Symptom Prevalence and Functional Status Among Patients with Advanced Cancers of the Head and Neck

Abstract

ABSTRACT Aim: There is no standard medical treatment or method of care for patients with advanced cancers of the head and neck. However, because the treatment received by terminally ill patients with head and neck cancers differ among institutions, evaluations and examinations are not being adequately performed. We aimed to clarify the symptoms in these patients contributing to changes in quality of life (QOL). In the future, we aim to reduce the suffering of these patients as far as possible by establishing a systematic method for care. Methods: This multicenter, prospective, observational study included 100 patients with advanced head and neck cancers in 11 oncology units. We evaluated changes in global QOL (European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire–Palliative 15), respiratory tract morphology, tumor site, bleeding, pulmonary metastasis, nutritional course, phonation ability, edema, and respiratory tract secretions. Results: of the 100 patients who met the entry criteria, 71 could be observed until death. Average survival from entry was 33.5 days (range, 0–167 days). Patients with worse performance status were shorter-lived. Questionnaires on QOL were answered by 48 of the 71 patients. There was no significant difference in global QOL between entry and 3 weeks later. 32 patients (45.1%) were breathing with a tracheostoma, and 15 patients needed a cuffed endotracheal tube. 26 patients (36.6%) needed a change of dressing because of bleeding or oozing, and 5 patients had severe bleeding. 17 patients (23.9%) had head and neck edema at entry, and 26 patients (36.6%) had edema at the time of death. 53 patients (74.6%) had received enteral nutrition. Conclusions: With this prospective study we have clarified symptoms in terminally ill patients with head and neck cancers. On the basis of this study, we plan to establish a care system for terminally ill patients with head and neck cancers and prepare further prospective studies. Disclosure: All authors have declared no conflicts of interest.