Preliminary Functional Outcomes and Quality of Life after Tongue Reconstruction with the Vastus Lateralis Myofascial Free Flap

2021 ◽  
Author(s):  
Armando De Virgilio ◽  
Andrea Costantino ◽  
Raul Pellini ◽  
Gerardo Petruzzi ◽  
Giuseppe Mercante ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Head And Neck ◽  
Free Flap ◽  
Functional Outcomes ◽  
Vastus Lateralis ◽  
Life Questionnaire ◽  
Donor Area ◽  
Tongue Reconstruction ◽  
Eortc Qlq

AbstractThe aim of the present study is to report our preliminary experience with the vastus lateralis myofascial free flap (VLMFF) for tongue reconstruction according to tongue and donor site functional outcomes. Twelve consecutive patients (F: 5; median age: 54.0 years, interquartile range or IQR 42.75–69.0) were included. The validated European Organization for Research and Treatment of Cancer of the Head and Neck 35 Quality of Life Questionnaire (EORTC QLQ-H&N35) and the performance status scale for head and neck cancer (PSS-HN) questionnaires were used to assess the health-related quality of life (HRQOL). The lower extremity functional scale (LEFS) was used to self-report the donor area function. All patients were successfully treated, and no VLMFF failure was detected during a median follow-up period of 10.5 months (IQR: 6.5–33.0). The HRQOL showed a median EORTC QLQ-H&N35 score of 56.0 (IQR: 50.0–72.5). The median PSS-HN score was 80.0 (IQR: 45.0–95.0), 75.0 (IQR: 62.5–100.0), 75.0 (IQR: 62.5–100.0) for “Normalcy of Diet,” “Public Eating,” and “Understandability of Speech,” respectively. The self-reported function of the lower extremities (donor area) showed a median LEFS of 59.0 (IQR: 32.5–74.0). This study reports optimistic data regarding the functional and quality of life outcomes after tongue reconstruction using VLMFF. Prospective controlled studies are needed to demonstrate advantages and disadvantages when compared with other reconstructive techniques.

scholarly journals Head and Neck Osteosarcoma—The Ongoing Challenge about Reconstruction and Dental Rehabilitation

Cancers ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 1948 ◽  
Author(s):  
Andrea Cassoni ◽  
Edoardo Brauner ◽  
Resi Pucci ◽  
Valentina Terenzi ◽  
Nicolò Mangini ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Head And Neck ◽  
Functional Results ◽  
Life Questionnaire ◽  
Prosthetic Rehabilitation ◽  
European Organization ◽  
Aesthetic Result ◽  
Dental Rehabilitation ◽  
Eortc Qlq

Head and Neck osteosarcoma is an uncommon disease. Hitherto, the treatment is surgical resection and survival is influenced by the presence of free margins. However, the dimension of the resection may represent a hurdle for an adequate Quality of Life (QOL). Maxillofacial district is a narrow space where the function, esthetics and patient’s relational skills fit together like the gears of a clock. The functional results depend on the type of reconstruction and prosthetic rehabilitation that are both important to guarantee a good aesthetic result and finally increase the patient’s self-esteem. This study aims to report our experience about head and neck (HN) osteosarcoma focusing the attention on reconstructive and dental-rehabilitative problems. It is a retrospective study all patients were surgically treated in our department. Subjects with histological diagnosis of HN osteosarcoma, treated between 2005 and 2017 were included. The demographic characteristics, surgical treatment, eventually secondary reconstruction and prosthetic rehabilitation, performed in the same department, have been collected. The QOL was assessed through the EORTC QLQ-H&N35 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Head and Neck 35) questionnaire. Fifteen patients were enrolled, eight received a free flap microsurgical reconstruction. Dental rehabilitation was performed in five cases and a mobile prosthesis was always delivered. Eighteen implants were inserted in fibula bones for three patients; highly porous implants were used.

scholarly journals Assessment of Quality of Life in Recurrent and Metastatic Head and Neck Cancer after Oral Metronomic Chemotherapy: A Prospective Interventional Study

2021 ◽  
Author(s):  
Vipul Nautiyal ◽  
Viney Kumar ◽  
Anshika Arora ◽  
Meenu Gupta ◽  
Shivani Mehra ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Head And Neck ◽  
Symptom Score ◽  
Eastern Cooperative Oncology Group ◽  
Metronomic Chemotherapy ◽  
P Value ◽  
Life Questionnaire ◽  
Eortc Qlq C30 ◽  
Eortc Qlq

Introduction: Most of the Recurrent or Metastatic (R/M) Head and Neck Squamous Cell Carcinomas (HNSCC) patients are treated only by palliative treatment. Metronomic Chemotherapy (MC) low doses is an emerging therapeutic option in these patients. It exerts tumour angiogenesis, stimulate anticancer immune response, induces tumour dormancy and offers a significant improvement in Quality of Life (QoL) with minimal toxicity. Aim: To assess the changes in QoL in patients with Metastatic, Recurrent (M/R) HNSCC receiving MC. Materials and Methods: This was a prospective interventional hospital-based study from February 2015 to September 2018, conducted at Cancer Research Institute, Himalayan Institute of Medical Sciences, SRHU University, Dehradun, Uttarakhand, India. A total of 175 patients more than 18 years, with Eastern Cooperative Oncology Group (ECOG) performance status score <2, with M/R HNSCC, not amenable to any radical treatment, were equally distributed by lottery method in three arms, in those receiving Capecitabine (Arm A, n: 59), Celecoxib and Methotrexate (Arm B, n: 62); and placebo with best supportive care (Arm C, n: 54). In addition to demographic and baseline clinical characteristics, patients were assessed for physical examination and questioned to score their QoL by European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) at presentation and followed every month for two months. Results: A total of 175 patients enrolled for the study, the mean age of study population was 56.73±6.84 years with male preponderance 77.71%. A 60% suffered from carcinoma oral cavity (n=105), followed by carcinoma oropharynx (24%) (n=42), carcinoma larynx and carcinoma hypopharynx consisted rest 16% (n=28). Altogether the QoL was quite divergent amongst the three arms. Symptom score for fatigue, dyspnoea, loss of appetite, nausea and vomiting showed rise representing worsening in Arm A and Arm C; whilst these symptoms also showed fall in symptom score in Arm B (fatigue: p-value=0.007; dyspnoea; p-value=0.042; Appetite loss: p-value=0.008 Nausea: p-value=0.02; Vomiting: p-value=0.03). There was a statistically significant improvement in overall EORTC QLQ-C30 score from baseline in the Methotrexate and Celecoxib arm (Arm B) compared with Capecitabine and with placebo. Conclusion: Metronomic Chemotherapy (MC) with Methotrexate and Celecoxib seems promising and well tolerated in patients with metastatic or advanced HNSCC as compared to Capecitabine or keeping on symptomatic treatment solely.

Quality of Life in Head and Neck Cancer Patients: Validation of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-H&N35

1999 ◽  
Vol 17 (3) ◽  
pp. 1008-1008 ◽  
Author(s):  
Kristin Bjordal ◽  
Eva Hammerlid ◽  
Marianne Ahlner-Elmqvist ◽  
Alexander de Graeff ◽  
Morten Boysen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Head And Neck ◽  
Cancer Patients ◽  
Performance Status ◽  
Compliance Rate ◽  
Life Questionnaire ◽  
European Organization ◽  
Quality Of Life Questionnaire ◽  
Eortc Qlq

PURPOSE: The aim of this study was to define the scales and test the validity, reliability, and sensitivity of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ)-H&N35, a questionnaire designed to assess the quality of life of head and neck (H&N) cancer patients in conjunction with the general cancer-specific EORTC QLQ-C30. PATIENTS AND METHODS: Questionnaires were given to 500 H&N cancer patients from Norway, Sweden, and the Netherlands as part of two prospective studies. The patients completed the questionnaires before, during (Norway and Sweden only), and after treatment, yielding a total of 2070 completed questionnaires. RESULTS: The compliance rate was high, and the questionnaires were well accepted by the patients. Seven scales were constructed (pain, swallowing, senses, speech, social eating, social contact, sexuality). Scales and single items were sensitive to differences between patient subgroups with relation to site, stage, or performance status. Most scales and single items were sensitive to changes, with differences of various magnitudes according to the site in question. The internal consistency, as assessed by Cronbach's alpha coefficient, varied according to assessment point and within subsamples of patients. A low overall alpha value was found for the speech and the senses scales, but values were higher in assessments of patients with laryngeal cancer and in patients with nose, sinus, and salivary gland tumors. Scales and single items in the QLQ-H&N35 seem to be more sensitive to differences between groups and changes over time than do the scales and single items in the core questionnaire. CONCLUSION: The QLQ-H&N35, in conjunction with the QLQ-C30, provides a valuable tool for the assessment of health-related quality of life in clinical studies of H&N cancer patients before, during, and after treatment with radiotherapy, surgery, or chemotherapy.

scholarly journals Construct Validity of the EuroQoL–5 Dimension and the Health Utilities Index in Head and Neck Cancer

2021 ◽  
pp. 019459982110301
Author(s):  
Christopher W. Noel ◽  
Sareh Keshavarzi ◽  
David Forner ◽  
Robert F. Stephens ◽  
Erin Watson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Life Questionnaire ◽  
Health Utilities Index ◽  
Eortc Qlq C30 ◽  
Eortc Qlq ◽  
Disease Specific

Objective The objective of this study was to evaluate the construct validity of 2 health utility instruments—the EuroQoL–5 Dimension (EQ-5D) and the Health Utilities Index–Mark 3 (HUI-3)—and to compare them with disease-specific measures in patients with head and neck cancer. Study Design Prospective cross-sectional analysis. Setting Princess Margaret Cancer Centre. Methods Patients were administered the EQ-5D, HUI-3, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and its head and neck cancer module (EORTC QLQ-H&N35), and the University of Washington Quality of Life Questionnaire (UWQoL). Several a priori expected relations were examined. The correlative and discriminative properties of the various instruments were examined. Results A total of 209 patients completed the 4 questionnaires. A significant ceiling effect was observed among EQ-5D responses (23% reported a maximum score of 1). The EQ-5D (rho = 0.79) and HUI-3 (rho = 0.60) had a strong correlation with the social-emotional domain of the UWQoL. The EQ-5D had a moderate correlation with the physical domain of the UWQoL (rho = 0.42), whereas the HUI-3 had a weak correlation (rho = 0.29). The EQ-5D and HUI-3 were able to distinguish among levels of health severity measured on the EORTC QLQ-C30 though not the QLQ-H&N35. Comparatively, the UWQoL was able to distinguish levels of disease severity on the EORTC QLQ-C30 and QLQ-H&N35. Conclusion The results of this study demonstrate that disease-specific domains from head and neck quality-of-life instruments are not strongly correlated with the EQ-5D and HUI-3. Consideration should be put toward development of a disease-specific preference-based measure for health economic evaluation. Level of evidence 4.

United States Utility Algorithm for the EORTC QLU-C10D, a Multiattribute Utility Instrument Based on a Cancer-Specific Quality-of-Life Instrument

2021 ◽  
pp. 0272989X2110035
Author(s):  
Dennis A. Revicki ◽  
Madeleine T. King ◽  
Rosalie Viney ◽  
A. Simon Pickard ◽  
Rebecca Mercieca-Bebber ◽  
...  
Keyword(s):  
Quality Of Life ◽  
United States ◽  
Emotional Functioning ◽  
Health State ◽  
Life Questionnaire ◽  
Multiattribute Utility ◽  
Value Set ◽  
Eortc Qlq C30 ◽  
Eortc Qlq

Background The EORTC QLU-C10D is a multiattribute utility measure derived from the cancer-specific quality-of-life questionnaire, the EORTC QLQ-C30. The QLU-C10D contains 10 dimensions (physical, role, social and emotional functioning, pain, fatigue, sleep, appetite, nausea, bowel problems). The objective of this study was to develop a United States value set for the QLU-C10D. Methods A US online panel was quota recruited to achieve a representative sample for sex, age (≥18 y), race, and ethnicity. Respondents undertook a discrete choice experiment, each completing 16 choice-pairs, randomly assigned from a total of 960 choice-pairs. Each pair included 2 QLU-C10D health states and duration. Data were analyzed using conditional logistic regression, parameterized to fit the quality-adjusted life-year framework. Utility weights were calculated as the ratio of each dimension-level coefficient to the coefficient for life expectancy. Results A total of 2480 panel members opted in, 2333 (94%) completed at least 1 choice-pair, and 2273 (92%) completed all choice-pairs. Within dimensions, weights were generally monotonic. Physical functioning, role functioning, and pain were associated with the largest utility weights. Cancer-specific dimensions, such as nausea and bowel problems, were associated with moderate utility decrements, as were general issues such as problems with emotional functioning and social functioning. Sleep problems and fatigue were associated with smaller utility decrements. The value of the worst health state was 0.032, which was slightly greater than 0 (equivalent to being dead). Conclusions This study provides the US-specific value set for the QLU-C10D. These estimated health state scores, based on responses to the EORTC QLQ-C30 questionnaire, can be used to evaluate the cost-utility of oncology treatments.

Mapping the University of Washington Quality of life questionnaire onto EQ‐5D and HUI‐3 indices in patients with head and neck cancer

Head & Neck ◽  
2019 ◽  
Vol 42 (3) ◽  
pp. 513-521 ◽  
Author(s):  
Robert F. Stephens ◽  
Christopher W. Noel ◽  
Jie (Susie) Su ◽  
Wei Xu ◽  
Murray Krahn ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Life Questionnaire ◽  
University Of Washington ◽  
Quality Of Life Questionnaire ◽  
The University

Psychometric properties of the EORTC Quality of Life Questionnaire in inpatient cancer rehabilitation in Germany

2004 ◽  
Vol 2 (2) ◽  
pp. 115-124 ◽  
Author(s):  
JÖRG DIRMAIER ◽  
SILKE ZAUN ◽  
UWE KOCH ◽  
TIMO HARFST ◽  
HOLGER SCHULZ
Keyword(s):  
Quality Of Life ◽  
Psychometric Properties ◽  
Cancer Patients ◽  
Scale Structure ◽  
Cancer Rehabilitation ◽  
Life Questionnaire ◽  
European Organization ◽  
Eortc Qlq C30 ◽  
Eortc Qlq

Objective: Recent years have shown an increase in the use of questionnaires measuring health-related quality of life to verify the quality of treatment in the field of oncology. An often used cancer-specific questionnaire is the “Quality of Life Core Questionnaire of the European Organization for the Research and Treatment of Cancer” (EORTC QLQ-C30). The purpose of this study is to analyze the psychometric properties of the EORTC QLQ-C30 (version 1) in order to determine the feasibility and appropriateness for its use in inpatient cancer rehabilitation in Germany with heterogeneous diagnoses.Methods: The questionnaire was administrated to a sample of 972 cancer patients at the beginning of treatment and to 892 patients after treatment. Besides descriptive analysis, the statistical analyses include confirmatory analysis and the multitrait/multimethod approach to test the questionnaire's postulated scale structure (factorial validity) and its reliability (internal consistencies). The analysis also includes a comparison of responsiveness indices (effect size, reliable change index) to test the sensitivity of the instrument.Results: The EORTC QLQ-C30 showed satisfactory levels of reliability and sensitivity, but the postulated scale structure could not be confirmed. The results illustrate that the varimax-rotated solution of a principal component analysis does not confirm the scale structure postulated by the authors. Correspondingly, the selected fit indices within the scope of the confirmatory factor analysis do not show satisfactory results either.Significance of results: We therefore consider version 1 of the EORTC QLQ-C30 to be only limitedly useful for the routine assessment of changes in the quality of life of cancer patients in inpatient rehabilitation in Germany, especially because of the instrument's length and possible redundancies. For this reason, a scoring procedure limited to a subset of items is suggested, revealing satisfactory to good psychometric indices. However, further psychometric tests are necessary, especially with regard to validity and sensitivity.

scholarly journals Factors associated with depression and the relationship to quality of life among Saudi women with breast cancer

2020 ◽  
Vol 11 (4) ◽  
pp. 43
Author(s):  
Monefah Al-Shammari ◽  
Amani Khalil
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Life Questionnaire ◽  
Primary Therapy ◽  
Convenience Sample ◽  
Saudi Women ◽  
Patient Reported ◽  
Eortc Qlq ◽  
The Relationship

Background and objective: Breast cancer is the most common malignancy among women worldwide, diagnosis and treatment and the months following primary therapy associated with different psychological symptoms that affect quality of life (QoL) in most women with breast cancer. The aim of this study was to identify the relationship between depression and quality of life QoL among Saudi women with breast cancer.Methods: Design: This is a descriptive, cross-sectional study. Methods: A convenience sample of 370 women with breast cancer was recruited from the out-clinic in King Faisal Specialist Hospital \& Research Center (KFSH&RC). Data were collected using self-report tools derived from the Patient-Reported Outcomes Measurement Information System (PROMIS) Emotional Distress-Depression-Short Form; the EORTC quality of life questionnaire (QLQ) (EORTC QLQ-C30, v.3.0 and EORTC QLQ-BR23); and from the Demographic and Clinical Data Sheet.Results: The correlation between depression and global health status with functioning subscales for the women was negative (Pearson’s r = -.357, p < .001; r = -.368, p < .001); whereas a positive correlation was found between depression and symptom subscales, together with its items.Conclusions: This study shows that depression is associated with QoL among Saudi women diagnosed with breast cancer. Therefore, depression affects upon QoL among the breast cancer population. However, enhancement of mental health statuses and psychological interventions helps to reduce the severity of depression and improves health related QoL among this population.

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