Long Term Monitoring of Nutritional, Clinical Status and Quality of Life in Head and Neck Cancer Patients

Česká verzia

Authors: E. Malá ¹; E. Vejražková ²; J. Bielmeierová ³; M. Jindra ³; M. Vošmik ⁴ ; J. Novosad ¹; L. Sobotka ⁵
Authors place of work: Ústav klinické imunologie a alergologie, LF UK a FN Hradec Králové ¹; IV. interní klinika LF UK a FN Hradec Králové ²; Rehabilitační klinika LF UK a FN Hradec Králové ³; Klinika onkologie a radioterapie LF UK a FN Hradec Králové ⁴; III. interní gerontometabolická klinika LF UK a FN Hradec Králové ⁵
Published in the journal: Klin Onkol 2015; 28(3): 200-214
Category: Original Articles
doi: https://doi.org/10.14735/amko2015200

Summary

Background:
Malnutrition in head and neck cancer (HNC) patients decreases survival, quality of life (QOL) and oncological outcomes. The aim of the prospective three-year study was to compare QOL, clinical symptoms and variables (complications, survival and mortality rates in HNC patients).

Patients and Methods:
A total of 726 patients aged 55 to 72 years with treatable HNC were included from January 2004 to December 2009; these patients were randomized to either group with PEG and enteral nutrition and nonPEG group with nutritional counselling according to nutritional care. We used EORTC questionnaires QOL C-30 and Head and neck module (HN-35) for measuring of QOL. The following variables due to expectable influence on QOL (demographic data, oncological data, nutritional screening, Clinical symptom score, Karnofsky performance status score, Charlson comorbidity index) were included. Monitoring was done five times in three years.

Results:
In the first six months, we found decrease of weight and body mass index (BMI). After this critical time point and finish of oncological treatment, a marked difference in the development of patients treated with PEG. Negative factors influencing patients survival, QOL, clinical status were males aged > 63 years, hypopharyngeal cancer (stage III– IV), smoking, weight loss > 10%, BMI < 21 and disallowance of PEG.

Conclusions:
QOL is an essential factor for cancer patients. Our study showed that nutritional intervention with early enteral nutrition may improve QOL and survival in HNC patients. The PEG group better tolerated oncological treatment, had lower incidence of complications, shorter time to re-entry of permanent increase in weight, lower rate of rehospitalization and its shorter length. We found QOL questionnaires to be very important for better understanding and communication and a key instrument for improving solution of patient’s difficulties during their therapy in multidisciplinary approach.

Key words:
head and neck cancer – quality of life – EORTC – C-30 – HN-35 – PEG – malnutrition

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Submitted:
16. 4. 2015

Accepted:
4. 5. 2015

Zdroje

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