title: Feasibility and impact of a dedicated multidisciplinary rehabilitation program on health-related quality of life in advanced head and neck cancer patients.
abstract: In an observational prospective study, feasibility and outcomes of a dedicated multidisciplinary rehabilitation program (HNR) for head and neck cancer (HNC) patients were evaluated. HRQoL was assessed before and after HNR with EORTC C30 and H&N-35 QoL questionnaires in 52 consecutive patients. Initial HRQoL scores were compared with EORTC reference scores for HNC patients and post-HNR with those available for the general healthy population. Distress was assessed before and after HNR with the distress thermometer (DT). At completion of HNR with a mean duration of 7 months, overall HRQoL was significantly improved (p < 0.001). Role, Emotional, and Social function scales and most EORTC C30 and H&N35 symptom scale items showed a statistically significant (p < 0.01) and clinically relevant improvement. Mean distress score before HNR was above the cutoff value of 5, suggesting the need for referral to rehabilitation. After completing HNR, distress decreased significantly to 3.0 (p < 0.001). HRQoL pretreatment was poorer than that of the EORTC reference HNC population, whereas at the completion of the HNR program, the HRQoL was comparable to that of the general population reference level. We conclude that a dedicated multidisciplinary HNR program is feasible and suggest that it has a positive impact on HRQoL. The multidisciplinary approach may have added value over mono-disciplinary interventions. However, our results should be judged cautiously due to the observational nature of the study.
authors.affiliation: Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands. e.passchier@nki.nl.
authors.forename: Ellen
authors.initials: E
authors.lastname: Passchier
authors.affiliation: Department of Physical Therapy, The Netherlands Cancer Institute, Amsterdam, The Netherlands.|Department of Clinical Epidemiology Biostatistics and Bioinformatics,Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Martijn M
authors.initials: MM
authors.lastname: Stuiver
authors.affiliation: Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
authors.forename: Lisette
authors.initials: L
authors.lastname: van der Molen
authors.affiliation: Reade, Centre of Rehabilitation and Rheumatology Amsterdam, Amsterdam, The Netherlands.
authors.forename: Stefanie I C
authors.initials: SI
authors.lastname: Kerkhof
authors.affiliation: Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.|Institute of Phonetic Sciences, University of Amsterdam, Amsterdam, The Netherlands.|Department of Oral and Maxillofacial Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Michiel W M
authors.initials: MW
authors.lastname: van den Brekel
authors.affiliation: Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.|Institute of Phonetic Sciences, University of Amsterdam, Amsterdam, The Netherlands.|Department of Oral and Maxillofacial Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Frans J M
authors.initials: FJ
authors.lastname: Hilgers
mesh_terms: D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D011446:Prospective Studies; D011788:Quality of Life; D013315:Stress, Psychological / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D063189:Symptom Assessment
keywords: Distress; Head and neck cancer; Health-related quality of life; Multidisciplinary rehabilitation