Projectdetails

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On the need for prediction of treatment outcomes in head and neck cancer patients with emphasis on the elderly population.

Keywords:
Head and neck cancer Comprehensice geriatric assessment Frailty screening

Researchers:
Prof. dr. G.H. de Bock
dr. G.B. Halmos
drs. L. Bras

Nature of the research:
Qualitative study at the outpatient clinic of Head and Neck Oncology.

Fields of study:
ENT medicine oncology geriatrics

Background / introduction
Careful selection of patients eligible for the intensive treatment of head and neck cancer (HNC) is extremely important, especially since most HNC is diagnosed in patients over 60 years of age. A reliable predictor for treatment outcomes in this, often vulnerable, population is not yet available. Recent studies showed a poor predictive value of comorbidity, especially in the growing population of elderly HNC patients. However, decision is often based on comorbid status.1-3
A more promising method for the prediction of treatment-related outcomes is comprehensive geriatric assessment of the patient.4 This holistic screening tool includes several validated screening tools. However, it is rarely applied in the clinical practice as it is highly time consuming. Instead, frailty-questionnaires are developed to indicate increased vulnerability. Several of these frailty-screening instruments are available, but their sensitivity and specificity in detecting frailty are disappointing.5,6 More reliable predictors for outcomes after head and neck cancer treatment are needed.
Research question / problem definition
To define independent an reliable predictors of treatment-related outcomes in elderly head and neck cancer patients.
Workplan
All newly diagnosed head and neck cancer patients are asked to fill out a number of selected questionnaires, all together approaching a comprehensive geriatric assessment. Some of these questionnaires needs to be conducted by a healthcare professional (e.g. Mini Mental State Examination). The participation of an interested and motivated student is asked for interviewing these patients and filling out the required questionnaires. Furthermore, the involved student will participate in the data analysis, further interpretation of the data and writing scientific papers.
As interviewing patients plays a central role in this research, a good command of the Dutch language, both spoken and written, is required.
References
(1)Barzan et al. Head and neck cancer and ageing: a retrospective study in 438 patients. Laryngol Otol 1990;104:634-640;
(2)Peters TTA et al. comes of elderly pharyngeal cancer patients: a matched control study. Oral Oncol 2011 12;47(12):1159-1164.;
(3)Peters TTA et al. The impact of comorbidity on treatment-related side effects in older patients with laryngeal cancer. Oral Oncol 2011 1;47(1):56-61.;
(4)Clegg A et al. Frailty in elderly people. The Lancet 2013 3/2–8;381(9868):752-762. ;
(5)Decoster L et al. Screening tools for multidimensional health problems warranting a geriatric assessment in older cancer patients: an update on SIOG recommendations. Ann Oncol 2015, 26(2):288-300
(6)Hamaker ME et al. Frailty screening methods for predicting outcome of a comprehensive geriatric assessment in elderly patients with cancer: a systematic review. Lancet Oncol 2012 Oct;13(10):e437-44.
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