Biomedical subjects

Kristin Bjordal

Publications and source records attributed to Kristin Bjordal.

8 recordsLinked to original sources

PubMed2007

EORTC QLQ-INFO26: a questionnaire to assess information given to cancer patients a preliminary analysis in eight countries.

Information disclosure is a key factor in the support for cancer patients. The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Group has developed a questionnaire to evaluate the level of information received by cancer patients at different stages of their disease and treatment: the EORTC QLQ-INFO26. It can be used in clinical practice and research, including clinical trials. The questionnaire was developed following EORTC Quality of Life Group guidelines. The paper presents the data on 133 patients from eight countries. The resulting EORTC QLQ-INFO26 questionnaire includes four sub-scales on information regarding their cancer, medical tests, treatment and other services and several single items.

Adult↗

PubMed2006

[Tumour-modifying therapy].

Symptom relief as well as symptom prevention may be achieved in patients with advanced malignant disease and short life expectancy by use of radiotherapy and systemic cancer treatment (hormones and chemotherapy). Sometimes the treatment may be life prolonging as well. This knowledge is mostly based upon empirical data and personal experiences - to a much lower extent on evidence-based medicine. For these patients, it is of particular importance to minimise the level and duration of acute treatment-related toxicity. Shortened radiotherapy regiments may be effective, with few side effects. The efficacy of the systemic treatment must be evaluated at regular intervals and terminated if there is a lack of response or high level of toxicity. Bisphosphonates are standard treatment of hypercalcaemia. In addition, in patients with bone metastasies from various cancer sites with a life expectancy of six months or more, bisphosphonates may reduce the number of skeletal events.

Antineoplastic Agents↗

PubMed2006

[Approaching patients who require palliative care].

The aim of palliative medicine is the best possible quality of life. Based upon literature and clinical experience we address factors of importance for the meeting between the palliative patient and the physician. Family and network, personality and behaviour vary between palliative patients and have effect upon their coping; these factors should be reflected in the meeting between the physician and the patient. Communication with a palliative patient also aims at a systematic assessment of his or her various symptoms and the physician should have a broad armamentarium of communications skills. The optimal way to assess symptoms is by use of clinical interviews supplemented with standardized measurements. Instruments such as the Edmonton Symptom Assessment System are very useful in the assessment of the commonest symptoms. The assessments should include patients' perspectives and what priority they give to relevant interventions. Treatment should be evaluated systematically in order to avoid ineffective treatments and to reduce side effects and interactions. The aim is to give patients as good and as long a time as possible in the place in which they want to spend the last part of their lives. Palliative medicine often combines the art of medicine with new technology. The focus on quality of life and the patient perspective is paramount, and the approach to the patient should reflect this.

Adaptation, Psychological↗

PubMed2006

Health-related quality of life in patients with pharyngeal carcinoma: a five-year follow-up.

PURPOSE: The purpose was to evaluate the health-related quality of life (HRQL) of patients with pharyngeal carcinoma at diagnosis and after 1 and 5 years in relation to tumor location and treatment modality in a prospective multicenter study. METHODS: Eighty-nine patients with pharyngeal carcinoma (mean age, 60.0 years; 76% men) were evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck Cancer Module (EORTC QLQ-H&N35). RESULTS: Problems with dry mouth and teeth became worse between diagnosis and the 5-year follow-up. Problems with thick secretions and teeth increased between 1 and 5 years. The HRQL at diagnosis was associated with survival. Patients with oropharyngeal carcinoma reported better HRQL than patients with hypopharyngeal carcinoma. CONCLUSIONS: For patients with pharyngeal carcinoma, the HRQL at diagnosis seems to be an important factor for the prognosis of both HRQL over time and survival. Treatment of pharyngeal carcinoma often results in long-term side effects such as dry mouth, problems with teeth, and thick secretions.

Aged↗

PubMed2005

Quality of life and head and neck cancer: a 5 year prospective study.

OBJECTIVES: Assessment of health-related quality of life (HRQL) in head and neck cancer patients from diagnosis to 5 years after start of treatment. STUDY DESIGN: A prospective, descriptive study METHODS: three hundred fifty-seven patients from Norway and Sweden filled in HRQL questionnaires, the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and the EORTC QLQ-H and N35, six times during the first year and then after 5 years. At 5 years, 167 (87%) of the 192 living patients filled in questionnaires. RESULTS: Group data: clinical significant improvements in HRQL were not found between 1 and 5 years. Problems with teeth, opening of the mouth, dryness in the mouth, and sticky saliva were persistent or worsening. Similar findings were found regardless of sex, age, stage, or site when clinical significant changes are considered. Patients who died between 1 and 5 years reported reduced HRQL on 15 of 28 scales at 1 year compared with the survivors. Individual data: 40% of patients reported improved global HRQL from diagnosis to 5 years after start of treatment. In addition, 11% had "top scores" at both assessment points. The pattern in global HRQL scores also applies for most of the other function and symptom scales. CONCLUSION: After the first year after treatment, recovery of the persisting side effects of treatment cannot be expected for the group as a whole. Patients must be prepared for this. Some individual patients experience improvement in global HRQL. HRQL assessments in daily clinical practice can identify patients who are in need of additional support and symptom relief.

Adolescent↗

PubMed2004

[Palliative cytostatic treatment].

When chemotherapy is given with palliative intent, one should avoid treatment that is more troublesome to the patients than the disease itself. Palliative chemotherapy should be evidence-based in the same way as other treatment regimens. It is given in order to extend life, to prevent development of symptoms, and/or to relieve symptoms. The treatment intention has to be clarified to the patient as well as his or her significant others before chemotherapy is initiated. We recommend drawing up an oral or written agreement with the patient on the number of cycles, parameters for effect evaluation, and rules for when treatment should be stopped. It is important that non-effective chemotherapy is not given, even if it is without side effects, or even if the patient is eager to continue the treatment.

Antineoplastic Agents↗

PubMed2003

Health-related quality of life five years after diagnosis of laryngeal carcinoma.

PURPOSE: To evaluate the health-related quality of life (HRQL) of patients with laryngeal carcinoma in a prospective longitudinal multicenter study at diagnosis, after 1 and 5 years in relation to tumor location and treatment modality. SUBJECTS AND METHODS: Eighty-six patients (mean age 66 years; 84% males) with laryngeal carcinoma were evaluated with standardized HRQL questionnaires: the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core-30 (EORTC QLQ-C30), the EORTC QLQ-Head and Neck Cancer Module (EORTC QLQ-H&N35), and the Hospital Anxiety and Depression Scale (HADS). RESULTS: Some significant changes in HRQL were found between diagnosis and 5 years after diagnosis, depending on the treatment given. The patients' ability to speak improved whereas some general functions deteriorated and treatment-related side effects increased. When comparing HRQL at 1 and 5 years after diagnosis, it appears that most values at the 1-year follow-up assessment persist until 5 years, but a few deteriorate. The HRQL at diagnosis seems to be associated with survival rate after 5 years, and the global quality of life scale at diagnosis tends to predict HRQL after 5 years. CONCLUSIONS: The use of HRQL questionnaires is valuable when comparing different treatments and as an aid in predicting treatment side effects. Evaluation of HRQL at diagnosis for patients with laryngeal carcinoma seems to be of value for the prognosis of HRQL over time and for the prognosis of survival.

Adult↗

PubMed2002

Side effects and quality of life after inadvertent radiation overdosage in brachytherapy of head-and-neck cancer.

PURPOSE: By comparing our old (DP5, in use from 1978 to 1994) and new (Plato, Nucletron) dose planning system, we found that the old system underestimated doses by 20-25%. To study the possible consequences for the patients treated between 1978 and 1994, all who were still alive were invited to undergo an examination with respect to side effects and quality of life (QOL). MATERIALS AND METHODS: The degree of overdosage was calculated by comparing the isodose distribution generated on the two dose planning systems. Eighty-four patients were then invited to undergo an examination with respect to side effects and QOL. The side effects were scored according to the LENT SOMA system and QOL according to European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30), and EORTC Quality of Life Questionnaire-Head & Neck 35 (QLQ-H&N35). RESULTS: The mean overdosage of brachytherapy was 19.3%. No association was found between overdosage and side effects or QOL. For implants in the lateral border of the tongue, we found a statistically significant correlation between osteoradionecrosis and the following parameters: linear activity, total activity, dose rate, and extrapolated response dose. By multivariate analysis, only total implanted activity and the use of lead protection during brachytherapy were found to be of prognostic significance with respect to development of osteoradionecrosis. CONCLUSION: The incidence of side effects after brachytherapy at the Norwegian Radium Hospital seems to have been somewhat higher in the period under investigation than at other institutions. There may be several explanations, including the use of external beam radiotherapy before brachytherapy and departure from the Paris system among others. However, the side effects were not associated with the overdosage that was the basis for the study. As opposed to the general consensus of opinion, long-term QOL was found to be worse after brachytherapy than after external beam radiotherapy. This calls for increased awareness and a systematic prospective registration of the long-term side effects of brachytherapy.

Adult↗