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Health-related Quality of Life in Head and Neck Cancer. A Five-year Prospective Multicenter Study

Nordgren, Mats LU (2005)
Abstract
The aim of this prospective longitudinal multicenter study was to evaluate the health-related quality of life (HRQL) in patients with head and neck cancer at diagnosis, after one and five years in relation to tumour location, stage, sub site, treatment modality, gender and age.



The first part of the study, lasting for one year, consisted of 357 patients (mean age 63 years; 72% males) that were included between 1993 and 1995. Their health-related quality of life (HRQL) was evaluated repeatedly with standardized HRQL questionnaires; the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core-30 (EORTC QLQ-C30) and the EORTC Head and Neck Cancer Module (EORTC QLQ-H&N35).

... (More)
The aim of this prospective longitudinal multicenter study was to evaluate the health-related quality of life (HRQL) in patients with head and neck cancer at diagnosis, after one and five years in relation to tumour location, stage, sub site, treatment modality, gender and age.



The first part of the study, lasting for one year, consisted of 357 patients (mean age 63 years; 72% males) that were included between 1993 and 1995. Their health-related quality of life (HRQL) was evaluated repeatedly with standardized HRQL questionnaires; the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core-30 (EORTC QLQ-C30) and the EORTC Head and Neck Cancer Module (EORTC QLQ-H&N35).



A follow-up was performed 1998-2000 on the 192 surviving patients after five years, and 167 (87%) of them answered the same questionnaires once more. The results, i.e. the mean score for the entire study population showed no improvements in HRQL. Deterioration was found already after 3 months for treatment related symptoms, such as problems with teeth, opening of the mouth, dryness in the mouth and sticky saliva. These problems persisted or worsened over time. Similar results were found regardless of tumour location, stage, sub site, most treatment modalities, gender and age. Patients who died during the study, reported worse HRQL both at diagnosis and at the one-year follow-up compared to the survivors. The HRQL at diagnosis was associated with survival and with quality of life after five years. When the data were analyzed individually, 40% of the patients reported improved score on the global quality of life scale from diagnosis to the five-year follow-up. In addition, 11% had a high quality of life at both assessment points. This pattern also applied for most of the other function and symptom scales, except for treatment related symptoms. The side-effects of treatment were noteworthy even in those patients that showed stable or improved global quality of life.



In conclusion, treatment of head and neck cancer often result in side-effects for at least five years, and problems with dry mouth, teeth and sticky saliva are considerable. The HRQL at diagnosis for patients with head and neck cancer seems to be an important factor for the prognosis of both HRQL over time and survival. (Less)
Abstract (Swedish)
Popular Abstract in Swedish

Detta är en prospektiv longitudinell multicenterstudie som har haft som mål att utvärdera livskvaliteten (HRQL) hos patienter med cancer i huvudhalsregionen, vid diagnos, efter ett och fem år i relateration till tumörlokal, stadium, subsite, behand-ling, kön och ålder.



Den första delen av studien, som varade i ett år, bestod av 357 patienter (medelålder 63 år; 72% män) som inkluderades 1993-1995 och deras livskvalitet utvärderades upprepade gånger under ett år med stan-dardiserade livskvalitetsformulär: the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core-30 (EORTC QLQ-C30) och EORTC Head and Neck Cancer Module (EORTC... (More)
Popular Abstract in Swedish

Detta är en prospektiv longitudinell multicenterstudie som har haft som mål att utvärdera livskvaliteten (HRQL) hos patienter med cancer i huvudhalsregionen, vid diagnos, efter ett och fem år i relateration till tumörlokal, stadium, subsite, behand-ling, kön och ålder.



Den första delen av studien, som varade i ett år, bestod av 357 patienter (medelålder 63 år; 72% män) som inkluderades 1993-1995 och deras livskvalitet utvärderades upprepade gånger under ett år med stan-dardiserade livskvalitetsformulär: the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core-30 (EORTC QLQ-C30) och EORTC Head and Neck Cancer Module (EORTC QLQ-H&N35).



En femårsuppföljning genomfördes 1998-2000 på de överlevande 192 patien-terna och 167 (87%) svarade på samma livskvalitetsformulär en gång till. Resultaten, dvs. medeltalen för hela studiepopulationen, visade inga förbättringar i livskvaliteten. Däremot skedde försämring av be-handlingsrelaterade symptom redan efter tre månader, såsom muntorrhet, seg saliv, tandproblem och svårigheter att öppna munnen.



Dessa problem kvarstod eller ökade med tiden. Liknande resultat noterades oavsett tumörlokal, stadium, subsite, de flesta behandlingar, kön eller ålder. Patienter som avled under studiens gång rapporterade sämre livskvalitet både vid diagnos och vid ettårskontrollen jämfört med dem som överlevde.



När data analyserades individuellt visade 40% av patienterna förbättrade resultat för den globala livskvalitetsskalan från diagnos till femårskontrollen. Dessutom hade 11% av patienterna en hög livskvalitet vid båda mättillfällena. Mönstret enligt den globala livskvalitetsskalan var också jämförbart med de flesta av de andra funktions- och symptomskalorna, utom för behandlingsrelaterade symptom. Dessa försämrades även hos de patienter som hade stabil eller förbättrad livskvalitet enligt den globala livskvalitetsskalan.



Sammanfattningsvis visar studien att behandling av huvudhalscancer ofta resulterar i mångåriga biverkningar i minst fem år med muntorrhet, tandproblem och seg saliv. Livskvaliteten vid diagnos för patienter med huvudhalscancer verkar vara en viktig faktor för prognosen för både livskvaliteten efter fem år och för överlevnaden. (Less)
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author
supervisor
opponent
  • Docent Zätterström, Ulf, Uppsala Universitet
organization
publishing date
type
Thesis
publication status
published
subject
keywords
EORTC QLQ-H&N35, Health-related quality of life, hörsel- och talorganen, prospective, longitudinal, predictive factors, Medicine (human and vertebrates), Medicin (människa och djur), audiologi, auditive system and speech, Otorinolaryngologi, audiology, Otorhinolaryngology, head and neck cancer, EORTC QLQ-C30
pages
158 pages
publisher
Mats Nordgren, Department of Otorhinolaryngology, Malmö University Hospital, SE-205 02 Malmö, Sweden
defense location
Jubileumsaulan MFC, Malmö University Hospital, Malmö, Sweden
defense date
2005-12-03 09:15:00
ISBN
91-85481-01-7
language
English
LU publication?
yes
additional info
H Abendstein, M Nordgren, M Boysen, M Jannert, E Silander, E Ahlner-Elmqvist, E Hammerlid and K Bjordal. . Quality of Life and Head and Neck Cancer - A Five-Year Prospective Study. Laryngoscope, (accepted)
M Nordgren, H Abendstein, M Jannert, M Boysen, M Ahlner-Elmqvist, E Silander, K Bjordal and E Hammerlid. 2003. Health-related quality of life five years after diagnosis of laryngeal carcinoma. Intl J Rad Oncol Biol Phys, vol 56 pp 1333-43.
M Nordgren, M Jannert, M Boysen, M Ahlner-Elmqvist, E Silander, K Bjordal and E Hammerlid. . Health-Related Quality of Life in Patients with Pharyngeal Carcinoma: a Five-Year Follow-up. Head and Neck, (accepted)
M Nordgren, E Hammerlid, K Bjordal, M Boysen, M Ahlner-Elmqvist and M Jannert. . Quality of Life in Oral Carcinoma: a Five-Year Prospective Study. (manuscript)
id
02fedebf-d252-44b8-993e-de518325b0b4 (old id 545673)
date added to LUP
2016-04-01 15:54:51
date last changed
2018-11-21 20:37:19
@phdthesis{02fedebf-d252-44b8-993e-de518325b0b4,
  abstract     = {{The aim of this prospective longitudinal multicenter study was to evaluate the health-related quality of life (HRQL) in patients with head and neck cancer at diagnosis, after one and five years in relation to tumour location, stage, sub site, treatment modality, gender and age.<br/><br>
<br/><br>
The first part of the study, lasting for one year, consisted of 357 patients (mean age 63 years; 72% males) that were included between 1993 and 1995. Their health-related quality of life (HRQL) was evaluated repeatedly with standardized HRQL questionnaires; the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core-30 (EORTC QLQ-C30) and the EORTC Head and Neck Cancer Module (EORTC QLQ-H&amp;N35).<br/><br>
<br/><br>
A follow-up was performed 1998-2000 on the 192 surviving patients after five years, and 167 (87%) of them answered the same questionnaires once more. The results, i.e. the mean score for the entire study population showed no improvements in HRQL. Deterioration was found already after 3 months for treatment related symptoms, such as problems with teeth, opening of the mouth, dryness in the mouth and sticky saliva. These problems persisted or worsened over time. Similar results were found regardless of tumour location, stage, sub site, most treatment modalities, gender and age. Patients who died during the study, reported worse HRQL both at diagnosis and at the one-year follow-up compared to the survivors. The HRQL at diagnosis was associated with survival and with quality of life after five years. When the data were analyzed individually, 40% of the patients reported improved score on the global quality of life scale from diagnosis to the five-year follow-up. In addition, 11% had a high quality of life at both assessment points. This pattern also applied for most of the other function and symptom scales, except for treatment related symptoms. The side-effects of treatment were noteworthy even in those patients that showed stable or improved global quality of life.<br/><br>
<br/><br>
In conclusion, treatment of head and neck cancer often result in side-effects for at least five years, and problems with dry mouth, teeth and sticky saliva are considerable. The HRQL at diagnosis for patients with head and neck cancer seems to be an important factor for the prognosis of both HRQL over time and survival.}},
  author       = {{Nordgren, Mats}},
  isbn         = {{91-85481-01-7}},
  keywords     = {{EORTC QLQ-H&N35; Health-related quality of life; hörsel- och talorganen; prospective; longitudinal; predictive factors; Medicine (human and vertebrates); Medicin (människa och djur); audiologi; auditive system and speech; Otorinolaryngologi; audiology; Otorhinolaryngology; head and neck cancer; EORTC QLQ-C30}},
  language     = {{eng}},
  publisher    = {{Mats Nordgren, Department of Otorhinolaryngology, Malmö University Hospital, SE-205 02 Malmö, Sweden}},
  school       = {{Lund University}},
  title        = {{Health-related Quality of Life in Head and Neck Cancer. A Five-year Prospective Multicenter Study}},
  year         = {{2005}},
}