The impact of Radiotherapy on Swallowing and Speech in Patients who Undergo total Laryngectomy

2008 ◽  
Vol 139 (6) ◽  
pp. 792-797 ◽  
Author(s):  
Carmen de Casso ◽  
Nicholas J. Slevin ◽  
Jarrod J. Homer
Keyword(s):  
Total Laryngectomy ◽  
Chart Review ◽  
Detrimental Effect ◽  
Definitive Treatment ◽  
Soft Diet ◽  
Carcinoma Of The Larynx ◽  
Voice Development ◽  
The Impact ◽  
Single Modality

Objectives Quality of life studies have shown no detrimental effect with radiotherapy (RT) in patients who have a total laryngectomy. We wished to determine the effect of RT (initial or postoperative) specifically on the swallowing and voice function in patients treated by total laryngectomy (TL) for carcinoma of the larynx. Design Multicenter chart review. Setting Multicenter study in the Greater Manchester and Lancashire area. Participants A total of 121 postlaryngectomy patients all of whom had completed definitive treatment at least 6 months before this study. Twenty-six patients had total laryngectomy as a single modality treatment and 95 had total laryngectomy and radiotherapy. Main Outcome Measures Swallowing (solid food, soft diet or fluid/PEG) and voice development. Results Swallowing was better in the group who had no radiotherapy ( P = 0.0037). There was no difference in voice function between the two groups. We also demonstrated that females had a worse swallowing outcome ( P = 0.0101), as did advanced nodal stage ( P = 0.001). Conclusions RT adversely affects the swallowing results but not the speech results after TL when given either as initial treatment or postoperatively. This should be kept in mind in the decision-making process in the treatment of patients with carcinoma of the larynx.

scholarly journals Quality of Life following Chemoradiotherapy for Localized Muscle Invasive Bladder Carcinoma: A Systematic Review

2021 ◽  
pp. 1-13
Author(s):  
Ben-Max De Ruiter ◽  
Abel N. Keijzer ◽  
Maarten C.C.M. Hulshof ◽  
Adriaan D. Bins ◽  
Theo M. de Reijke ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Sexual Function ◽  
Bladder Carcinoma ◽  
Bowel Function ◽  
Definitive Treatment ◽  
Cochrane Library ◽  
Social And Emotional ◽  
Muscle Invasive ◽  
The Impact

BACKGROUND: Health related Quality of Life (HRQoL) is an important factor regarding treatment for localized Muscle Invasive Bladder Carcinoma (MIBC), as it may affect choice of treatment. The impact of chemoradiotherapy (CRT) for MIBC on HRQoL has not yet been well-established. OBJECTIVE: To systematically evaluate evidence regarding HRQoL as assessed by validated questionnaires after definitive treatment with CRT for localized MIBC. METHODS: We performed a critical review of PubMed/MEDLINE, EMBASE, and the Cochrane Library in October 2020. Two reviewers independently screened articles for eligibility and assessed the methodological quality of the included articles using Joanna Briggs Institute critical appraisal tools. A narrative synthesis was undertaken. RESULTS: Of 579 articles identified, 11 studies were eligible for inclusion, including three RCTs and 8 non-randomized studies, reporting on HRQoL data for 606 CRT patients. Global health declined at End of treatment (EoT), and recovered 3 months following treatment. Physical function declined from baseline at EoT and recovered between 3 and 24 months and was maintained at 5 years follow up. CRT had little effect on social and emotional function in the short-term, but HRQoL results in the long-term were lower compared to the general population. Urinary function declined from baseline at EoT, but returned to baseline at 6 months following CRT. After initial decline in bowel function, a complete return to baseline occurred 4 years following treatment. The majority of studies assessing sexual function showed no to little effect on sexual function. CONCLUSIONS: HRQoL recovers to baseline within 3 months to 2 years in almost all domains. The amount of available evidence regarding HRQoL following CRT for MIBC is limited and the quality of evidence is low.

scholarly journals Social isolation and quarantine in the COVID-19 pandemic: impacts on mental health and quality of population life

2021 ◽  
Vol 10 (2) ◽  
pp. e30510212535
Author(s):  
Gabriel Kiaro Leite Nunes ◽  
Karinne Alice Santos de Araújo ◽  
Thais Ranielle Souza de Oliveira ◽  
Marcelina da Conceição Botelho Teixeira ◽  
Ieler Ferreira Ribeiro ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Social Isolation ◽  
Negative Impact ◽  
Definitive Treatment ◽  
World Population ◽  
The World ◽  
The Face ◽  
The Impact

The COVID-19 pandemic brought about major changes in the lifestyle of the world population. Due to the lack of vaccines or a definitive treatment for disease, governments around the world have adopted social isolation and quarantine as methods to control the spread of the virus. Objective: Thus, the objective of this study was to discuss how social isolation and quarantine periods affected people's mental health and quality of life during the COVID-19 pandemic. Methods: An integrative literature review was carried out during the COVID-19 pandemic between March and September 2020, establishing the following guiding question: How did social isolation and quarantine affect the mental health and quality of life of the population in the COVID-19 pandemic? Results: The final sample consisted of nineteen (19) articles, two (2) addressed depression during the pandemic period, three (3) presented the pandemic and the relationship with sociodemographic aspects, five (5) analyzed mental health in the pandemic, four (4) reported the impact of COVID-19 on the population's style and quality of life and the last five (5) demonstrated the quality of human relationships and emotional aspects in the face of the pandemic. Conclusion: It was demonstrated that isolation and the quarantine period had a negative impact on the population's quality of life and long-term mental health.

Retrospective Chart Review of Cryopreserved Amniotic Membrane for Knee Pain

2020 ◽  
Author(s):  
Ruben Berrocal Timmons
Keyword(s):  
Quality Of Life ◽  
Adverse Events ◽  
Amniotic Membrane ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Final Analysis ◽  
Mean Values ◽  
Number Of Patients ◽  
The Impact

Objective: Treatment of joint pain with an injection of the amniotic membrane has not been adequately studied. This study retrospectively reviewed Visual Analog Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and analgesic usage data from patients treated with the injection of cryopreserved amniotic membrane (CAM) in their knees to determine the impact of treatment on patients’ pain, quality of life, and analgesic usage. Methods: Chart review was conducted on 40 patients. Institutional Review Board (IRB) approval was obtained prior to initiation of the project. The membrane was utilized as per the FDA guidance of 21CFR1271. Retrospective data, including demographics, medical history, pain score, quality of life score, analgesic usage and adverse events, were collected from their medical records for each consenting patient through 6 months after CAM injection. Results: A total of 40 patients were considered in the final analysis. Mean VAS for pain level improved from 7.0 to 2.6 (p<0.001). WOMAC daily activity function score improved from a mean score of 52 to 28 (p<0.001). Opioid and non-steroidal anti-inflammatory drug (NSAID) usage decreased from 97% to 25% (p<0.001). No adverse events were reported. Conclusion: Mean values for VAS and WOMAC scores significantly improved at all time points and the number of patients who used analgesics decreased as compared to baseline. CAM injection into painful knee joints decreases pain, improves physical function, and decreases the use of analgesics in the absence of adverse events.

scholarly journals Burden of disease and adaptation to life in patients with Crohn’s perianal fistula: a qualitative exploration

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Samuel O. Adegbola ◽  
Lesley Dibley ◽  
Kapil Sahnan ◽  
Tiffany Wade ◽  
Azmina Verjee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Perianal Fistula ◽  
Well Being ◽  
Definitive Treatment ◽  
Emotional Impact ◽  
Published Data ◽  
Perianal Fistulas ◽  
Patient Reported ◽  
The Impact

Abstract Background Perianal fistulas are a challenging manifestation of Crohn’s disease. Best medical and surgical therapy results in only about a third of patients remaining in remission at one year on maintenance treatment and sustained healing is often elusive. There is little published data on patient perspective of living with the condition or coping strategies in the face of non-curative/non-definitive treatment. We aimed to understand the experience of living with perianal fistula(s) and their impact on quality of life and routine functioning. Methods This exploratory qualitative study used purposive sampling to recruit participants with current / previous diagnosis of Crohn’s anal fistulas, from national IBD / bowel disease charities. The “standards for reporting qualitative research” (SRQR) recommendations were followed. Unstructured individual face-to-face interviews were audio recorded, transcribed and analysed thematically. Early themes were reviewed by the study team including patient advocates, clinicians and qualitative researchers. Results Twelve interviews were conducted, achieving apparent data saturation. Three broad themes were uncovered: Burden of symptoms; Burden of treatment; and Impact on emotional, physical and social well-being. Each included several sub-themes, with considerable interplay between these. The impact of perianal fistula(s) on patients with CD is intense and wide reaching, negatively affecting intimate, close and social relationships. Fistulas cause losses in life and work-related opportunities, and treatments can be difficult to tolerate. Conclusion Crohn’s perianal fistulas exert a heavy negative physical and emotional impact on patients. These findings will inform development of a patient reported outcome measure to assess treatment effectiveness and quality of life for patients living with this challenging condition.

Emotional well-being and quality of life in patients undergoing radiation therapy for pancreatic and hepatobiliary malignancies.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 297-297
Author(s):  
B. T. Samuelson ◽  
E. K. Fromme ◽  
J. Waller ◽  
C. R. Thomas
Keyword(s):  
Quality Of Life ◽  
Radiation Therapy ◽  
Positive Response ◽  
Well Being ◽  
Definitive Treatment ◽  
Hepatobiliary Malignancies ◽  
Before And After ◽  
Patient Related Outcome ◽  
The Impact

297 Background: Therapy for GI malignancies has long been known to have a marked impact on quality of life, yet this relationship remains poorly understood. The specific aim of this analysis was to evaluate the impact of radiation therapy (RT) on emotional well-being and QOL in patients receiving RT for pancreatic and hepatobiliary malignancies. Methods: A retrospective, IRB-approved chart review was performed of 722 patients receiving RT for any cancer diagnosis between 1/1/2006 and 12/31/2008. Subjects completed the Functional Assessment of Cancer Therapy General (FACT-G) questionnaire before and after RT. Pre- and immediately post-RT course scores were compared using student t-tests with Bonferroni correction for multiple comparisons (7 comparisons, alpha =.007). Results: 722 of 1369 (52.7%) patients participated in the Patient Related Outcome database. Complete pre and post RT spirituality data were available for 73 (64.6%) patients with GI malignancies, including 24 (33%) with pancreatic or hepatobiliary disease. Average age was 61, 15 (63%) were male and 14 (58%) received definitive treatment. A decrease in both functional and physical well-being was demonstrated in post-RT scores as compared to pre-RT. Emotional well-being, however, increased (17.60 to 18.72, p=0.051), a trend not replicated in any of the other GI malignancies. Further analysis demonstrated this improvement was largely due to a decrease in positive response to the statements “I feel nervous” (1.21 to 0.67, p=0.009) and “I worry my condition will get worse” (1.58 to 1.25, p=0.043). A decrease in positive response to “I feel sad” and an increase in positive response to “I am satisfied with how I am coping with my illness” were also noted, but differences were not significant. Conclusions: Emotional well-being of those receiving RT for pancreatic and hepatobiliary malignancies appears to improve over the course of therapy, even while other measures of QOL decline. Additional investigations in larger populations are warranted to further elucidate this relationship. Documentation of PROs may have potential for impact on QOL for patients with these and other malignancies. No significant financial relationships to disclose.

Is there a difference in quality of life, comparing summer and winter, in patients who have undergone total laryngectomy?

2007 ◽  
Vol 122 (9) ◽  
pp. 967-971
Author(s):  
F C Van Wyk ◽  
F Vaz ◽  
M Harries ◽  
J Weighill
Keyword(s):  
Quality Of Life ◽  
Total Laryngectomy ◽  
Cross Sectional Study ◽  
Short Term ◽  
Cross Sectional ◽  
European Organization ◽  
Eortc Qlq C30 ◽  
Eortc Qlq ◽  
The Impact

AbstractIntroduction:Several studies have implied that patients' quality of life stabilises six months after undergoing total laryngectomy. However, these studies may well have overlooked persistent short term variations in patients' quality of life. The aim of this study was to assess the impact of seasonal change (i.e. summervswinter) on the quality of life of patients following total laryngectomy.Methods:A prospective, cross-sectional study of recurrence-free laryngectomy patients was performed, using the European Organization for Research and Treatment of Cancer (version three) QLQ-C30 questionnaires (EORTC QLQ-C30), during January 2004 (i.e. winter), August 2004 (summer) and January 2005 (winter).Results:Thirty-six patients were entered into the study. The response rate was 70.3 per cent. Patient's time elapsed since surgery varied from six months to 12 years. In all questionnaire domains, responses seemed remarkably consistent over time.Conclusion:No statistically significant differences were found between summer and winter scores in all the domains analysed by the EORTC QLQ-C30.

Quality of Life after Surgical Treatment of Cancer of the Larynx

1995 ◽  
Vol 104 (10) ◽  
pp. 763-769 ◽  
Author(s):  
Lawrence W. DeSanto ◽  
Kerry D. Olsen ◽  
Daniel E. Rohe ◽  
William C. Perry ◽  
Robert L. Keith
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Psychosocial Adjustment ◽  
Total Laryngectomy ◽  
Negative Impact ◽  
Partial Laryngectomy ◽  
Partial Operation ◽  
As Stress ◽  
The Impact

The purpose of the study was to assess the quality of life of patients after surgical treatment for cancer of the larynx. Three groups of patients were identified according to surgical treatment: total laryngectomy, 111 patients; near-total laryngectomy, 38 patients; and partial laryngectomy, 23 patients. The impact of successful surgical treatment on their life roles was analyzed in terms of work, activities, familial and spousal relationships, sexuality, and psychologic features such as stress and anxiety. Two questionnaires were used: the Psychosocial Adjustment to Illness Scale (PAIS) and the Mayo Clinic Postlaryngectomy Questionnaire. With the PAIS questionnaire, no difference was found in role adjustment between the total laryngectomy and near-total laryngectomy groups, with one exception. In the work domain, the total laryngectomy patients who were working had better adjustment than the near-total laryngectomy patients. The overall adjustment of both groups was less favorable than that of a comparison group of patients with nonlaryngeal cancer. The patients who had the classic conservation operations adjusted in all domains more favorably than the patients with permanent tracheostomas. The partial operation patients adjusted better than the nonlaryngeal cancer patients. We conclude that the stoma has a negative impact on adjustment postoperatively and that it may have a more serious impact on life adjustment than voice alteration. Further investigation and standardization of measurement tools are needed.

scholarly journals A review of pharyngeal mucosal closure technique in total laryngectomy

2018 ◽  
Vol 5 (1) ◽  
pp. 145
Author(s):  
Gopu Govindasamy ◽  
Subbiah Shanmugam ◽  
Arul Murugan
Keyword(s):  
Medical Records ◽  
Total Laryngectomy ◽  
Salvage Surgery ◽  
Pharyngocutaneous Fistula ◽  
Closure Technique ◽  
Carcinoma Of The Larynx ◽  
The Impact ◽  
Salvage Laryngectomy ◽  
Radiotherapy Failure ◽  
Hospital Center

<p class="abstract"><strong>Background:</strong> The purpose of this retrospective analysis was to review our single institute based experience with the pharyngocutaneous fistula following total laryngectomy and to determine the impact of pharyngeal closure technique in the development of PCF in our patients.</p><p class="abstract"><strong>Methods:</strong> The medical records of the patients, who underwent total laryngectomy for squamous cell carcinoma of the larynx and hypopharynx in Government Royapettah Hospital, center for oncology between January 2010 and December 2017, were retrospectively reviewed.  </p><p class="abstract"><strong>Results:</strong> 26 patients were included in the study of which 25 were male and 1 was female. Mean age of the patients were 58 years. Horizontal closure was done in 9 patients (35%) and T closure was done in 17 patients (65%). PCF was observed in 1 of 9 patients in horizontal closure. Remaining 17 patients underwent T closure of whom 8 patients developed PCF (p=0.06). Eight out of 18 patients (44%) developed PCF after salvage surgery after radiotherapy failure, Remaining 8 patients underwent primary laryngectomy for advanced stage cancers with cartilage involvement, of whom 1 patient developed PCF (12.5%) (p=0.11). In salvage laryngectomy (n=18), 1 of 6 cases developed PCF in horizontal closure and 7 of 12 cases in T closure technique (p=0.09).</p><p class="abstract"><strong>Conclusions:</strong> The incidence of fistula in our study was 34%. Horizontal closure was associated with decreased incidence of PCF when compared to ‘T’ closure of the defect. Prior radiotherapy had increased incidence of PCF.</p>

Impact of pure fumonisin B1 on various metabolic parameters and carcass quality of growing-finishing swine — preliminary findings

1997 ◽  
Vol 77 (3) ◽  
pp. 465-470 ◽  
Author(s):  
B. A. Rotter ◽  
D. B. Prelusky ◽  
A. Fortin ◽  
J. D. Miller ◽  
M. E. Savard
Keyword(s):  
Detrimental Effect ◽  
Fumonisin B1 ◽  
Carcass Characteristics ◽  
High Standard ◽  
Feed Consumption ◽  
Carcass Quality ◽  
High Standard Deviation ◽  
Elevated Cholesterol ◽  
The Impact

Mycotoxin fumonisin B1 (FB1) is a common contaminant of corn and a causative agent of different animal and human diseases. An experiment was conducted to assess the impact of pure FB1 on carcass quality of growing-finishing swine. Pigs were fed diets containing 0, 0.11, 0.33 and 1.0 mg FB1 kg−1 (ppm) until market weight. Although performance characteristics were not different among the respective treatments, an increase in feed consumption variability was observed between weeks 3 and 9 for the 1 ppm FB1 fed pigs as compared with controls. The same animals showed an increased variability in carcass characteristics, in particular in the fat content of loin and ham. The estimated lean yield tended to decrease with increasing dose, but a high standard deviation abolished treatment differences. An elevated cholesterol value at the end of the experiment for the 1 ppm FB1 fed pigs suggested a disruption of lipid metabolism. No other significant (P > 0.06) changes were observed. We conclude that a diet containing 1 ppm FB1 could have a detrimental effect on the carcass quality of a market pig and be a source of a monetary loss to the producer. Key words: Mycotoxin fumonisin B1, swine, carcass

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