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Increased Pain Reporting by Head and Neck Cancer Patients at Radiation Oncology Consultation: A Quality‐of‐Life Analysis
Author(s) -
Havard Molly,
Esslinger Hope,
Mierzwa Michelle,
Kharofa Jordan,
Takiar Vinita
Publication year - 2021
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.28784
Subject(s) - medicine , quality of life (healthcare) , head and neck cancer , univariate analysis , cancer , multivariate analysis , physical therapy , radiation therapy , medical prescription , odds ratio , oncology , nursing , pharmacology
Objectives Head and neck cancers (HNC) are associated with significant morbidity. Quality‐of‐life (QoL) analyses can assist with understanding subjective factors shaping the patient experience. Here, we assess for patient and/or tumor factors associated with increased pain reporting at the time of initial radiation oncology consultation at a single institution in 2015. Study Design Prospective cross‐sectional questionnaire research. Methods All new patient consultations in 2015 were offered the European Organization for Research and Treatment of Cancer Quality‐of‐Life Questionnaire Core‐30 (EORTC QLQ‐C30) survey. HNC patients were also offered the EORTC QLQ‐HN35 module. Retrospective chart review was performed on patients who completed the surveys. Patient demographics, tumor characteristics, and QoL responses were analyzed for potential associations. Statistical analyses were conducted using SAS v9.4 (SAS Institute, Cary, NC), with P < .05 considered significant. Results Of 771 new patient consultations, 137 consultations were for HNC patients. Of those, 62 patients completed both surveys. HNC patients reported greater pain relative to all other disease sites (odds ratio [OR]: 2.05; P < .01). On univariate analysis of the EORTC QLQ‐C30 data, increased pain was found to be associated with tumor size > 4 cm (OR: 3.05; P ≤ .05). The EORTC QLQ‐HN35 data revealed lymph node involvement to be independently associated with pain (OR: 3.12; P ≤ .05). On multivariate analysis, increased pain was associated with lack of pain medication prescription at the time of consultation ( P ≤ .05) and age ≥ 65 years ( P ≤ .05). Conclusion Patients with HNC reported significantly more pain at consultation than patients with other primary malignancies. Understanding factors contributing to subjective pain may allow providers to potentially address these symptoms proactively to improve patients’ QoL. Level of Evidence 2c – Outcomes research. Laryngoscope , 131:326–332, 2021