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Supportive Care in Cancer

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01.04.2015 | Original Article

Differences in quality of life in obese and normal weight head and neck cancer patients undergoing radiation therapy

verfasst von: Helen Egestad, Carsten Nieder

Erschienen in: Supportive Care in Cancer | Ausgabe 4/2015

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Abstract

Purpose

The aim of this study was to evaluate health-related quality of life (HRQOL) in patients with different body mass indices (BMI, <25 vs ≥25) undergoing radiation treatment for head and neck cancer.

Methods

HRQOL was examined by the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and the EORTC QLQ-H&N35, in the beginning and in the end of radiation treatment in 60 patients treated at University Hospital in Northern Norway. Information about nutritional status with weight loss, hemoglobin level (Hb), serum albumin, and a study-specific questionnaire also was filled out in the beginning and in the end of treatment. The patients’ general condition, skin, and mucous membranes (CTCAE v.3.0) (grades 1 to 5 with unique clinical descriptions) were documented four times during radiation treatment. Changes in HRQOL were calculated and compared by paired sample t test. Multiple regression analyses were used to examine correlations between baseline BMI and changes in HRQOL, CTCAE v.3.0 toxicity, nutritional status, and information that radiotherapists provided to patients.

Results

Patients with BMI ≥ 25 had less mucosal changes after 2 weeks of radiation treatment than patients with BMI < 25 (p = 0.010). Differences regarding feeding tube use (p = 0.037) and intake of nutritional supplements before radiation treatment (p = 0.001) were also seen. Patients with overweight had more dyspnea (p = 0.033) before treatment and more problems with dry mouth (p = 0.042) after treatment. During treatment, patients with BMI ≥ 25 had more problems with opening mouth (p = 0.034) than patients with BMI < 25 and more changes in sexuality (p = 0.019). Patients with BMI ≥ 25 received less information about food and drink (p = 0.011) in the radiation treatment period than normal weight patients.

Conclusions

BMI influences HRQOL and toxicity. Additional longitudinal studies should examine whether or not overweight patients persistently experience more problems with dry mouth and opening their mouth. Regardless of BMI, all patients should be informed about nutritional recommendations during treatment.

Lees J (1999) Incidence of weight loss in head and neck cancer patients on commencing radiotherapy treatment at a regional oncology centre. Eur Cancer Care 8:133–136CrossRef

Mekhail TM, Adelstein DJ, Rybicki LA, Larto MA, Saxton JP, Lavertu P (2001) Enteral nutrition during the treatment of head and neck carcinoma. Cancer 91:1785–1790CrossRefPubMed

Head BA, Heitz L, Keeney C, Myers J, Appana SN, Studts L, Bumpous J, Pfeifer M (2011) The relationship between weight loss and health-related quality of life in persons treated for head and neck cancer. Support Care Cancer 19:1511–1518CrossRefPubMedCentralPubMed

Beaver ME, Matheny KE, Roberts DB, Myers JN (2001) Predictors of weight loss during radiation therapy. Otolaryngol Head Neck Surg 125:645–648CrossRefPubMed

Delafuente JC (1991) Nutrients and immune responses. Rheum Dis Clin N Am 17:203–212

Copeland EM, Daly JM, Dudrick SJ (1977) Nutrition as an adjunct to cancer treatment in the adult. Cancer Res 37:2451–2456PubMed

Ravasco P, Monteiro-Grillo I, Marques VP, Camilo ME (2005) Impact of nutrition on outcome: a prospective randomized controlled trial in patients with head and neck cancer undergoing radiotherapy. Head Neck 27:659–668CrossRefPubMed

Borggreven PA, Verdonck-de Leeuw IM, Muller M, Heiligers LCH, de Bree R, Aaronson NK, Leemans CR (2007) Quality of life and functional status in patients with cancer of the oral cavity and oropharynx: pretreatment values of a prospective study. Eur Arch Otorhinolaryngol 264:651–657CrossRefPubMedCentralPubMed

Funk G, Hynds L (1997) Baseline and post-treatment assessment of the general health status of head and neck cancer patients compared with United States population norms. Head Neck 19:675–683CrossRefPubMed

10.

Maciejewski O, Smeets R, Gerhards F, Kolk A, Kloss F, Stien JM, Kasaj A, Koch F, Grosjean M, Riediger D, Yetka SS (2010) Gender specific quality of life in patients with oral squamous cell carcinomas. Head Face Med 6:21CrossRefPubMedCentralPubMed

11.

Michelson H, Bolund C, Nilsson B, Brandberg Y (2000) Health-related quality of life measured by the EORTC QLQ-C30. Reference values from a large sample of the Swedish population. Acta Oncol 39:477–484CrossRefPubMed

12.

Hammerlid E, Ahlner-Elmqvist M, Bjordal K, Björklund A, Evensen JF, Boysen M, Jannert M, Kaasa S, Sullivan M, Westin T (1999) A prospective multicenter study in Sweden and Norway of mental distress and psychiatric morbidity in head and neck cancer patients. Br J Cancer 80:766–774CrossRefPubMedCentralPubMed

13.

De Leuw JRJ, de Graeff A, Ros WJG, Blijham GH, Hordijk G-J, Winnubst JAM (2000) Prediction of depressive symptomatology after treatment of head and neck cancer: the influence of pre-treatment physical and depressive symptoms, coping, and social support. Head Neck 22:799–807CrossRef

14.

List MA, Lee Rutherford J, Stracks J, Haraf D, Kies MS, Vokes EE (2002) An exploration of the pretreatment coping strategies of patients with carcinoma of the head and neck. Cancer 95:98–104CrossRefPubMed

15.

De Graeff A, de Leeuw RJ, Ros WJG, Hordijk G-J, Blijham GH, Winnubst JAM (2001) Sociodemographic factors and quality of life as prognostic indicators in head and neck cancer. Eur J Cancer 37:332–339CrossRefPubMed

16.

Duffy SA, Terrell JE, Valenstein M, Ronis DL, Copeland LA, Connors M (2002) Effect of smoking, alcohol, and depression on the quality of life of head and neck cancer patients. Gen Hosp Psychiatry 24:140–147CrossRefPubMed

17.

Lebel S, Devins GM (2008) Stigma in cancer patients whose behavior may have contributed to their disease. Future Oncol 4:717–733CrossRefPubMed

18.

Pai PC, Chuang CC, Tseng CK, Tsang NM, Chang KP, Yen TC, Liao CT, Hong JH, Chang JTC (2012) Impact of pretreatment body mass index on patients with head-and-neck cancer treated with radiation. Int J Radiat Oncol Biol Phys 83:e93–e100CrossRefPubMed

19.

Ramsay SE, Whincup PH, Shaper AG, Wannamethee SG (2006) The relations of body composition and adiposity measures to ill health and physical disability in elderly men. Am J Epidemiol 164:459–469CrossRefPubMed

20.

Egestad H & Emaus N (2014) Changes in health related quality of life in women and men undergoing radiation treatment for head and neck cancer and the impact of smoking status in the radiation treatment period, European Journal of Oncology Nursing; http://dx.doi.org/j.ejon.2014.04.003

21.

Egestad H (2013) The significance of fellow patients for head and neck cancer patients in the radiation treatment period. Eur J Oncol Nurs 17(5):618–624CrossRefPubMed

22.

Egestad H (2013) How does the radiation therapist affect the cancer patients’ experience of the radiation treatment? Eur J Cancer Care 22(5):580–588CrossRef

23.

Egestad H (2013) Radiographers relationship with head and neck cancer patients. J Radiother Pract 12:245–254CrossRef

24.

Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez J, Filiberti A, Flechtner H, Fleishman SB, de Haes JCJM, Kaasa S, Klee M, Osobam D, Razavi D, Rofe PB, Schraub S, Sneeuw K, Sullivan M, Takeda F (1993) The European organization for research and treatment of cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials on oncology. J Natl Cancer Inst 85:365–376CrossRefPubMed

25.

Bjordal K, de Graeff A, Fayers PM, Hammerlid E, van Pottelsberghe C, Curran D, Ahlner- Elmqvist M, Maher EJ, Meyza JW, Brèdart A, Söderholm AL, Arraras JJ, Feine JS, Abendstein H, Morton RP, Pignon T, Huguenin P, Bottomly A, Kaasa S (2000) A 12 country field study of the EORTC QLQ-C30 (version 3.0) and the head and neck cancer specific module (EORTC QLQ-H&N35) in head and neck patients. Eur J Cancer 36:1796–1807CrossRefPubMed

26.

Fang P, Tan KS, Troxel AB, Rengan R, Freedman G, Lin LL (2013) High body mass index is associated with worse quality of life in breast cancer patients receiving radiotherapy. Breast Cancer Res Treat. doi:10.1007/s10549-013-26663-2

27.

Al-Naggar RA, Nagi NMS, Ali MMS, Almuasli M (2011) Quality of life among breast cancer patients in Yemen. Asian Pac Cancer Prev 12:2335–2341

28.

Bokhorst-de V, van der Schueren MAE, Langendoen SI, Vondeling H, Kuik DJ, Quak JJ, van Leeuwen PAM (1999) Perioperative enteral nutrition and quality of life of severely malnourished head and neck cancer patients: a randomized clinical trial. Clin Nutr 19:437–444

29.

Høgdal N (2010) Funktionel status og helbredelsesrelatert livskvalitet hos pasienter med cancer cavi oris og cancer oropharynges ved start av strålebehandling (Functional status and quality of life in patients with cancer cavi oris and oropharynx at the start of radiotherapy). Masteroppgave I Helsefagvitenskap ved Det medisinske fakultet, seksjon for helsefag. (Master in Health Sciences Faculty of Medicine). University of Oslo, Norway

30.

Hammerlid E, Taft C (2001) Health-related quality of life in long-term head and neck cancer survivors: a comparison with general population norms. Br J Cancer 84:149–156CrossRefPubMedCentralPubMed

31.

Hjermstad MJ, Fayers PM, Bjordal K, Kaasa S (1998) Using reference data on quality of life—the importance of adjusting for age and gender, exemplified by the EORTC QLQ-C30 (+3). Eur J Cancer 34:1381–1389CrossRefPubMed

32.

Hammerlid E, Wirblad RD, Sandin RN, Mercke C, Edström MD, Kaasa S, Sullivan M, Westin T (1998) Malnutrition and food intake in relation to quality of life in head and neck cancer patients. Head Neck 20:540–548CrossRefPubMed

33.

van den Berg MG, Rasmussen-Conrad EL, van Nispen L, van Binsbergen JJ, Merkx MA (2008) A prospective study on malnutrition and quality of life in patients with head and neck cancer. Oral Oncol 44:830–837CrossRefPubMed

34.

Ravasco P, Monteiro-Grillo I, Marques Vidal P, Camilo ME (2003) Nutritional deterioration in cancer: the role of disease and diet. Clin Oncol 15:443–450CrossRef

35.

Raber-Durlacher JE (1999) Current practices for management of oral mucositis in cancer patients. Support Care Cancer 7:71–74CrossRefPubMed

36.

Raber-Durlacher JE, Weijk NI, Abu Saris M, de Koning B, Zwinderman AH, Osanto S (2000) Oral mucositis in patients treated with chemotherapy for solid tumors: a retrospective analysis of 150 cases. Support Care Cancer 8:366–371CrossRefPubMed

37.

Dreizen S (1990) Oral complications of cancer therapy. Description and incidence of oral complications. NCI Monogr 9:11–15PubMed

38.

Saito N, Imai Y, Muto T, Sairenchi T (2012) Low body mass index as a risk factor of moderate to severe oral mucositis in oral cancer patients with radiotherapy. Support Care Cancer 20:3373–3377CrossRefPubMed

39.

Vera-Llonch M, Oster G, Haigwara M, Sonis S (2006) Oral mucositis in patients undergoing radiation treatment for head and neck carcinoma—risk factors and clinical consequences. Cancer 106:329–336CrossRefPubMed

40.

Trotti A, Bellm LA, Epstein JB, Frame D, Fuchs HJ, Gwede CK, Komaroff E, Nalysnyk L, Zilberberg MD (2003) Mucositis incidence, severity and associated outcomes in patients with head and neck cancer receiving radiotherapy with or without chemotherapy: a systematic literature review. Radiother Oncol 66:253–262CrossRefPubMed

41.

Vissink A, Jansma J, Spijkervet FK, Burlage FR, Coppes RP (2003) Oral sequelae of head and neck radiotherapy. Crit Rev Oral Biol Med 14:199–212CrossRefPubMed

42.

Kakoei S, Haghdoost A-A, Rad M, Mohammadadalizadeh S, Pourdamghan N, Nakhaei M, Bahador M (2012) Xerostomia after radiotherapy and its effect on quality of life in head and neck cancer patients. Arch Iran Med 15:214–218PubMed

43.

Dirix P, Nuyts S, Vander Poorten V, Delaere P, Van den Bogaert W (2008) The influence of xerostomia after radiotherapy on quality of life: results of a questionnaire in head and neck cancer. Support Care Cancer 16:171–179CrossRefPubMed

44.

Pow EH, Kwong DL, McMillan AS, Wong MC, Sham JST, Leung LH, Leung WK (2006) Xerostomia and quality of life after intensity-modulated radiotherapy vs. conventional radiotherapy for early-stage nasopharyngeal carcinoma: initial report on a randomized controlled clinical trial. Int J Radiat Oncol Biol Phys 66:981–991CrossRefPubMed

45.

Lin SC, Jen YM, Chang YC, Lin CC (2008) Assessment of xerostomia and the impact on quality of life in head and neck cancer patients undergoing radiotherapy, and validation of the Taiwanese version of the xerostomia questionnaire. J Pain Symptom Manag 36:141–148CrossRef

46.

You SH, Kim SY, Lee CG, Keum KC, Kim JH, Lee IJ, Kim YB, Koom WS, Cho J, Kim SK, Kim GE (2012) Is there a clinical benefit to adaptive planning during tomotherapy in patients with head and neck cancer at risk for xerostomia? Am J Clin Oncol 35:261–266CrossRefPubMed

47.

Chao KSC, Perez CA, Brady LW (1999) Fundamentals of patient management. In: Chao KSC, Perez CA, Brady LW (eds) Radiation oncology: management decisions. Lippincott-Raven, Philadelphia, pp 1–13

48.

Jamieson C, Norton B, Day T, Lakeman M, Powell-Tuck J (1997) The quantitative effect of nutrition support on quality of life in outpatients. Clin Nutr 16:25–28CrossRef

49.

Tchekmedyian S, Fesen M, Price L, Ottery F (2003) Ongoing placebo-controlled study of oxandrolone in cancer-related weight loss. Int J Radiat Oncol Biol Phys 57:283–284CrossRef

Titel: Differences in quality of life in obese and normal weight head and neck cancer patients undergoing radiation therapy
verfasst von: Helen Egestad
Carsten Nieder
Publikationsdatum: 01.04.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: Supportive Care in Cancer / Ausgabe 4/2015
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-014-2463-1

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Differences in quality of life in obese and normal weight head and neck cancer patients undergoing radiation therapy

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Methods

Results

Conclusions

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