Associations between markers of social functioning and depression and quality of life in survivors of head and neck cancer: Findings from the Head and Neck Cancer 5000 study

Patterson, Joanne; Lu, Liya; Watson, Laura-Jayne; Harding, Sam; Ness, Andy R; Thomas, Steve; Waylen, Andrea; Pring, Miranda; Waterboer, Tim; Sharp, Linda

doi:10.1002/pon.5830

Cited by 18 publications

(13 citation statements)

References 46 publications

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“…Dysphagia is a major quality of life issue for patients treated for head and neck cancer treated either surgically or nonsurgically [19,20]. This potential longterm radiation damage has a profound impact on social functioning and mental health [21]. In order to reduce or limit these sequelae while maintaining excellent oncological outcomes, multiple paradigms have been explored with regard to treatment deescalation including cetuximab-RT [22,23], reduced-dose RT/CRT [24][25][26], induction chemotherapy followed by reduced-dose RT [27,28], postoperative RT with either reduced dose or RT volume [29][30][31], and TORS followed by the deintensified adjuvant therapy [32].…”

Section: Discussionmentioning

confidence: 99%

Survival and Swallowing Function after Primary Radiotherapy versus Transoral Robotic Surgery for Human Papillomavirus-Associated Oropharyngeal Squamous Cell Carcinoma

Hughes,

Levine,

May

et al. 2023

ORL

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Introduction: The aim of this study was to investigate the impact of primary transoral robotic surgery (TORS) versus radiotherapy (RT) on progression-free survival (PFS), overall survival (OS), and 1-year swallowing function for patients with early-stage HPV-associated oropharyngeal squamous cell carcinoma (OPSCC). Methods: Patients with stage I-II (AJCC 8th Ed.) HPV-associated OPSCC treated with TORS followed by risk-adapted adjuvant therapy or (chemo)radiotherapy between 2014 and 2019 were identified. PFS, OS, and swallowing outcomes including gastrostomy tube (GT) use/dependence, and Functional Oral Intake Scale (FOIS) change over 1 year were compared. Results: One hundred sixty-seven patients were analyzed: 116 treated with TORS with or without adjuvant RT and 51 treated with RT (50 chemoRT). The RT group had more advanced tumor/nodal stage, higher comorbidity, and higher rates of concurrent chemotherapy. There were no differences in 3-year PFS (88% TORS vs. 75% RT) or OS (90% vs. 81%) between groups, which persisted after adjusting for stage, age, and comorbidity. GT use/dependence rates were higher in the RT group. Mean (SD) FOIS scores in the TORS group were 6.9 (0.4) at baseline and 6.4 (1.0) at 1 year, compared with 6.7 (0.6) and 5.6 (1.7) for the RT group. Only clinical nodal stage was found to be significantly associated with FOIS change from baseline to 1 year. Conclusion: There were no differences in PFS or OS between patients treated with primary TORS or RT for early-stage HPV-associated OPSCC. Clinical N2 status is associated with FOIS change at 1 year and may be the major factor affecting long-term swallowing function, irrespective of primary treatment modality.

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Section: Discussionmentioning

confidence: 99%

Survival and Swallowing Function after Primary Radiotherapy versus Transoral Robotic Surgery for Human Papillomavirus-Associated Oropharyngeal Squamous Cell Carcinoma

Hughes,

Levine,

May

et al. 2023

ORL

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“…For example, Patterson et al . showed that loneliness was linked to the depressive state in HNC survivors ( 20 ). They showed that quality of life improved when self-esteem and social relationships improved.…”

Section: Discussionmentioning

confidence: 99%

Quality of life of patients irradiated for head and neck cancer and impact of rehabilitation with a removable dental prosthetic: 1-year follow-up study

Silvestri¹,

Saliba-Serre²,

Ruquet³

et al. 2022

J Clin Exp Dent

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Background Head and neck cancer and its treatment cause significant functional, aesthetic, and social disabilities. These disabilities have a major impact on the quality of life of patients. When irradiation is required, removable dental prostheses are often the treatment of choice. This study investigated whether removable prosthetic rehabilitation improved patient function and aesthetics over the long term. Material and Methods In this prospective study, we assessed quality of life in 78 patients with the General Oral Health Assessment Index (GOHAI) questionnaire. Assessments were performed before, and 1 week, 3 months, 6 months, and 12 months after denture insertion. We evaluated whether quality of life was influenced by the type of removable prosthesis and the primary tumour location. Results We constructed mixed-effects linear regression models to identify correlates of the overall GOHAI score (GOAHI-add score) and the three domain-scores (functional, psychosocial, and discomfort/pain) in a longitudinal analysis over a 12-month follow-up. We compared scores (GOHAI-add score and domain-scores) in multivariate analyses between baseline (T0) and four post-insertion timepoints to determine significant changes. Conclusions We found that removable prosthetic rehabilitation had an influence on the evolution of quality of life. The psychosocial component scores increased steadily over the year and changed more significantly than the functional and discomfort-pain components. The mandibular location of the primary lesion had a negative influence on quality of life. The type of removable prosthesis did not influence the results. Key words: Quality of life, head and neck cancer, GOHAI, dental prosthesis, radiotherapy.

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“…Definitions of good and harm are much broader than will a person aspirate oral contents, and yet, this is so much the focus of risk feeding guidance and policies [5 ▪ ]. Advocating for restrictive consistencies or even nonoral feeding brings with it the very real harms of malnutrition and dehydration, withdrawal from society and isolation [23 ▪ ,24], family burden when trying to provide altered meals [25] and loss of patient and carer identity [26]. Comparing these harms with the less well evidenced potential benefits makes us question the received wisdom of traditional EDS intervention.…”

Section: Closer Inspection Of Principlesmentioning

confidence: 99%

Ethical considerations in the care of people with eating, drinking and swallowing difficulties

Leslie

Lisiecka

2022

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of reviewEating, drinking and swallowing difficulties are low on the list of clinical headlines. Until something affects the process and then we see how pervasive and devastating such issues are. Recent guidelines have been published looking at national competencies to be structured into preregistration education. Professional bodies have addressed the topic from a risk perspective, which may be counter to the patient-centred approach of shared decision making. Our review places the literature in the wider, historical context of bioethics and our experience regarding ethical challenges as we strive to support our patients. Recent findingsRecent literature addressing ethical care for a person with eating, drinking and swallowing difficulties, highlights shared decision-making. This is guided by patient preference, professional roles and approaches, cultural context and informed consent. Studies highlight the importance of appropriate communication and documentation, and ethical decision-making steps.

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Associations between markers of social functioning and depression and quality of life in survivors of head and neck cancer: Findings from the Head and Neck Cancer 5000 study

Cited by 18 publications

References 46 publications

Survival and Swallowing Function after Primary Radiotherapy versus Transoral Robotic Surgery for Human Papillomavirus-Associated Oropharyngeal Squamous Cell Carcinoma

Survival and Swallowing Function after Primary Radiotherapy versus Transoral Robotic Surgery for Human Papillomavirus-Associated Oropharyngeal Squamous Cell Carcinoma

Quality of life of patients irradiated for head and neck cancer and impact of rehabilitation with a removable dental prosthetic: 1-year follow-up study

Ethical considerations in the care of people with eating, drinking and swallowing difficulties

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