Dysphagia and Quality of Life in Patients With Oral Squamous Cell Carcinoma Before and After Treatment
While the group of oral cavity cancer (OCC) survivors continue to increase, surgeons and oncologist intensify their search for improved treatment and rehabilitation methods to reduce the morbidity of management without compromising the oncological safety. The predominant problem after treatment of OCC is dysphagia, which is associated with malnutrition, aspiration pneumonia, hospital re-admission, and reduced quality of life (QoL) and survival.
In a pilot study, the investigators found that 45% of OCC patients reported significant eating disabilities two years after surgical treatment. However, the international literature is limited on the dysphagia and QoL of OCC survivors.
With an overall goal to improve the QoL and health status in patients treated for OCC, the present study aims to
- systematically evaluate the swallowing function before and after treatment,
- investigate the impact of swallowing function on QoL,
- identify risk factors for dysphagia,
- investigate if swallowing function is an independent factor for the number of ´days alive and out of hospital´
- evaluate the rehabilitation offered to OCC patients in Danish municipalities and the effect on swallowing outcomes.
One hundred patients treated for OCC will be included prospectively during a 2-year period. Data on type and location of tumour, treatment modality, complications, patient weight, dietary intake, rehabilitation program, hospital admissions, recurrences, and survival will be collected. Questionnaires and Modified Barium Swallow Study (MBSS) will be performed before and 2 and 12 months after treatment.
Study Overview
Status
Status
Conditions
Conditions
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Contacts and Locations
Study Contact
Study Contact
- Name: Mathilde Aalling
- Phone Number: 4520258983
- Email: mathaall@rm.dk
Study Locations
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-
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Aarhus, Denmark
- Aarhus University Hospital
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Contact:
- Mathilde Aalling
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Histologically confirmed squamous cell carcinoma with any location in the oral cavity including recurrences. Patients will only be included once
- Treatment with curative intent (surgery and/or (chemo)radio therapy)
Exclusion Criteria:
- Allergy to barium contrast
- Pregnancy or breastfeeding
- Inability or unwillingness to complete questionnaires and undergo examinations
Study Plan
How is the study designed?
Design Details
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Modified Barium Swallow Impairment profile (MBSImp)
Time Frame: Baseline, 2 and 12 months post-operative
|
MBSImp is a 17-point assessment tool (0-55 points, a higher score indicates worse swallowing function) for interpreting MBSS that includes evaluation of the oral, pharyngeal and esophageal phase.
The Penetration/Aspiration Scale will be applied for evaluating swallow safety ranging from 1 (no penetration/aspiration) to 8 (silent aspiration).
The recordings as well as the interpretations are carried out by one of two trained otorhinolaryngologists.
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Baseline, 2 and 12 months post-operative
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MD Anderson Dysphagia Inventory (MDADI)
Time Frame: Baseline, 2 and 12 months post-operative
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The MDADI is a 20-item questionnaire assessing dysphagia-related QoL in head and neck cancer patients covering global, emotional, functional, and physical domains.
The score ranges from 20 (poor function) to 100 (high function).
The patient answers the questionnaire assisted by a nurse.
A 10-point difference between groups in composite score is considered significant.
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Baseline, 2 and 12 months post-operative
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Days alive and out of hospital
Time Frame: 12 months post-operative
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During regular outpatient follow-up, the patient will be asked about hospital admission/re-admission since the last visit and the electronic chart will be accessed for verification of reason and length of stay.
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12 months post-operative
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Weight
Time Frame: Baseline, 2 and 12 months post-operative
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Bodyweight will be measured at each visit
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Baseline, 2 and 12 months post-operative
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European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30)
Time Frame: Baseline, 2 and 12 months post-operative
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Scoring ranges from 0-100 where a high score in the functioning scales and global QoL indicate better functioning but for the symptom scales higher scores indicate higher symptom burden.
The patient answers the questionnaires assisted by a nurse.
A 10-point difference in instrument score is considered significant
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Baseline, 2 and 12 months post-operative
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European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Head And Neck 35 (EORTC H&N-35)
Time Frame: Baseline, 2 and 12 months post-operative
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Scoring ranges from 0-100 where a high score in the functioning scales and global QoL indicate better functioning but for the symptom scales higher scores indicate higher symptom burden.
The patient answers the questionnaires assisted by a nurse.
A 10-point difference in instrument score is considered significant
|
Baseline, 2 and 12 months post-operative
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Functional oral intake score (FOIS)
Time Frame: Baseline, 2 and 12 months post-operative
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The patient will be asked about their food intake at each visit.
FOIS is a 7 point scale regarding the level of oral intake, ranging from total tube dependency (1) to oral intake of a normal diet (7).
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Baseline, 2 and 12 months post-operative
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Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Rehabilitation program
Time Frame: 12 months post-operatively
|
At the 12-month follow-up a questionnaire will be sent to the patient's occupational therapist addressing the offered rehabilitation program (type and frequency).
Patient satisfaction will be measured on a 10-point VAS-scale.
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12 months post-operatively
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Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Digestive System Diseases
- Neoplasms by Histologic Type
- Neoplasms
- Neoplasms by Site
- Carcinoma
- Neoplasms, Glandular and Epithelial
- Gastrointestinal Diseases
- Head and Neck Neoplasms
- Pharyngeal Diseases
- Stomatognathic Diseases
- Otorhinolaryngologic Diseases
- Mouth Diseases
- Esophageal Diseases
- Neoplasms, Squamous Cell
- Deglutition Disorders
- Carcinoma, Squamous Cell
- Squamous Cell Carcinoma of Head and Neck
- Mouth Neoplasms
Other Study ID Numbers
Other Study ID Numbers
- CCOdysphagia
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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