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 2,979 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study evaluated post-treatment performance and quality of life (QOL) outcome in head and neck cancer (HNC) patients treated with organ preservation, intensive chemoradiotherapy (FHX). Participants were 47 Stage II-IV HNC patients with no evidence of disease at least one year post-completion of organ preservation, concomitant FHX treatment. Patients were assessed via a semi-structured in-person interview, standardized measures of QOL (FACT-H&N, CES-D), performance (PSS-HN) and patients' perception of residual side effects. Disease, treatment and toxicity data were retrieved from medical charts and protocol records. The most salient performance impairment was inability to eat a normal solid food diet, with 50% of patients able to eat soft foods or take liquids only. This specific functional deficit was not related to global QOL, nor to specific quality of life dimensions. Dry mouth, the most frequent and severe residual effect, was not associated with outcome diet, depression or QOL. Residual pain, seen in only 15% of patients, appeared to influence both functional and QOL parameters as well as being a marker for other troublesome symptoms. Twenty-three per cent of patients were depressed; depression was associated with past problems related to alcohol abuse. Decreased QOL and increased depressive symptomatology were related to total number and severity of residual effects. The data highlight the importance of systematic study of QOL dimensions and caution against making assumptions about patients' experience of particular disease and treatment sequelae.
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PMID:Performance and quality of life outcome in patients completing concomitant chemoradiotherapy protocols for head and neck cancer. 922 85

The aim of this study was to evaluate (by postal questionnaire) quality of life and function in patients who have had resections of oral cancer and reconstruction by radial forearm flaps. Between October 1987 and December 2002, 258 patients had reconstructions by radial forearm flaps after resection of tumours in the oral cavity. Of these, 139 surviving patients were identified from the database and were sent questionnaires comprising five sections: Functional Assessment of Cancer Therapy-General (FACT-G) and -Head and Neck (FACT-HN); University of Washington Quality of Life Scale (UWQoL); Performance Status Scale for Head and Neck Cancer (PSS-HN); and the final section addressed dental rehabilitation and morbidity at the donor site. Sixty-three questionnaires (45%) were returned. In 17 (27%), parts of the questionnaire were incomplete. The median UWQoL score was 623/900, FACT-G was 92/108, FACT-HN was 31/48, and PSS-HN showed that eating in public, understandability of speech and normality of diet were 75/100, 75/100 and 50/100, respectively. The effect of stage and site on quality of life and function did not reach statistical significance. The effect of radiotherapy on speech (p=0.036) and diet (p=0.007) was significant. Patients who worried about their cancer returning had a lower UWQoL score (p=0.016). Ninety percent regarded their arm as disfigured, but 81% felt comfortable wearing short-sleeved shirts. Sensation and function of the hand were reported as normal in 87 and 92%, respectively. We conclude that patients who have had oral cancer have a persistent reduction in quality of life and function long after completion of treatment. The effects can be assessed by postal questionnaire, but the low rate of return (45%) and difficulties with completion reduce the quality of the data. Quality of life and function are essential components of improvements in outcome.
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PMID:Measures of health-related quality of life and functional status in survivors of oral cavity cancer who have had defects reconstructed with radial forearm free flaps. 1609 76

The objective of this study is to provide a content comparison of frequently used questionnaires that assess health-related quality of life (hrQOL) in head and neck cancer (HNC) survivors. This systematic content comparison describes which specific areas of hr-QOL research are covered by each questionnaire. Thereby, it shall assist the clinician in the decision process of instrument selection depending on the content of the study question. As a reference, we chose the international classification of functioning, disability and health (ICF), which was adopted by the WHO in 2001. A systematic literature review identified current hrQOL questionnaires relevant for HNC. The concepts of functioning contained in each questionnaire were translated (linked") to the ICF according to standardized guidelines. Nine questionnaires were selected for further analyses: EORTC-QLQ (C30 + HN35), FACT (G + HN), UW_QOL, QOL-RTI, HN-QOL, PSS-HN, VHI, LORQ, XQ. Within the selected questionnaires, there are 474 concepts, matching 74 second-level ICF categories. The results are presented in tables, showing for each of the validated questionnaires, which of these 74 categories of functioning are addressed. In terms of diversification of content among the questionnaires, there are just eight categories that are used rather frequently and apply to at least five (out of nine) of the questionnaires: e110 Products for personal consumption (i.e., food, drugs), b510 ingestion function, b152 emotional function, b280 sensation of pain, b310 voice, d550 eating, b130 energy and drive function and d850 employment. This ICF-based content comparison provides detailed information on the content that is covered in each questionnaire and thereby assists questionnaire selection. The results question the assumption that HNC-specific questionnaires generally cover the same content. Depending on the study question, the population to be studied and the intervention, there is no unique ideal questionnaire. Compared with other types of qualitative review, the most important advantage of content comparison based on the ICF is the use of an external and independent reference.
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PMID:Content comparison of quality of life questionnaires used in head and neck cancer based on the international classification of functioning, disability and health: a systematic review. 1839 33