Beumer, L.J. (2013) Inventariserende studie naar symptomen van patienten in het palliatieve behandeltraject van hoofd-halskanker. thesis, Dentistry.
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Abstract
Head and neck cancer is world-wide one of the ten most common cancers.1 The 5-year survival rate (50%) has not significantly improved in the past few decades. Because of the large numbers of deaths there is a great demand for palliative care. The main purpose of palliative care is to provide patients with symptom relief. In the case of head and neck cancer it is really important to take care of the symptoms, because of the structures affected. Previous studies into symptoms during the period of palliative treatment had important shortcomings regarding the design or the report of the study, which made the clinical relevance of the results limited. The objective of this study is to make an inventory of the several symptoms that appear to head and neck cancer patients during the palliative treatment in the Universitair Medisch Centrum Groningen and to analyze which patient-, tumor-, and treatment-characteristic variables have a relationship with the appearance of those symptoms. Materials and methods The charts of patients who were treated at the department kaak- en aangezichtschirurgie between 2007 and 2012 were reviewed to identify charts that meet our inclusion criteria. 57 patients were included. The charts were screened on 29 symptoms and 16 patient characteristics. The resulting data were tested by Chi-Square test, Fisher's Exact test, Mann Whitney test, Kruskal Wallis test and the Log Rank test. Spearmans Rangcorrelation coefficient was used to analyse possible associations. Results The average age at the moment of death was 67,5 year (SD =12,5 year). The median survival time was 145 days and the mean number of symptoms was 3,8 per patient. Patients that were treated with RTX or MTX had significantly more new symptoms (p=0,006) and a longer survival time (p=0,007) compared to patients who were not treated with RTX or MTX. The age of the patients had a negative association with the number of symptoms (R2=0,0615 after filtering the outliers). The sex, the location of the tumor, the presence of comorbidity, the presence of a second tumor and the initial stage of the tumor did not give a significant difference in the kind and/or number of symptoms and/or survival. Discussion and conclusions A huge number of symptoms were during palliative treatment. There were differences in the frequencies of symptoms depending on patient-, tumor-, or treatmentcharacteristics. These differences were all not statistically significant. As result of the retrospective character, the collection of data in dossiers was not carried out in a controlled way. Patient- or physician-related differences may result in differences in the way the charts were written and therefore result in differences in the database. A randomized controlled trial is needed to increase the sensitivity of the results, to decrease the inter- and intraobserver bias and to investigate causal associations. Quality of life evaluation should be involved in next studies to increase the clinical relevance of the results.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Roodenburg, Prof. dr. J.L.N. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:40 |
| Last Modified: | 25 Jun 2020 10:40 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/178 |
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