scholarly journals Prognostic Factors Predict Oncological Outcome in Older Patients With Head and Neck Cancer Undergoing Chemoradiation Treatment

2021 ◽  
Vol 10 ◽  
Author(s):  
Carmen Stromberger ◽  
Berna Yedikat ◽  
Annekatrin Coordes ◽  
Ingeborg Tinhofer ◽  
Goda Kalinauskaite ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Older Patients ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Treatment Decision ◽  
Oncological Outcome ◽  
Treatment Decision Making ◽  
Treatment Data

PurposeOlder patients with head and neck cancer (HNC) represent a challenging group, as frailty and comorbidities need to be considered. This study aimed to evaluate the efficacy and side effects of curative and palliative (chemo) radiation ([C]RT) with regard to basic geriatric screening in older patients.MethodsThis study included HNC patients aged ≥70 years who were treated with curative or palliative (C)RT. Clinicopathological data including Charlson Comorbidity Index (CCI), Karnofsky performance status (KPS), and treatment data were analyzed as predictors of overall survival (OS).ResultsA total of 271 patients (median age, 74 years) were enrolled. The majority had UICC stage III/IV (90%) and underwent curative treatment (85.2%). A total of 144 (53.1%) patients received definitive and 87 (32.1%) had adjuvant (C)RT. Overall, 40 patients (14.8%) received palliative (C)RT. Median follow-up duration (curative setting) was 87 months, and the 2- and 5-year OS rates were 57.8 and 35.9%, respectively. Median OS was significantly different for age ≤75 vs. >75 years, CCI <6 vs. ≥6, KPS ≥70 vs. <70%, Tx/T1/T2 vs. T3/T4, and adjuvant vs. definitive (C)RT, respectively. Age 70–75 years (p = 0.004), fewer comorbidities when CCI < 6 (p = 0.014), good KPS ≥ 70% (p = 0.001), and adjuvant (C)RT (p = 0.008) independently predicted longer survival. Palliative RT resulted in a median OS of 4 months.ConclusionOlder age, lower KPS, higher CCI, and definitive (C)RT are indicators of worse survival in older patients with HNC treated curatively. Without a comprehensive geriatric assessment in patients aged >75 years, the KPS and CCI can be useful tools to account for “fitness, vulnerability or frailty” to help in treatment decision-making.

Factors That Influence Treatment Decision in Older Patients With Resectable Head and Neck Cancer

2007 ◽  
Vol 117 (5) ◽  
pp. 835-840 ◽  
Author(s):  
Alvaro Sanabria ◽  
Andr?? Lopes Carvalho ◽  
Jos?? Guilherme Vartanian ◽  
Jos?? Magrin ◽  
Mauro Kasuo Ikeda ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Older Patients ◽  
Treatment Decision

scholarly journals A qualitative examination of patient priorities and preferences during treatment decision-making for recurrent head and neck cancer

2020 ◽  
Vol 29 (1) ◽  
pp. 377-385
Author(s):  
Bethany A. Rhoten ◽  
Jessie I. Sellers ◽  
Breanna Baraff ◽  
Kelly H. Holler ◽  
Sheila H. Ridner
Keyword(s):  
Decision Making ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Treatment Decision ◽  
Treatment Decision Making ◽  
Recurrent Head

scholarly journals Barriers to and Facilitators of Return to Work in Head and Neck Cancer Patients with in the First Six Months Post-Treatment

2022 ◽  
Author(s):  
Bing-Shen Huang ◽  
Chien-Yu Lin ◽  
Ya-Lan Chang ◽  
Ching-Fang Chung ◽  
Shu-Ching Chen
Keyword(s):  
Head And Neck Cancer ◽  
Health Status ◽  
Return To Work ◽  
Head And Neck ◽  
Neck Cancer ◽  
Rating Scale ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Post Treatment ◽  
Cancer Center

Abstract Objective To identify the factors associated with barriers to and facilitators of return to work (RTW) in head and neck cancer (HNC) patients in the first six months post-treatment. Methods This cross-sectional study examined HNC patients who completed treatment from the outpatient radiation department of a single cancer center in northern Taiwan from October 2018 to July 2020. Demographic and clinical characteristics were recorded, and patients were assessed using the Return to Work Barrier Scale, Return to Work Facilitator Scale, Distress Thermometer, Numeric Rating Scale, and Karnofsky Performance Status Scale questionnaires. Results Of the 106 HNC patients surveyed, 54.7% successfully RTW. Barriers to RTW included patient-perceived worst health status, greater symptom burden, and age ≥55 years. These factors explained 34.6% of the variance in overall barriers to RTW. Facilitators of RTW were lower psychological distress and who did not receive reconstruction surgery. These factors explained 17.9% of the variance in facilitators to RTW. Conclusion Patient-perceived health status and age most strongly influence RTW in HNC patients. HNC patients who can RTW should be encouraged to do so, and clinician awareness of potential barriers can aid patients in their RTW.

scholarly journals Swedish National Multicenter Study on Head and Neck Cancer of Unknown Primary: Prognostic Factors and Impact of Treatment on Survival

2020 ◽  
Author(s):  
Lars Axelsson ◽  
Erik Holmberg ◽  
Jan Nyman ◽  
Anders Högmo ◽  
Helena Sjödin ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Prognostic Factors ◽  
Head And Neck ◽  
Neck Dissection ◽  
Neck Cancer ◽  
Multicenter Study ◽  
Performance Status ◽  
Cancer Of Unknown Primary ◽  
Unknown Primary ◽  
N Stage

Abstract Introduction Head and neck cancer of unknown primary (HNCUP) is a rare condition whose prognostic factors that are significant for survival vary between studies. No randomized treatment study has been performed thus far, and the optimal treatment is not established. Objective The present study aimed to explore various prognostic factors and compare the two main treatments for HNCUP: neck dissection and (chemo) radiation vs primary (chemo) radiation. Methods A national multicenter study was performed with data from the Swedish Head and Neck Cancer Register (SweHNCR) and from the patients' medical records from 2008 to 2012. Results Two-hundred and sixty HNCUP patients were included. The tumors were HPV-positive in 80%. The overall 5-year survival rate of patients treated with curative intent was 71%. Age (p < 0.001), performance status (p= 0.036), and N stage (p= 0.046) were significant factors for overall survival according to the multivariable analysis. Treatment with neck dissection and (chemo) radiation (122 patients) gave an overall 5-year survival of 73%, and treatment with primary (chemo) radiation (87 patients) gave an overall 5-year survival of 71%, with no significant difference in overall or disease-free survival between the 2 groups. Conclusions Age, performance status, and N stage were significant prognostic factors. Treatment with neck dissection and (chemo) radiation and primary (chemo) radiation gave similar survival outcomes. A randomized treatment study that includes quality of life is needed to establish the optimal treatment.

How Do Head and Neck Cancer Patients Prioritize Treatment Outcomes Before Initiating Treatment?

2000 ◽  
Vol 18 (4) ◽  
pp. 877-877 ◽  
Author(s):  
Marcy A. List ◽  
John Stracks ◽  
Laura Colangelo ◽  
Pamela Butler ◽  
Natasha Ganzenko ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Treatment Effects ◽  
Performance Status ◽  
Treatment Strategies ◽  
Individual Variability ◽  
Lower Priority ◽  
Disease Characteristics

PURPOSE: To determine, pretreatment, how head and neck cancer (HNC) patients prioritize potential treatment effects in relationship to each other and to survival and to ascertain whether patients’ preferences are related to demographic or disease characteristics, performance status, or quality of life (QOL). PATIENTS AND METHODS: One hundred thirty-one patients were assessed pretreatment using standardized measures of QOL (Functional Assessment of Cancer Therapy-Head and Neck) and performance (Performance Status Scale for Head and Neck Cancer). Patients were also asked to rank a series of 12 potential HNC treatment effects. RESULTS: Being cured was ranked top priority by 75% of patients; another 18% ranked it second or third. Living as long as possible and having no pain were placed in the top three by 56% and 35% of patients, respectively. Items that were ranked in the top three by 10% to 24% of patients included those related to energy, swallowing, voice, and appearance. Items related to chewing, being understood, tasting, and dry mouth were placed in the top three by less than 10% of patients. Excluding the top three rankings, there was considerable variability in ratings. Rankings were generally unrelated to patient or disease characteristics, with the exception that cure and living were of slightly lower priority and pain of higher priority to older patients compared with younger patients. CONCLUSION: The data suggest that, at least pretreatment, survival is of primary importance to patients, supporting the development of aggressive treatment strategies. In addition, results highlight individual variability and warn against making assumptions about patients’ attitudes vis-à-vis potential outcomes. Whether patients’ priorities will change as they experience late effects is currently under investigation.

Sign in / Sign up

Export Citation Format

Share Document