PO-057: Radiation induced skin reaction in head neck malignancies and assessment of quality of life

Purpose Childhood cancer survivors are at increased risk for adverse outcomes and chronic medical conditions. Treatment-related scarring, disfigurement, and persistent hair loss, in addition to their long-term impact on psychological distress or health-related quality of life (HRQOL), have received little attention. Patients and Methods Self-reported scarring/disfigurement and persistent hair loss were examined in 14,358 survivors and 4,023 siblings from the Childhood Cancer Survivor Study. Multivariable models were used to examine associations with demographic and cancer treatment. The impact of disfigurement and hair loss on HRQOL (ie, Medical Outcomes Short Form–36) and emotional distress (ie, Brief Symptom Inventory–18) was examined. Results Survivors reported a significantly higher rate of scarring/disfigurement compared with siblings for head/neck (25.1% v 8.4%), arms/legs (18.2% v 10.2%), and chest/abdomen (38.1% v 9.1%), as well as hair loss (14.0% v 6.3%). In age-, sex-, and race-adjusted models, cranial radiation exposure ≥ 36 Gy increased risk for head/neck disfigurement (relative risk [RR], 2.42; 95% CI, 2.22 to 2.65) and hair loss (RR, 4.24; 95% CI, 3.63 to 4.95). Adjusting for cranial radiation, age, sex, race, education, and marital status, survivor hair loss increased risk of anxiety (RR, 1.60; 95% CI, 1.23 to 2.07), whereas head/neck disfigurement increased risk of depression (RR, 1.19; 95% CI, 1.01 to 1.41). Limitations due to emotional symptoms were associated with head/neck disfigurement (RR, 1.24; 95% CI, 1.10 to 1.41), arm/leg disfigurement (RR, 1.19; 95% CI, 1.05 to 1.35), and hair loss (RR, 1.26; 95% CI, 1.09 to 1.47). Conclusion Survivors of childhood cancer are at increased risk for disfigurement and persistent hair loss, which is associated with future emotional distress and reduced quality of life. Future studies are needed to better identify and manage functional outcomes in these patients.

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P3.99. Dose related radiation-induced mucositis in oral andoropharyngeal cancer and its impact on quality of life

Oral Oncology Supplement ◽

10.1016/j.oos.2009.06.625 ◽

2009 ◽

Vol 3 (1) ◽

pp. 233-234

Author(s):

J. Bardy ◽

N.J. Slevin ◽

K. Mais ◽

D. Ryder ◽

A. Molassiotis

Keyword(s):

Quality Of Life ◽

Radiation Induced

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Manuka honey mouthwash does not affect oral mucositis in head and neck cancer patients in New Zealand

Journal of Radiotherapy in Practice ◽

10.1017/s1460396911000410 ◽

2011 ◽

Vol 11 (4) ◽

pp. 249-256 ◽

Cited By ~ 12

Author(s):

Emma Parsons ◽

Aubrey Begley ◽

Patries Herst

Keyword(s):

Quality Of Life ◽

Weight Loss ◽

New Zealand ◽

Head And Neck ◽

Oral Mucositis ◽

Standard Care ◽

Manuka Honey ◽

Patient Health ◽

Radiation Induced

AbstractOral mucositis is an unavoidable side effect of radiation therapy to the head and neck, which can compromise patient health and quality of life. This study investigates the effect of manuka honey on the extent of oral mucositis in head and neck patients in New Zealand. A total of 28 patients were recruited; 10 patients received standard care and 18 patients were given additional manuka honey. Honey was used three times a day; assessment included: extent of oral mucositis using a multi-site mucositis scoring system, weight and quality of life. The first six patients, randomised to the honey arm, used undiluted honey and pulled out in the first week because of extreme nausea, vomiting and stinging sensations in the mouth. The next 12 honey patients used a honey mouthwash (diluted 1:3). Six of these patients completed the trial and four more completed the first 4 weeks of the trial. Eight control patients completed the trial. In contrast to previous honey trials in Malaysia, Egypt, Iran and India, diluted manuka honey did not decrease the extent and onset of radiation-induced oral mucositis but did appear to ameliorate radiation-induced weight loss and increase quality of life in the absence of cisplatin chemotherapy.

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Antiemesis

Journal of the National Comprehensive Cancer Network ◽

10.6004/jnccn.2007.0004 ◽

2007 ◽

Vol 5 (1) ◽

pp. 12 ◽

Cited By ~ 35

Author(s):

_ _

Keyword(s):

Quality Of Life ◽

Cancer Patients ◽

Nausea And Vomiting ◽

Poor Adherence ◽

Chemotherapy Treatment ◽

Radiation Induced ◽

Recent Version

Chemotherapy-induced nausea and vomiting (emesis) can significantly affect a patient's quality of life, leading to poor adherence with further chemotherapy treatment. In addition, nausea and vomiting can result in other serious complications and deterioration of the patient's status. These guidelines explore the prevention, treatment, and management of various types of emesis experienced by cancer patients, such as breakthrough, radiation-induced, and anticipatory. For the most recent version of the guidelines, please visit NCCN.org

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Association Between the Prevalence of Symptoms and Health-Related Quality of Life in Adult Survivors of Childhood Cancer: A Report From the St Jude Lifetime Cohort Study

Journal of Clinical Oncology ◽

10.1200/jco.2012.47.8867 ◽

2013 ◽

Vol 31 (33) ◽

pp. 4242-4251 ◽

Cited By ~ 59

Author(s):

I-Chan Huang ◽

Tara M. Brinkman ◽

Kelly Kenzik ◽

James G. Gurney ◽

Kirsten K. Ness ◽

...

Keyword(s):

Quality Of Life ◽

Cohort Study ◽

Adult Survivors ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

Survivors Of Childhood Cancer ◽

Head Neck ◽

Cumulative Prevalence

Purpose We investigated the association between prevalence of symptoms and health-related quality of life (HRQOL) in adult survivors of childhood cancer enrolled in the St Jude Lifetime Cohort study. Methods Eligibility criteria include childhood malignancy treated at St Jude, survival ≥ 10 years from diagnosis, and current age ≥ 18 years. Study participants were 1,667 survivors (response rate = 65%). Symptoms were self-reported by using a comprehensive health questionnaire and categorized into 12 classes: cardiac; pulmonary; motor/movement; pain in head; pain in back/neck; pain involving sites other than head, neck, and back; sensation abnormalities; disfigurement; learning/memory; anxiety; depression; and somatization. HRQOL was measured by using physical/mental component summary (PCS/MCS) and six domain scores of the Medical Outcomes Study 36-Item Short-Form Health Survey. Multivariable regression analysis was performed to investigate associations between symptom classes and HRQOL. Cumulative prevalence of symptom classes in relation to time from diagnosis was estimated. Results Pain involving sites other than head, neck and back, and disfigurement represented the most frequent symptom classes, endorsed by 58.7% and 56.3% of survivors, respectively. Approximately 87% of survivors reported multiple symptom classes. Greater symptom prevalence was associated with poorer HRQOL. In multivariable analysis, symptom classes explained up to 60% of the variance in PCS and 56% of the variance in MCS; demographic and clinical variables explained up to 15% of the variance in PCS and 10% of the variance in MCS. Longer time since diagnosis was associated with higher cumulative prevalence in all symptom classes. Conclusion A large proportion of survivors suffered from many symptom classes, which was associated with HRQOL impairment.

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Quality of life in patients undergoing treatment for chronic radiation-induced rectal bleeding

British Journal of Surgery ◽

10.1046/j.1365-2168.1999.0985c.x ◽

1999 ◽

Vol 86 (1) ◽

pp. 135-136

Author(s):

M. Guest ◽

J. J. Smith ◽

A. H. Davies

Keyword(s):

Quality Of Life ◽

Rectal Bleeding ◽

Chronic Radiation ◽

Radiation Induced

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Group Acupuncture to Relieve Radiation Induced Xerostomia: A Feasibility Study

Acupuncture in Medicine ◽

10.1136/aim.2009.000935 ◽

2009 ◽

Vol 27 (3) ◽

pp. 109-113 ◽

Cited By ~ 21

Author(s):

Richard Simcock ◽

Lesley Fallowfield ◽

Valerie Jenkins

Keyword(s):

Quality Of Life ◽

Feasibility Study ◽

Randomised Trial ◽

Subjective Assessment ◽

Structured Interview ◽

Acupuncture Points ◽

Post Intervention ◽

Oral Dryness ◽

Radiation Induced

Background A distressing complication of radiotherapy treatment for head and neck cancer is xerostomia (chronic oral dryness). Xerostomia is difficult to treat conventionally but there are reports that acupuncture can help. We conducted a feasibility study to examine the acceptability of a standardised group acupuncture technique and adherence to group sessions, together with acceptability of the objective and subjective measurements of xerostomia. Methods 12 males with established radiation induced xerostomia were treated in three groups of four. Each received eight weekly sessions of acupuncture using four bilateral acupuncture points (Salivary Gland 2; Modified Point Zero; Shen Men and one point in the distal radial aspect of each index finger (LI1)). Sialometry and quality of life assessments were performed at baseline and at the end of treatment. A semi-structured interview was conducted a week after completing the intervention. Results Adherence to and acceptability of the treatment and assessments was 100%. There were objective increases in the amounts of saliva produced for 6/12 patients post intervention and the majority also reported subjective improvements. Mean quality of life scores for domains related to salivation and xerostomia also showed improvement. At baseline 92% (11/12) patients reported experiencing a dry mouth “quite a bit/very much” as compared to 42% (5/12) after the treatment. Qualitative data revealed that the patients enjoyed the sessions. Conclusion The pilot study shows that a standardised group technique is deliverable and effective. The tools for objective and subjective assessment are appropriate and acceptable. Further examination in a randomised trial is now warranted.

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