Impact of the treatment on the short-term quality of life in head and neck cancer patients with different age.

quality of life Head and neck cancer

Prof. dr. G.H. de Bock
dr. G.B. Halmos

Nature of the research:
literature research / prospective pilot cohort study

Fields of study:
health psychology oncology

Background / introduction
Head and neck tumors involve many different locations, including the lips, oral cavity, pharynx, larynx, nasal cavity, par nasal sinuses, major salivary glands, and thyroid gland.1 In 2011 the incidence of head en neck cancer in the Netherlands was 2970, with a peak around the age of 60-65. 2 The percentage of elderly people with head and neck cancers (HNC) is rising due to increasing average lifespan.3
Because head and neck cancer includes many different tumors, these tumors require various treatment modalities, adapted to the characteristics of the tumor and to patient’s factors.4 The disease itself and the treatment have a major impact on all the aspects of patient’s quality of life (QOL). QOL is a multi-dimensional construct of an individual’s subjective assessment of the impact of an illness or treatment on the physical, psychological, social and somatic functioning and general well-being.5 The different domains of the QOL have shown to predict survival among HNC patients, therefore QOL becomes an important treatment outcome.5
The impact of HNC on QOL is a major factor, not only to the evaluation of treatment options, but also to the development of rehabilitative services and patient education materials. Despite this fact there is a lack of understanding of the true clinical significance of QOL in HNC.5
Research question / problem definition
What is the impact of treatment on the short-term (three months) quality of life in head neck cancer patients with different age?
study design/data collection:
First, literature on the QOL in HNC will be studied. The literature, that will be used, includes five systematic reviews on the impact of treatment on the short-term quality of life in head and neck cancer patients at different ages. By reference to the articles we will find results of different questionnaires about the effect of treatment on QoL in head and neck cancer for the different age groups.
Secondly, a prospective pilot study will be performed, where QoL data of head and neck cancer in six patients in two different age groups (three under the age of 60 and three over the age of 70) will be collected before and 3 months after the surgical treatment. The period of three months in chosen due the fact that the first follow-up appointment is scheduled three months after the treatment. If we collect the QoL data earlier than three months, there is there a chance that we measure the post-operative effects or the complications of the surgical treatment.
Literature data will be collected from PubMed and Embase databases. Full text articles will be used whenever available. In the pilot study the EORTC QLO-30 and HNC modules will be used.6
1- Dingman C, Hegedus PD, Likes C, McDowell P, McCarthy E, Zwilling C. A Coordinated, Multidisciplinary Approach to Caring for the Patient With Head and Neck Cancer. J Support Oncology 2008Mar;6(3):125-31
2 integraal kankercentrum Nederland. Dataset 1 incidentie hoofd & hals. 2001-2011. Geraadpleegd op 17-12-2013
3: Syrigos KN, Karachalios D, Karapanagiotou EM, Nutting CM, Manolopoulos L, Harrington KJ. Head and neck cancer in the elderly: An overview on the treatment modalities. Cancer Treat Rev. 2009 May;35(3):237-45.
4 - Lalami Y, de Castro GJ, Bernard-Marty C, Awada A. Management of Head and Neck Cancer in Elderly Patients. Drugs Aging. 2009;26(7):571-83

5 - Ojo B, Genden EM, Teng MS, Milbury K, Misiukiewicz KJ, Badr H. A systematic review of head and neck cancer quality of life assessment instruments. Oral Oncology. 2012 Oct;48(10):923-37.
6: Chaukar DA, Das AK, Deshpande MS, Pai PS, Pathak KA, Chaturvedi P, Kakade AC, Hawaldar RW, D'Cruz AK. Quality of life of head and neck cancer patient: validation of the European organization for research and treatment of cancer QLQ-C30 and European organization for research and treatment of cancer QLQ-H&N 35 in Indian patients. Indian J Cancer. 2005 Oct-Dec;42(4):178-84.
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