Ewa Silander

Quality of Life and Head and Neck Cancer: A 5 Year Prospective Study.

Objectives: Assessment of health‐related quality of life (HRQL) in head and neck cancer patients from diagnosis to 5 years after start of treatment.

Impact of prophylactic percutaneous endoscopic gastrostomy on malnutrition and quality of life in patients with head and neck cancer: a randomized study.

The purpose of this randomized study was to examine if a prophylactic percutaneous endoscopic gastrostomy (PEG) for enteral nutrition could prevent malnutrition, reduce hospital stay, and improve health‐related quality of life (HRQOL).

Quality of life as predictor of weight loss in patients with head and neck cancer

The purpose of this prospective study was to evaluate whether a relationship exists between malnutrition (≥10% weight loss) and health‐related quality of life (HRQL) in patients with head and neck cancer and whether weight loss can be predicted with HRQL questionnaires.

Health-related quality of life in patients with pharyngeal carcinoma: a five-year follow-up

The purpose was to evaluate the health‐related quality of life (HRQL) of patients with pharyngeal carcinoma at diagnosis and after 1 and 5 years in relation to tumor location and treatment modality in a prospective multicenter study.

Effects of psychosocial intervention on quality of life in patients with head and neck cancer.

A longitudinal, prospective, case‐control study evaluated if a psychosocial support program improved health‐related quality of life (HRQL) in head and neck (H&N) cancer patients.

An exploration of factors predicting malnutrition in patients with advanced head and neck cancer

Malnutrition is common among head and neck cancer patients and negatively impacts on survival and quality of life. This study aimed to identify predictors of malnutrition at time of diagnosis in order to identify patients at risk and enable early nutritional support and prevent malnutrition.

Effect of prophylactic percutaneous endoscopic gastrostomy tube on swallowing in advanced head and neck cancer: A randomized controlled study

Dysphagia is common in head and neck cancer. A percutaneous endoscopic gastrostomy (PEG) tube is used to facilitate nutrition; however, some retrospective studies have indicated that the PEG tube causes dysphagia.

Population‐based reference values for the European Organization for Research and Treatment of Cancer Head and Neck module

The purpose of this study was to establish population‐based norms for the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire‐Head and Neck 35 (EORTC QLQ‐HN35) to be used as references to facilitate the interpretation of results from health‐related quality of life (HRQOL) studies of patients with head and neck cancer.

An Exploration of Factors Predicting Malnutrition in Head and Neck Cancer

Objective: Malnutrition is common among head and neck cancer patients and it impacts survival and quality of life. This study aims to identify predictors of malnutrition at time of diagnosis in order to enable early nutritional support and prevent malnutrition in patients at risk. Method: A total of 134 patients with advanced oral and pharyngeal cancer were included in the study. Weight, body mass index (BMI), fat-free mass (FFM), dysphagia, and quality of life were measured at diagnosis and after 6 months. Two definitions for malnutrition were applied: >10% weight loss and BMI <20 after 6 months. Results: Six months after diagnosis, 66% of the patients were malnourished, applying >10% weightloss definition and 26% applying BMI <20. In multivariate analysis, chemotherapy and high BMI at diagnosis were the strongest predictors of malnutrition, using 10% weight loss definition and low BMI followed by low FFM and dysphagia were the strongest predictors using BMI <20. Conclusion: Inconsistent predictors were found depending on the definition used for defining malnutrition. Unintended weight loss of more than 10% seems to be the most reasonable definition for malnutrition since this also correlated to a significant loss of FFM, consequently pointing out treatment with chemoradiotherapy as the strongest predictor for malnutrition.

Health-Related Quality of Life in Patients with Pharyngeal Carcinoma: A Five-Year Follow-Up:

Abstract Objectives: To evaluate the health-related quality of life (HRQL) of patients with pharyngeal carcinoma in a prospective longitudinal multicenter study at diagnosis, after 1 and 5 years in relation to tumor location and treatment. Methods: 89 patients (mean age 60.0 years; 76 % males) with pharyngeal carcinoma were evaluated with standardized HRQL-questionnaires; the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core-30 (EORTC QLQ-C30), the EORTC QLQ-Head and Neck Module (EORTC QLQ-H&N35). Results: Treatment related side-effects deteriorated between diagnosis and the 5-year follow-up. Some specific side-effects got worse between 1 and 5 years such as teeth problems and sticky saliva. The HRQL-results from the EORTC QLQ-H&N35 were significantly different from the norm data, whereas the HRQL-results from the EORTC QLQ-C30 were not. Physical function scale at diagnosis as well as a low stage disease seems to be associated with survival. Patients with oropharyngeal carcinoma had during and after treatment better HRQL than patients with hypopharyngeal carcinoma. Patients treated with brachytherapy had a variation of HRQL over time similar to the whole study group. Conclusion: HRQL-questionnaires could be valuable instruments in treatment planning and serve as aid in foreseeing treatment side-effects. Evaluation of HRQL at diagnosis for patients with pharyngeal carcinoma is of value for the prognosis of HRQL over time and for survival. It should be recognized that treatment for pharyngeal carcinoma often results in long term side-effects such as problems with senses and dry mouth and often generate increasing problems with teeth and sticky saliva.