Dysphagia, voice problems, and pain in head and neck cancer patients

Abstract Purpose Head and neck cancer (HNC) and its treatment can leave devastating side effects with a relevant impact on physical and emotional quality of life (QoL) of HNC patients. The objectives were to examine the amount of dysphagia, voice problems, and pain in HNC patients, the impact of sociodemographic, behavioral, and clinical factors on these symptoms, the psychometric properties of the EAT-10, and the relationship between these symptoms and QoL variables. Methods HNC patients attending for regular follow-up from 07/2013 to 09/2019 completed questionnaires (Eating Assessment Tool-10 (EAT-10); questions from the EORTC QLQ-C30 and EORTC H&N35) on dysphagia, voice problems, pain, fatigue, and QoL collected with the software OncoFunction. Associations between prognostic factors and symptoms were tested with analyses of variance (ANOVAs). Associations between the symptom scales and QoL variables were expressed with Pearson correlations. Results Of 689 patients, 54.9% suffered from dysphagia, the EAT-10 proved to be a reliable measure. The mean voice score was 37.6 (± 33.9) [range 0–100], the mean pain score 1.98 (± 2.24) [range 0–10]. Trimodality treatment was associated with the highest dysphagia scores. Dysphagia, voice problems, and pain significantly correlated with each other, the highest association was found for dysphagia and pain (r = 0.51). QoL was strongly correlated with dysphagia and pain (r = − 0.39 and r = − 0.40, respectively), while the association with voice problems was weaker (r = − 0.28). Conclusion Dysphagia is an important symptom in HNC patients greatly affecting patients’ QoL and significantly correlating with voice problems and pain.

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Course of Self-Reported Dysphagia, Voice Impairment and Pain in Head and Neck Cancer Survivors

Biology ◽

10.3390/biology10020144 ◽

2021 ◽

Vol 10 (2) ◽

pp. 144

Author(s):

Veit Zebralla ◽

Susanne Wiegand ◽

Andreas Dietz ◽

Gunnar Wichmann ◽

Thomas Neumuth ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Assessment Tool ◽

Outpatient Setting ◽

Functional Impairments ◽

Substantial Impact ◽

Related Quality ◽

Eortc Qlq ◽

The Impact

Background: Head and neck cancer (HNC)-specific symptoms have a substantial impact on health-related quality of life. The aim of this study was to determine whether self-reported dysphagia, voice problems and pain of HNC patients changed over time and whether specific clinical or sociodemographic variables were associated with these symptoms. Methods: HNC patients (n = 299) in an outpatient setting answered questionnaires (Eating Assessment Tool-10; questions from the EORTC QLQ-C30 and EORTC H&N35) on dysphagia, voice problems and pain, collected with the software “OncoFunction” at three different timepoints (t1–t3) after diagnosis. The mean score changes from t1 to t3 were expressed in terms of effect sizes d. The impact of sociodemographic and clinical factors on the course of the variables was tested with multivariate analyses of variance. Results: Dysphagia, voice impairment and pain in HNC survivors significantly improved over a period of approximately 14 months after diagnosis. Tumor site, stage, treatment modality, occupational state and ECOG state were significantly correlated with self-reported functional outcome. The pain level of the HNC patients was rather low. Conclusions: Patients suffer from functional impairments after HNC treatment, but an improvement in self-reported symptoms could be demonstrated within this time period.

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Mapping the EORTC QLQ-C30 and QLQ-H&N35 to the EQ-5D for head and neck cancer: Can disease-specific utilities be obtained?

PLoS ONE ◽

10.1371/journal.pone.0226077 ◽

2019 ◽

Vol 14 (12) ◽

pp. e0226077 ◽

Cited By ~ 2

Author(s):

Ann-Jean C. C. Beck ◽

Jacobien M. Kieffer ◽

Valesca P. Retèl ◽

Lydia F. J. van Overveld ◽

Robert P. Takes ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Eortc Qlq C30 ◽

Eortc Qlq ◽

Disease Specific

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Prospective, Longitudinal Quality-of-Life Study of Patients With Head and Neck Cancer: A Feasibility Study Including the EORTC QLQ-C30

Otolaryngology ◽

10.1016/s0194-5998(97)70246-8 ◽

1997 ◽

Vol 116 (6) ◽

pp. 666-673 ◽

Cited By ~ 76

Author(s):

Eva Hammerlid ◽

Kristin Bjordal ◽

Marianne Ahlner-ELMQVIST ◽

Magnus Jannert ◽

Stein Kaasa ◽

...

Keyword(s):

Quality Of Life ◽

Head And Neck Cancer ◽

Psychological Distress ◽

Pilot Study ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Eortc Qlq C30 ◽

Eortc Qlq

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.

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Identifying cutoff scores for the EORTC QLQ-C30 and the head and neck cancer-specific module EORTC QLQ-H&N35 representing unmet supportive care needs in patients with head and neck cancer

Head & Neck ◽

10.1002/hed.24266 ◽

2015 ◽

Vol 38 (S1) ◽

pp. E1493-E1500 ◽

Cited By ~ 12

Author(s):

Femke Jansen ◽

Claire F. Snyder ◽

C. René Leemans ◽

Irma M. Verdonck-de Leeuw

Keyword(s):

Head And Neck Cancer ◽

Supportive Care ◽

Head And Neck ◽

Neck Cancer ◽

Supportive Care Needs ◽

Care Needs ◽

Eortc Qlq C30 ◽

Cutoff Scores ◽

Eortc Qlq

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PCN378 - MINIMALLY IMPORTANT DIFFERENCES FOR INTERPRETING EORTC QLQ-C30 SCORES IN MELANOMA, BREAST CANCER AND HEAD AND NECK CANCER PATIENTS ON BEHALF OF THE EORTC BREAST, HEAD AND NECK, MELANOMA AND QUALITY OF LIFE GROUPS

Value in Health ◽

10.1016/j.jval.2018.09.460 ◽

2018 ◽

Vol 21 ◽

pp. S78

Author(s):

Z.J. Musoro ◽

C. Coens ◽

F. Fiteni ◽

K. Pogoda ◽

F. Cardoso ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Eortc Qlq C30 ◽

Eortc Qlq ◽

Head And Neck Melanoma

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A relationship between quality-of-life and head and neck cancer: A systemic review

South Asian Journal of Cancer ◽

10.4103/2278-330x.175955 ◽

2015 ◽

Vol 04 (04) ◽

pp. 179-182 ◽

Cited By ~ 8

Author(s):

Sujal Mitul Parkar ◽

Mihir N. Shah

Keyword(s):

Quality Of Life ◽

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Observational Studies ◽

Systemic Review ◽

European Organization ◽

Eortc Qlq ◽

The Impact

Abstract Aim: The aim was to identify the literature and to assess the association between quality-of-life (QoL) and head and neck cancer (HNC) related outcomes systemically. Materials and Methods: The full articles published in English language bio-medical journals between 1992 and December 2014 were searched using Medline database. The keywords used for searching the articles include the combination of "health-related of QoL," "QoL," "HNC." The search limited only to the observational studies using questionnaires European Organization for Research and Treatment of Cancer (EORTC) QLQ C 30 and EORTC QLQ H and N 35. Purely psychological studies were excluded. Results: A total of 5055 articles were retrieved, and 16 articles were selected for this review. Of 16 observational studies, 13 (81.25%) were prospective cohort studies while remaining 3 (18.75%) were cross-sectional studies. The main findings of the studies revealed that the treatment of HNC had a statistically significant influence on QoL. Others associated factors like age, female sex, duration of treatment, advance tumor, and site of the tumor has also the impact on QoL on patients suffering from HNC. Conclusion: This review provides evidence for a positive relationship between cancer-related outcomes and QoL. Assessment of QoL in relation to HNC with proper methodology and validated instruments is lacking hence there is a need for further evidence to support the relation between cancer and QoL.

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Mapping the EORTC QLQ‐C30 and QLQ‐H & N35 , onto EQ‐5D‐5L and HUI ‐3 indices in patients with head and neck cancer

Head & Neck ◽

10.1002/hed.26181 ◽

2020 ◽

Vol 42 (9) ◽

pp. 2277-2286 ◽

Cited By ~ 1

Author(s):

Christopher W. Noel ◽

Robert F. Stephens ◽

Jie (Susie) Su ◽

Wei Xu ◽

Murray Krahn ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Eortc Qlq C30 ◽

Eortc Qlq

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Nutrition impact symptoms and weight loss in head and neck cancer during radiotherapy: a longitudinal study

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2019-002077 ◽

2020 ◽

pp. bmjspcare-2019-002077

Author(s):

Sanli Jin ◽

Qian Lu ◽

Yan Sun ◽

Shaowen Xiao ◽

Baomin Zheng ◽

...

Keyword(s):

Weight Loss ◽

Body Weight ◽

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Post Treatment ◽

Nutrition Impact Symptoms ◽

The Mean ◽

The Impact ◽

Interference Score

ObjectivePatients with head and neck cancer (HNC) receiving radiotherapy (RT) are at high risk of weight loss (WL) due to a variety of nutrition impact symptoms (NIS). This study aimed to describe the NIS through the Head and Neck patient Symptom Checklist and body weight over time and further explore the impact of NIS on WL in patients with HNC undergoing RT.MethodsThis was a prospective, longitudinal observational study. NIS and body weight of 117 participants were assessed at baseline, mid-treatment and post-treatment of RT. Generalised estimation equations (GEE) were used to conduct repeated measures analysis of NIS interference score and body weight at each time point and estimate the impact of NIS interference score on WL.ResultsAll participants experienced a substantial increase in the mean number of NIS during RT, with each patient having eight to nine NIS at mid-treatment and post-treatment. Marked increases were noted in almost each NIS score during RT. Compared with their baseline body weight, 97 (82.9%) and 111 (94.9%) participants experienced WL at mid-treatment and post-treatment, with the mean WL of 2.55±1.70 kg and 5.31±3.18 kg, respectively. NIS of dry mouth (β=−0.681, p=0.002, 95% CI −1.116 to −0.247), difficulty swallowing (β=−0.410, p=0.001, 95% CI −0.651 to −0.169) and taste change (β=−0.447, p=0.000, 95% CI −0.670 to −0.225) impacted WL significantly in GEE multivariate model.ConclusionsPatients with HNC experience a variety of NIS which have significant impact on WL during RT. Assessment of NIS, especially dry mouth, difficulty swallowing and taste change, should be given more considerable attention in the supportive care of patients with HNC.

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