Head & neck
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The University of Washington Quality of Life (UW-QOL) questionnaire is an English-language survey instrument used worldwide to assess the quality of life of patients with head and neck cancer. To be used in other cultures, such instruments require careful translation and psychometric validation in other languages. ⋯ The Brazilian-Portuguese version of the UW-QOL questionnaire appears to be culturally appropriate and psychometrically valid. This version is a valuable tool to evaluate accurately the quality of life of Brazilian patients with head and neck cancer.
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Importance of patient examination to clinical quality assurance in head and neck radiation oncology.
When quality assurance programs in clinical radiation oncology focus mainly on the technical aspects of treatment, they tend to underplay questions of therapeutic process and outcome. We determined the value of clinical peer review in radiation therapy for head and neck cancer that involved head and neck examination. ⋯ Peer review of radiation target localization in RT plans led to changes that could potentially affect rates of cancer control or complication in about 10% of patients. We suggest that the accuracy of head and neck radiation oncology treatment plans might be increased by co-examination by another head and neck cancer specialist, typically a radiation oncologist or head and neck surgeon, to confirm RT target volumes.
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The purpose of this study was to evaluate the incidence and predictive factors of contralateral occult lymph node metastasis in squamous cell carcinomas of the oral cavity to form a rational basis for elective contralateral neck management. ⋯ The risk of contralateral occult neck involvement in the oral cavity squamous cell carcinomas above the T3 classification or those crossing the midline with unilateral metastases was high, and patients who presented with a contralateral metastatic neck had a worse prognosis than those whose disease was staged as N0. Therefore, we advocate an elective contralateral neck treatment with surgery or radiotherapy in patients with oral cavity squamous cell carcinoma with ipsilateral node metastases or tumors, or both, whose disease is greater than T3 or crossing the midline.
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Total laryngectomy is the standard of care for surgical salvage of radiation failure in laryngeal cancer. However, the role of conservation laryngeal surgery in this setting remains unclear. The objective was to compare the efficacy of conservation versus total laryngectomy for salvage of radiation failure in patients who initially presented with T1 or T2 squamous cancer of the larynx. ⋯ Although conservation laryngeal surgery was possible in a few patients with local failure after radiotherapy, conservation laryngeal surgery is an oncologically sound alternative to total laryngectomy for these patients.
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Xerostomia is a ubiquitous complication after conventional radiotherapy for nasopharyngeal carcinoma (NPC) that seriously impairs patient quality of life (QOL). The effect on QOL of parotid-sparing intensity-modulated radiotherapy (IMRT) for early-stage NPC was assessed prospectively. ⋯ IMRT for early-stage disease preserved key aspects of QOL, and a reduction in xerostomia symptoms enhanced broader aspects of QOL.