title: Functional and psychological evaluation after flap reconstruction plus radiotherapy in oral cancer.
abstract: BACKGROUND
  Head and neck tumors and their treatments negatively affect speech, swallowing, body image, and quality of life (QOL). The purpose of this study was to allow us to evaluate the impact of flap reconstructive surgery with adjuvant radiotherapy (RT) on QOL and psychological functioning.
  
  
  METHODS
  Thirty-six of 153 consecutive patients surgically treated for carcinoma of the oral cavity received adjuvant RT. Late effects of RT and psycho-oncological assessment were performed.
  
  
  RESULTS
  In more than 50% of the cases examined, moderate to severe late toxicity was observed, regarding subcutaneous tissues, salivary function, dysphagia, and taste impairment. Patients with severe dysphagia showed higher levels of depression and anxiety (p < .05). Dysphagia and taste impairment were seen to be associated with lower global health and QOL. The Draw a Person Test (DAP) showed severe problems in self-perceived body image in 33% of the sample.
  
  
  CONCLUSIONS
  Dysphagia and taste impairment are associated with QOL and depression; our data suggest a different evaluation between self-reported and clinician-rating scales. DAP is a provocative tool that merits further research.
authors.affiliation: Department of Medical Oncology, San Giovanni Battista Hospital, Turin, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Airoldi
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Garzaro
authors.forename: Luca
authors.initials: L
authors.lastname: Raimondo
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Pecorari
authors.forename: Carlo
authors.initials: C
authors.lastname: Giordano
authors.forename: Antonella
authors.initials: A
authors.lastname: Varetto
authors.forename: Paola
authors.initials: P
authors.lastname: Caldera
authors.forename: Riccardo
authors.initials: R
authors.lastname: Torta
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000175:diagnosis / Q000209:etiology; D002294:Carcinoma, Squamous Cell / Q000523:psychology* / Q000532:radiotherapy / Q000601:surgery; D003863:Depression / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000523:psychology / Q000532:radiotherapy / Q000601:surgery; D011788:Quality of Life; D011832:Radiation Injuries / Q000523:psychology; D018714:Radiotherapy, Adjuvant; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps; D011795:Surveys and Questionnaires