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Predictors of functional decline in locally advanced head and neck cancer patients from South Brazil
Author(s) -
Silver Heidi J.,
de Campos Graf Guimaraes Christine,
Pedruzzi Paola,
Badia Maraisa,
Spuldaro de Carvalho Adriana,
Oliveira Benedito V.,
Ramos Gyl H. A.,
Dietrich Mary S.,
Pietrobon Ricardo
Publication year - 2010
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.21322
Subject(s) - swallowing , medicine , activities of daily living , quality of life (healthcare) , head and neck cancer , weight loss , anthropometry , physical therapy , cancer , head and neck squamous cell carcinoma , surgery , obesity , nursing
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. © 2010 Wiley Periodicals, Inc. Head Neck, 2010