Document Detail


Predictors of functional decline in locally advanced head and neck cancer patients from south Brazil.
MedLine Citation:
PMID:  20054850     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Functional decline in Brazilian patients with head and neck squamous cell carcinoma (HNSCC) is associated with impaired recovery, quality of life, and health care costs.
METHODS: Sixty patients enrolled at the regional oncology center in Curitiba, Brazil, were assessed over 6 months for toxicities, nutritional status, anthropometry, fatigue, stress, and functionality.
RESULTS: Severe mid-arm and mid-calf circumference depletion accompanied weight loss. Total fatigue score increased 64% (p < .001), as did perceived stress and serum cortisol (p = .01). Instrumental activities of daily living (IADL) dependence doubled, and activities of daily living (ADL) dependence quadrupled (p < .001). Difficulty chewing or swallowing, weight loss, fatigue, perceived stress, and IADL dependence accounted for 48.2% of ADL dependence.
CONCLUSIONS: The physical and psychological impact of HNSCC and its treatment are universally experienced; yet, screening and intervention for symptoms such as fatigue and stress are not typical clinical practice. Moreover, assessment of functional status is usually limited to chewing and swallowing. This study identified symptoms that require systematic intervention and randomized trials with functional independence as the outcome.
Authors:
Heidi J Silver; Christine de Campos Graf Guimaraes; Paola Pedruzzi; Maraisa Badia; Adriana Spuldaro de Carvalho; Benedito V Oliveira; Gyl H A Ramos; Mary S Dietrich; Ricardo Pietrobon
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Head & neck     Volume:  32     ISSN:  1097-0347     ISO Abbreviation:  Head Neck     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-30     Completed Date:  2010-12-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8902541     Medline TA:  Head Neck     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1217-25     Citation Subset:  IM    
Affiliation:
Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA. heidi.j.silver@vanderbilt.edu
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living*
Adaptation, Physiological
Aged
Brazil
Carcinoma, Squamous Cell / mortality,  pathology,  therapy*
Cohort Studies
Combined Modality Therapy
Fatigue / epidemiology
Female
Head and Neck Neoplasms / mortality,  pathology,  therapy*
Humans
Linear Models
Male
Middle Aged
Multivariate Analysis
Neck Dissection / methods
Nutritional Status
Oncology Service, Hospital
Postoperative Complications / physiopathology
Predictive Value of Tests
Quality of Life*
Risk Assessment
Stress, Psychological
Time Factors
Weight Loss*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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