0000000000060179
AUTHOR
Andreas Dietz
Quality of life before and after total laryngectomy: Results of a multicenter prospective cohort study
Background The purpose of this study was to determine what quality of life (QOL) areas improve and deteriorate during the first year after total laryngectomy and to identify predictors of these changes. Methods One hundred seventy-four patients completed the European Organization for Research and Treatment of Cancer (EORTC) QOL questionnaires before laryngectomy, n = 133 before discharge from hospital, n = 110 at the end of rehabilitation, and n = 86 1 year after laryngectomy. Multivariate regression analysis was performed to estimate the effect of potential predictors on QOL. Results Areas that did not recover to baseline level were physical functioning, role functioning, social functionin…
Entwicklung eines ICF-basierten Leitfadens für die Beurteilung funktioneller Aspekte bei Kopf-Hals-Tumoren
Funktionelle Beeintrachtigungen bei Kopf-Hals-Tumoren werden bisher im klinischen Alltag selten standardisiert erhoben. Klinische Studien mit der Zielgrose Funktionserhalt bei KHT verwenden viele verschiedene Instrumente. Die Ergebnisse sind deshalb oft schlecht vergleichbar und lassen zu wenig klinische Schlussfolgerungen zu. Es war daher notwendig und Ziel dieser Studie, die nach bisheriger Evidenz und interdisziplinarem Expertenkonsens am besten geeigneten Instrumente zur Beurteilung von Funktionsfahigkeit bei KHT zu identifizieren und Empfehlungen fur deren Verwendung in einem Leitfaden zusammenzustellen. In Vorstudien wurde unter Verwendung festgelegter Kriterien eine Vorauswahl an Ins…
Cetuximab, fluorouracil and cisplatin with or without docetaxel for patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck (CeFCiD) : an open-label phase II randomised trial (AIO/IAG-KHT trial 1108)
Abstract Background The combination of cisplatin, 5-fluorouracil (5-FU) and cetuximab (PFC) is the reference first-line treatment for recurrent/metastatic (R/M) squamous cell carcinoma of the head and neck (SCCHN). We analysed whether treatment intensification by the addition of docetaxel to PFC improved efficacy in R/M SCCHN. Methods A total of 180 patients with R/M SCCHN (1:1) were assigned to receive either cisplatin (40 mg/m2), docetaxel (40 mg/m2) and 5-FU (2000 mg/m2) at days 1 and 8 and cetuximab (400/250 mg/m2) at days 1, 8 and 15 (DPFC) or standard cisplatin (100 mg/m2) at day 1, 5-FU (1000 mg/m2) at days 1–4 and cetuximab (400/250 mg/m2) at days 1, 8 and 15 (PFC). Chemotherapy was…
Inanspruchnahme von Selbsthilfegruppen für Laryngektomierte in Mitteldeutschland
Selbsthilfegruppen (SHG) dienen als Informationsquelle, Bewaltigungsressource und zur Vertretung von Patienteninteressen. Unbekannt war bisher, wie haufig diese von Laryngektomierten genutzt werden und wodurch sich Inanspruchnehmer von Nichtinanspruchnehmern unterscheiden. In einer multizentrischen Studie wurden 224 laryngektomierte Patienten ein Jahr postoperativ hinsichtlich der Teilnahme an SHG und moglicher Pradiktoren mittels eines halbstrukturierten Interviews und standardisierter Fragebogen befragt. Insgesamt 23% der laryngektomierten Patienten gehen regelmasig in eine SHG. Die Mitgliedschaft ist wahrscheinlicher bei Patienten mit hoherem Bildungsgrad und besserem Einkommen, beim …
Course of social support and associations with distress after partial laryngectomy
PURPOSE Social support has been shown to be positively associated with quality of life and adjustment after a cancer diagnosis. The present study investigates the course of social support up to one year after partial laryngectomy and its association with distress. DESIGN Longitudinal questionnaire study. SAMPLE A total of 428 patients after partial laryngectomy (mean age: 64, SD = 11, 91% male). METHODS Patients completed questionnaires before treatment (t1), one week after a partial laryngectomy (t2), 3 months (t3), and one year (t4) thereafter. Social support was evaluated at t2, t3, and t4 using a brief version of the Social Support Questionnaire. Distress was measured at t2, t3, and t4 …
Berufliche Rehabilitation nach Laryngektomie
Ziel dieser Studie war es herauszufinden, wie viele Patienten nach einer Laryngektomie (LE) erfolgreich ins Berufsleben zuruckkehren und welche Faktoren eine berufliche Wiedereingliederung unterstutzen. Laryngektomierte (n=231) im Alter von bis zu 60 Jahren wurden vor der LE (t1), vor der Anschlussheilbehandlung (AHB) (t2), am Ende der AHB (t3), 1 Jahr nach LE (t4), 2 Jahre nach LE (t5) und 3 Jahre nach LE (t6) mithilfe von strukturierten Interviews und Fragebogen befragt. Vor der LE waren n=76 (38%) der Befragten erwerbstatig, 34% erwerbslos, 23% erhielten eine Erwerbsminderungsrente und 3% waren in Vorruhestand. 1 Jahr nach der LE waren 13% erwerbstatig, 2 Jahre nach LE 15% und 3 Jahre n…
Quality of life during the first year after partial laryngectomy: Longitudinal study
This prospective study was conducted to assess changes in quality of life (QOL) of patients who undergo a partial laryngectomy.The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaires Core and Head and Neck (EORTC-QLQ-C30, QLQ-HN35) were used preprocedure (n = 218), 1 week (n = 159), 3 months (n = 122), and 1 year after partial laryngectomy (n = 88). Changes over time were analyzed with the Wilcoxon signed rank test and the Holm-Bonferroni method, and interpreted regarding clinical relevance.Most subscales worsened 1 week postprocedure, but many recovered to baseline level after 1 year. Dyspnea and cognitive functioning deteriorated over time, with worst…
Cetuximab, fluorouracil (5-FU), cisplatin, and docetaxel as first-line treatment in patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN): Interim results of a randomized phase II clinical trial (CeFCiD).
e17021 Background: This study investigates efficacy and toxicity of docetaxel added to cetuximab, cisplatin and 5-FU for patients with R/M SCCHN. We here report a planned second interim analysis to compare response rates between arms in order to decide on continuing to full accrual. Methods: Inclusion criteria were: stage III/IV R/M SCCHN and ECOG 0-1. Patients were randomized to arm A: cetuximab (standard dose) plus a maximum of 6 cycles of docetaxel (40 mg/m², day 1+8), cisplatin (40 mg/m², day 1+8) and 5-FU (2000 mg/m², day 1+8) or to arm B: cetuximab (standard dose), cisplatin (100 mg/m², day 1) and 5-FU (1000 mg/m², day 1-4). Treatment was administered until progression or intolerabil…
Effects of stepped psychooncological care on referral to psychosocial services and emotional well-being in cancer patients: A cluster-randomized phase III trial
Objective Emotional distress in cancer patients often goes unnoticed in daily routine; therefore, distress screening is now recommended in many national guidelines. However, screening alone does not necessarily translate into better well-being. We examined whether stepped psychooncological care improves referral to consultation-liaison (CL) services and improves well-being. Methods In a cluster-randomized trial, wards were randomly allocated to stepped versus standard care. Stepped care comprised screening for distress, consultation between doctor and patient about the patient's need for CL services, and provision of CL service. Primary outcomes were referral to psychosocial services and em…
Vorstellung des Screeningsystems (OncoFunction) für Funktionsstörungen im Kopf-Hals-Tumor-Follow-up
Einleitung: Die Nachsorge von Kopf-Hals-Tumoren (KHT) fokussiert bisher auf die Therapiekontrolle. Daneben ist die Langzeitfunktionalitat sehr wichtig. Diese wird beobachtet, aber nicht standardisiert erfasst. Zusatzlich bestehen bei den Patienten oft psychoonkologische Komorbiditaten, die die objektive Bewertung erschweren. Aus diesem Grunde wurde von Tschiesner et al. ein auf dem „ICF Core Set for Head and Neck Cancer“ basierender Leitfaden zur Erfassung von funktionellen Beeintrachtigungen bei Patienten mit KHT entwickelt und ein Screening-Tool vorgestellt. Mit den positiven Erfahrungen bei anderen Tumorentitaten wurde eine elektronische Version des Tools entwickelt (OncoFunction). Metho…
Factors associated with non-participation and dropout among cancer patients in a cluster-randomised controlled trial
We investigated the impact of demographic and disease related factors on non-participation and dropout in a cluster-randomised behavioural trial in cancer patients with measurements taken between hospitalisation and 6 months thereafter. The percentages of non-participation and dropout were documented at each time point. Factors considered to be potentially related with non-participation and dropout were as follows: age, sex, marital status, education, income, employment status, tumour site and stage of disease. Of 1,338 eligible patients, 24% declined participation at baseline. Non-participation was higher in older patients (Odds Ratio [OR] 2.1, CI: 0.6-0.9) and those with advanced disease …
Arctic avian predators synchronise their spring migration with the northern progression of snowmelt
AbstractMigratory species display a range of migration patterns between irruptive (facultative) to regular (obligate), as a response to different predictability of resources. In the Arctic, snow directly influences resource availability. The causes and consequences of different migration patterns of migratory species as a response to the snow conditions remains however unexplored. Birds migrating to the Arctic are expected to follow the spring snowmelt to optimise their arrival time and select for snow-free areas to maximise prey encounter en-route. Based on large-scale movement data, we compared the migration patterns of three top predator species of the tundra in relation to the spatio-te…
Co-morbid mental health conditions in cancer patients at working age - prevalence, risk profiles, and care uptake
Summary Objective This study examined the prevalence of mental health conditions in cancer patients, the role of socioeconomic position in relation to that, and the use of professional mental health care. Methods Prospective cohort with measurements at the beginning of inpatient treatment (baseline) and 3, 9, and 15 months after baseline using structured clinical interviews based on DSM-IV, questionnaires, and medical records. Results At baseline, 149 out of 502 cancer patients (30%) were diagnosed with a mental health condition. Prevalence was associated with unemployment (odds ratio [OR] 2.0), fatigue (OR 1.9), and pain (OR 1.7). Of those with mental health conditions, 9% saw a psychother…
Speech rehabilitation during the first year after total laryngectomy
Background Gaining a new voice is one of the major aims after total laryngectomy. The objective of this study was to describe the process and results of speech rehabilitation during the first year after surgery. Methods Speech intelligibility was measured 6 months (n = 273) and 1 year (n = 225) after total laryngectomy. Results Objective (23.4 to 47.5 points, p < .0001) and subjective (51.6 to 64.7 points, p < .0001) speech intelligibility improved between 6 months and 1 year after total laryngectomy. Patients who used tracheoesophageal puncture (TEP) had the best results in speech intelligibility 6 months and 1 year after total laryngectomy. In all, 12% of the patients who used TEP initial…
Age- and sex-standardised prevalence rates of fatigue in a large hospital-based sample of cancer patients
Background: The aim of this longitudinal study was to determine age- and sex-standardised prevalence rates of cancer-related fatigue in different groups of patients. Methods: This was a prospective study in a cohort of N=1494 cancer patients investigating fatigue at three time points t1–t3 (t1: admission to hospital, t2: discharge, t3: half a year after t1). Fatigue was measured with the Multidimensional Fatigue Inventory. Age- and sex-adjusted norms were derived from a representative community sample of N=2037, using a cutoff at the 75th percentile. Results: At admission to the hospital, 32% of the patients were classified as fatigued. At discharge, the overall prevalence rate was 40%, and…