Comparative Analysis of the Quality of Life in the Pretreatment of Head and Neck Cancer Patients According to Tumor Site

Abstract Introduction Head and neck cancer (HNC) and its treatment can cause physical, psychological, and quality of life (QoL) damage, because it can disturb the physiology of eating, breathing, speaking, and compromise self-image. Objective To evaluate the QoL of the pretreatment of patients diagnosed with head and neck cancer according to the anatomical location of the tumor. Methods A descriptive, cross-sectional study was performed on a sample of 144 patients undergoing pretreatment for cancer from February 2017 to July 2019. The University of Washington QoL Questionnaire (version 4) was used to assess the QoL. The anatomical location data were obtained from medical records. The ANOVA test was used to compare the differences in QoL according to tumor location. Results A total of 144 participants were included, 66 (45.5%) of whom had the primary tumor located in the mouth. The median age of the patients was 62 years, with a higher prevalence of male (75.7%), Black (78.5%), single/divorced/widowed people (59%), and illiterates (32.6%); most of them were smokers (84.7%) and alcohol drinkers (79.2%). The mean QoL score was 830 for mouth cancer, 858 for pharynx cancer, and 891 for laryngeal cancer patients. Conclusion Based on the results of this study, it can be concluded that the QoL of patients with head and neck cancer was not influenced by tumor location. The most affected domains in the three groups were pain, appearance, chewing, swallowing, and speech (p < 0.05).

Comparative Analysis of the Quality of Life in the Pretreatment of Head and Neck Cancer Patients According to Tumor Site.

Introduction Head and neck cancer (HNC) and its treatment can cause physical, psychological, and quality of life (QoL) damage, because it can disturb the physiology of eating, breathing, speaking, and compromise self-image. Objective To evaluate the QoL of the pretreatment of patients diagnosed with head and neck cancer according to the anatomical location of the tumor. Methods A descriptive, cross-sectional study was performed on a sample of 144 patients undergoing pretreatment for cancer from February 2017 to July 2019. The University of Washington QoL Questionnaire (version 4) was used to assess the QoL. The anatomical location data were obtained from medical records. The ANOVA test was used to compare the differences in QoL according to tumor location. Results A total of 144 participants were included, 66 (45.5%) of whom had the primary tumor located in the mouth. The median age of the patients was 62 years, with a higher prevalence of male (75.7%), Black (78.5%), single/divorced/widowed people (59%), and illiterates (32.6%); most of them were smokers (84.7%) and alcohol drinkers (79.2%). The mean QoL score was 830 for mouth cancer, 858 for pharynx cancer, and 891 for laryngeal cancer patients. Conclusion Based on the results of this study, it can be concluded that the QoL of patients with head and neck cancer was not influenced by tumor location. The most affected domains in the three groups were pain, appearance, chewing, swallowing, and speech ( p < 0.05).

Nighttime salivary cortisol as a biomarker of stress and an indicator of worsening quality of life in patients with head and neck cancer: A cross-sectional study.

Background: Head and neck cancer (HNC) is a generic term defined on an anatomical-topographic basis to describe malignant tumors located in the oral cavity, pharynx, larynx, and thyroid. A situation commonly presented by individuals with cancer is stress, with evidence indicating a close relationship between stress, behavior, and the immune system with the development and progression of cancer. Aim: To assess the association between stress levels and quality of life among individuals with HNC. Methods: This was a cross-sectional study involving 72 HNC patients. The University of Washington Quality of Life Questionnaire was used to assess the quality of life, while the Perceived Stress Scale and salivary cortisol were used to evaluate stress levels. Results: A negative association was found between quality of life and stress levels as indicated by both the PSS and nighttime salivary cortisol. Nighttime salivary cortisol showed the best accuracy estimated by the area under the receiver operating characteristic curve, slightly better than that of PSS. Conclusion: Among the time points for saliva sampling, nighttime cortisol was found to have the best accuracy, which was similar to that of the PSS, for the detection of patients with the worst quality of life.

Cross-cultural adaptation of a quality of life questionnaire for individuals with oral potentially malignant disorders in the Brazilian context.

The aim of this article is to describe the cross-cultural adaptation of a quality of life (QoL) questionnaire for individuals with potentially malignant oral diseases (OPMD) in the Brazilian context. This methodological study consisted of the following stages of content validation process: (1) Conceptual and item equivalence: stage during which a comprehensive literature review on the construct was performed; (2) Semantic equivalence. The extensive literature review showed that the questionnaire enables evaluation of QoL, and that domains and items are also considered and relevant to the Brazilian context. Semantic equivalence was evaluated as satisfactory by a committee of judges. The scope of the domains was analyzed according to the agreement rate and presented results equal to or greater than 84%. The general Content Validity Calculation (CVC) was 0.84 for clarity and 0.92 for representativeness. Of the 20 items, 18 presented CVC values above 0.8. The indicators for content validation, pre-test and operational equivalence indicate that the Brazilian version of the OPMD QoL questionnaire is a promising instrument and a tool that seems valid to evaluate the quality of life of people with oral potentially malignant disorders. As a next step, it is important to measure equivalences to evaluate the psychometric properties of this instrument.

Este artigo objetiva adaptar transculturalmente um questionário de qualidade de vida para indivíduos com doenças orais potencialmente malignas para o contexto brasileiro. Este estudo metodológico consistiu nas seguintes etapas do processo de validação de conteúdo: (1) Equivalência conceitual e de itens - etapa em que foi realizada uma ampla revisão da literatura sobre o construto; (2) Equivalência semântica. A extensa revisão da literatura mostrou que o questionário permite avaliar a QV e que os domínios e itens também são considerados e relevantes para o contexto brasileiro. A equivalência semântica foi avaliada pelo comitê de juízes de forma satisfatória. A análise do escopo dos domínios foi realizada pela taxa de concordância e apresentou resultados iguais ou superiores a 84%. Para a análise de clareza e representatividade, o resultado do cálculo geral do Cálculo de Validade de Conteúdo (CVC) foi de 0,84 e 0,92 respectivamente. Dos 20 itens, 18 apresentaram valores de IVC acima de 0,8. Os indicadores de validação de conteúdo, pré-teste e equivalência operacional indicam que a versão brasileira do QoL-OPMD é um instrumento promissor e que parece válido para avaliar a qualidade de vida de pessoas com doenças orais potencialmente malignas. Como próximo passo, é importante avaliar as propriedades psicométricas desse instrumento.

Cross-cultural adaptation of a quality of life questionnaire for individuals with oral potentially malignant disorders in the Brazilian context / Adaptapao transcultural do questionàrio de qualidade de vida para individuos com desordens orais potencialmente malignas para o contexto brasileir

ABSTRACT The aim ofthis article is to describe the cross-cultural adaptation of a quality of life (QoL) questionnaire for individuals with potentially malignant oral diseases (OPMD) in the Brazilian context. This methodological study consisted of the following stages of content validation process: (1) Conceptual and item equivalence: stage during which a comprehensive literature review on the construct was performed; (2) Semantic equivalence. The extensive literature review showed that the questionnaire enables evaluation of QoL, and that domains and items are also considered and relevant to the Brazilian context. Semantic equivalence was evaluated as satisfactory by a committee of judges. The scope of the domains was analyzed according to the agreement rate and presented results equal to or greater than 84%. The general Content Validity Calculation (CVC) was 0.84 for clarity and 0.92 for representativeness. Of the 20 items, 18 presented CVC values above 0.8. The indicator for content validation, pre-test and operational equivalence indicate that the Brazilian version of the OPMD QoL questionnaire is a promising instrument and a tool that seems valid to evaluate the quality of life of people with oral potentially malignant disorders. As a next step, it is important to measure equivalences to evaluate the psychometric properties of this instrument.

RESUMO Este artigo objetiva adaptar transculturalmente um questionário de qualidade de vida para individuos com doenças orais potencialmente malignas para o contexto brasileiro. Este estudo metodológico consistiu nas seguintes etapas do processo de validaçâo de conteúdo: (1) Equivalência conceitual e de itens - etapa em que foi realizada uma ampla revisao da literatura sobre o construto; (2) Equivalência semántica. A extensa revisao da literatura mostrou que o questionário permite avaliar a QV e que os dominios e itens também sao considerados e relevantes para o contexto brasileiro. A equivalência semántica foi avaliada pelo comité de juízes de forma satisfatória. A análise do escopo dos dominios foi realizada pela taxa de concordância e apresentou resultados iguais ou superiores a 84%. Para a análise de clareza e representatividade, o resultado do cálculo geral do Cálculo de Validade de Conteúdo (CVC) foi de 0,84 e 0,92 respectivamente. Dos 20 itens, 18 apresentaram valores de IVC acima de 0,8. Os indicadores de validaçâo de conteúdo, pré-teste e equivalência operacional indicam que a versâo brasileira do QoL-OPMD é um instrumento promissor e que parece válido para avaliar a qualidade de vida de pessoas com doenças orais potencialmente malignas. Como próximo passo, é importante avaliar as propriedades psicométricas desse instrumento.

Human papillomavirus in oral squamous cells carcinoma in a population of 75 Brazilian patients.

PURPOSE: In the present study, we investigated the presence of human papillomavirus (HPV) DNA and viral types in 75 cases of oral squamous cells carcinoma from Brazil to obtain data that would contribute to a better understanding of the role of HPV in the pathogenesis of this tumor. MATERIALS AND METHODS: DNA was extracted from paraffin-embedded tissue and amplified by polymerase chain reaction using a pair of primers designated PCO3+ and PCO4+ for the detection of a fragment of the human beta-globin gene, followed by polymerase chain reaction for the detection of HPV DNA using a pair of generic primers, GP5+ and GP6+. Viral typing was performed by dot blot hybridization. RESULTS: Human papillomavirus DNA was detected in 18 (24%) of the 75 cases positive for the human beta-globin gene. No significant association was observed between HPV and age, sex, or anatomical location of the tumor. The most prevalent viral type was HPV-18 (77,8%). CONCLUSION: The low frequency of detection of HPV DNA in oral epidermoid carcinomas suggests a possible participation of the virus in the development and progression of only a subgroup of these tumors.

HPV e carcinogênese oral: revisäo bibliográfica / HPV and oral carcinogenesis: a bibliographic review

O Papilomavírus humano (HPV) é um vírus ubíquo de DNA, epiteliotrópico, que tem a pele e as mucosas como principais sítios de infecçäo. Ultimamente, a sua associaçäo com neoplasias benignas e malignas da cavidade oral, principalmente o carcinoma epidermóide, tem sido mais evidente. O seu achado comum em epitélio de mucosa oral normal, amplamente divulgado na literatura, näo permite inferências mais precisas quanto ao seu papel na carcinogênese (se agente etiológico principal, coadjuvante ou simples habitante do epitélio de revestimento da mucosa oral). Säo mais de 100 tipos já identificados, dos quais 24 já foram localizados na cavidade oral. Desses, 4 säo particularmente importantes, os tipos 6 e 11 (que estäo envolvidos nas lesöes benignas do epitélio oral) e 16 e 18 (comprovadamente carcinogênicos e possivelmente envolvidos na etiologia de determinados carcinomas epidermóides orais). A açäo desses dois últimos tipos está principalmente associada às oncoproteínas E6 e E7 produzidas pelos mesmos. A E6 liga-se, seqüestra e degrada a p53, importante proteína supressora de tumor. A segunda liga-se e seqüestra a pRb, também supressora de tumor, facilitando a liberaçäo de E2F. Apesar do aprimoramento das técnicas de detecçäo do HPV nas lesöes de mucosa oral, o seu envolvimento direto com os carcinomas orais näo foi ainda devidamente comprovado, todavia a sua açäo sinérgica com outros carcinógenos químicos e físicos, tais como o fumo e o álcool, em determinados carcinomas epidermóides nos parece o caminho mais correto para explicar a açäo do papilomavírus humano na carcinogênese oral