Early self-care rehabilitation of head and neck cancer patients

Figures & data

Figure 1. Inclusion of patients and loss of patients. P-S, project-specific questionnaire; BL, baseline (time of diagnosis); EORTC, includes both QLQ-30 and H&N35. 6 months, 6 months after termination of treatment. *Year 2004 includes only patients treated at the southern RT unit and year 2007 runs only until June 30, since the study was terminated after this.

Table I. Patient characteristics.

Characteristics	Total (%)	Patients answering the project-specific questionnaire (%)
		Study group	Control group
Age (years), mean [SD]	63.7 (12.9)	63.6 (13.1)	64.1 (12.0)
Sex
Male	253 (68)	56 (67)	82 (68)
Female	121 (32)	28 (33)	39 (32)
Stage
I	40 (11)	9 (11)	17 (14)
II	51 (14)	16 (19)	19 (16)
III	76 (20)	12 (14)	23 (19)
IV	156 (42)	38 (45)	45 (37)
Missing	51 (14)	9 (11)	17 (14)
Site
Oral cavity	79 (21)	22 (26)	25 (21)
Oropharynx	111 (30)	26 (31)	33 (27)
Epipharynx	10 (3)	2 (2)	5 (4)
Hypopharynx	22 (6)	6 (7)	4 (3)
Larynx	47 (13)	8 (10)	14 (12)
Salivary gland	28 (8)	8 (10)	11 (9)
Nose and sinus	14 (4)	0 (0)	6 (5)
Other	63 (17)	12 (14)	23 (19)
Radiotherapy
Dose, mean [SD]	64 (6.8)	65 (5.7)	63 (7.3)
Preoperative RT	116 (31)	26 (31)	36 (30)
Postoperative RT	131 (35)	33 (39)	52 (43)
Only RT	122 (33)	25 (30)	32 (27)
Surgery
Any surgery	254 (68)	59 (70)	89 (74)
No surgery	120 (32)	25 (30)	32 (26)
Major surgery		6 (7)	12 (10)
Chemotherapy	86 (23)	10 (12)	35 (29)
Number of patients	374	84	121

Calculations of percentage and SD included patients with zero-values. SD, standard deviation; RT, radiotherapy; ND, neck dissection. Major surgery includes laryngectomy and free-flap reconstructions.

Table II. Comparison of outcome between study group and control group concerning weight loss and working ability.

Characteristics	Intervention study (%)			p value	Difference (95% confidence interval)
	n*	Study group	Control group
Weight loss*	197
Stable or increase		17 (21)	15 (13)
Decrease <;5%		18 (22)	27 (24)
Decrease 5–10%		27 (33)	30 (26)
Decrease >10%		21 (25)	42 (37)	0.23	–
Mean weight loss† in kg [SD]		–5.8 (7.8)	–6.2 (5.8)	0.68	0.4 (–1.5 to 2.3)
On sick leave at baseline	22
Situation unchanged at 6 months		7 (64)	7 (64)
Situation better at 6 months		4 (36)	4 (36)	1.0	–
Not on sick leave at baseline	133
Situation unchanged at 6 months		29 (55)	64 (80)
Situation worse at 6 months		24 (45)	16 (20)	0.003	25.2 (9.3 to 41.3)
Total number of patients	205	84	121

Calculations of percentage and SD included patients with zero-values.

*Number of patients included in the analysis.

^†The difference in weight loss after controlling for baseline weight was not significant (p = 0.42) and was estimated to be 0.7 (–1.0 to 2.4).

Table III. Comparison of outcome between study group and control group concerning self-reported loss of function 6 months after treatment.

Characteristics	Intervention study (%)			p value
	n	Study group	Control group
Do you have PEG?	167
1. Yes		12 (18)	15 (15)
2. No		46 (69)	71 (71)
3. No, but I used to have		9 (13)	14 (14)	0.88
Do you feel you have recovered after your treatment?	196
1. Yes, completely		4 (5)	18 (16)
2. Yes, partly		35 (42)	51 (45)
3. No		41 (49)	36 (32)
4. Don't know		3 (4)	8 (7)	0.016
Swallowing difficulties*	185
1. Not at all		20 (26)	51 (47)
2. A little		27 (36)	35 (32)
3. Quite a bit		23 (30)	16 (15)
4. Very much		6 (8)	7 (6)	0.003
Chewing difficulties*	186
1. Not at all		28 (38)	45 (40)
2. A little		21 (29)	31 (27)
3. Quite a bit		18 (25)	22 (20)
4. Very much		6 (8)	15 (13)	0.94
Reduced ability to open mouth*	187
1. Not at all		25 (34)	56 (50)
2. A little		20 (27)	28 (25)
3. Quite a bit		21 (28)	23 (20)
4. Very much		8 (11)	6 (5)	0.018
Speech problems*	184
1. Not at all		20 (28)	54 (48)
2. A little		26 (36)	39 (35)
3. Quite a bit		16 (22)	11 (10)
4. Very much		10 (14)	8 (7)	0.001
Stiffness in the neck/shoulders*	189
1. Not at all		23 (31)	33 (29)
2. A little		27 (36)	47 (41)
3. Quite a bit		20 (27)	22 (19)
4. Very much		5 (7)	12 (11)	0.98

*Data treated as ordinal.

Table IV. Comparison between study group and control group concerning global health (EORTC QLQ-30) and depression and anxiety (HAD-S) measured 6 months after treatment.

Characteristics	Intervention study (%)			p value
	n	Study group Mean (SD)	Control group Mean (SD)
HAD-S
Depression	183
1. Normal (0–7)		54 (74)	79 (72)
2. Mild (8–10)		11 (15)	16 (15)
3. Moderate (11–15)		5 (7)	14 (13)
4. Severe (16–21)		3 (4)	1 (1)	0.75
Anxiety	189
1. Normal (0–7)		53 (70)	81 (72)
2. Mild (8–10)		8 (11)	13 (12)
3. Moderate (11–15)		11 (15)	17 (15)
4. Severe (16–21)		4 (5)	2 (2)	0.66
EORTC QLQ-30 Global health status	75	56.6 (23.4)	61.4 (23.0)	0.29