Dysphagia, Oral Cavity Cancer, Quality of Life
Conditions
Keywords
Oral Cavity Cancer, Dysphagia, Quality of Life, Days alive and out of hospital, Rehabilitation
Brief summary
While the group of oral cavity cancer (OCC) survivors continue to increase, surgeons and oncologist intensify their search for improved treatment and rehabilitation methods to reduce the morbidity of management without compromising the oncological safety. The predominant problem after treatment of OCC is dysphagia, which is associated with malnutrition, aspiration pneumonia, hospital re-admission, and reduced quality of life (QoL) and survival. In a pilot study, the investigators found that 45% of OCC patients reported significant eating disabilities two years after surgical treatment. However, the international literature is limited on the dysphagia and QoL of OCC survivors. With an overall goal to improve the QoL and health status in patients treated for OCC, the present study aims to 1. systematically evaluate the swallowing function before and after treatment, 2. investigate the impact of swallowing function on QoL, 3. identify risk factors for dysphagia, 4. investigate if swallowing function is an independent factor for the number of ´days alive and out of hospital´ 5. evaluate the rehabilitation offered to OCC patients in Danish municipalities and the effect on swallowing outcomes. One hundred patients treated for OCC will be included prospectively during a 2-year period. Data on type and location of tumour, treatment modality, complications, patient weight, dietary intake, rehabilitation program, hospital admissions, recurrences, and survival will be collected. Questionnaires and Modified Barium Swallow Study (MBSS) will be performed before and 2 and 12 months after treatment.
Interventions
None listed
Sponsors
University of Aarhus
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Histologically confirmed squamous cell carcinoma with any location in the oral cavity including recurrences. Patients will only be included once * Treatment with curative intent (surgery and/or (chemo)radio therapy)
Exclusion criteria
* Allergy to barium contrast * Pregnancy or breastfeeding * Inability or unwillingness to complete questionnaires and undergo examinations
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Days alive and out of hospital | 12 months post-operative | During regular outpatient follow-up, the patient will be asked about hospital admission/re-admission since the last visit and the electronic chart will be accessed for verification of reason and length of stay. |
| Modified Barium Swallow Impairment profile (MBSImp) | Baseline, 2 and 12 months post-operative | MBSImp is a 17-point assessment tool (0-55 points, a higher score indicates worse swallowing function) for interpreting MBSS that includes evaluation of the oral, pharyngeal and esophageal phase. The Penetration/Aspiration Scale will be applied for evaluating swallow safety ranging from 1 (no penetration/aspiration) to 8 (silent aspiration). The recordings as well as the interpretations are carried out by one of two trained otorhinolaryngologists. |
| MD Anderson Dysphagia Inventory (MDADI) | Baseline, 2 and 12 months post-operative | The MDADI is a 20-item questionnaire assessing dysphagia-related QoL in head and neck cancer patients covering global, emotional, functional, and physical domains. The score ranges from 20 (poor function) to 100 (high function). The patient answers the questionnaire assisted by a nurse. A 10-point difference between groups in composite score is considered significant. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Head And Neck 35 (EORTC H&N-35) | Baseline, 2 and 12 months post-operative | Scoring ranges from 0-100 where a high score in the functioning scales and global QoL indicate better functioning but for the symptom scales higher scores indicate higher symptom burden. The patient answers the questionnaires assisted by a nurse. A 10-point difference in instrument score is considered significant |
| Functional oral intake score (FOIS) | Baseline, 2 and 12 months post-operative | The patient will be asked about their food intake at each visit. FOIS is a 7 point scale regarding the level of oral intake, ranging from total tube dependency (1) to oral intake of a normal diet (7). |
| Weight | Baseline, 2 and 12 months post-operative | Bodyweight will be measured at each visit |
| European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) | Baseline, 2 and 12 months post-operative | Scoring ranges from 0-100 where a high score in the functioning scales and global QoL indicate better functioning but for the symptom scales higher scores indicate higher symptom burden. The patient answers the questionnaires assisted by a nurse. A 10-point difference in instrument score is considered significant |
Other
| Measure | Time frame | Description |
|---|---|---|
| Rehabilitation program | 12 months post-operatively | At the 12-month follow-up a questionnaire will be sent to the patient's occupational therapist addressing the offered rehabilitation program (type and frequency). Patient satisfaction will be measured on a 10-point VAS-scale. |
Countries
Denmark
Contacts
Primary ContactMathilde Aalling
Outcome results
None listed