;135(4):380-384. Authors: Mark W. El-Deiry, MD et al. Objective: To examine the impact of clinical predictors (pretreatment variables) and other influences (treatment and posttreatment variables) on long-term quality of life (QOL) in patients treated for squamous cell carcinoma of the upper aerodigestive tract. We hypothesized that baseline QOL and comorbidity would be predictors of QOL 1 year after treatment. Design: Retrospective cohort study. Setting: Academic Medical Center in Seattle, Washington. Patients: Patients (N = 173) with baseline (pretreatment) and 1-year posttreatment QOL data. Main Outcome Measure: Head and neck–specific QOL scores at 1 year after treatment (as measured by the University of Washington Quality of Life [UW-QOL] scale). Results: We identified strong relationships between 1-year UW-QOL scores and baseline UW-QOL scores (correlation coefficient [Pearson r] = 0.58; P

Oral Cancer Foundation News Team - A2009-05-20T09:48:02-07:00May, 2009|Oral Cancer News|

Aspiration, weight loss, and quality of life in head and neck cancer survivors

Source: Arch Otolaryngol Head Neck Surg. 2004;130:1100-1103 Authors: Bruce H. Campbell, MD et al. Objective: To determine associations between objective assessments (swallowing function and weight change) and subjective quality-of-life (QOL) measures. Design: Observational case series using clinical testing and questionnaires. Setting: University hospital-based tertiary clinical practice. Patients: Convenience sample of 5-year survivors of head and neck cancer (62 nonlaryngectomy survivors were studied). Interventions: Objective testing included examination, weight history, videofluoroscopic swallow studies (VFSS), and oropharyngeal swallowing efficiency (OPSE). Subjective testing included QOL questionnaires (University of Washington Quality-of-Life [UWQOL] Scale, Performance Status Scale for Head and Neck Cancer Patients [PSS-HN], Functional Assessment of Cancer Treatment–General [FACT-G] Scales, and Functional Assessment of Cancer Therapy–Head and Neck [FACT-H&N] Scale). Main Outcome Measures: Aspiration (identified by VFSS), weight change, and QOL measures. Results: Aspiration was associated with the decreased QOL scores in chewing, swallowing, normalcy of diet, and additional concerns of the FACT-H&N Scale. No association was found between aspiration and willingness to eat in public, subjective understandability, or any of the FACT-G scales. Of the nonlaryngectomy survivors, 27 (44%) demonstrated some degree of aspiration during VFSS. Associations were found between aspiration, primary tumor T stage, weight change, and OPSE. Aspirators lost a mean of 10.0 kg from precancer treatment weight, while nonaspirators gained a mean of 2.3 kg (P

Oral Cancer Foundation News Team - A2009-05-20T09:37:36-07:00May, 2009|Oral Cancer News|