Quality of life after treatment for laryngeal carcinomas.

The objective of this study was to evaluate the impact of different surgical treatments as well as of radiotherapy for laryngeal carcinomas on health-related quality of life (QL). In a prospective, randomized multicenter study (five university hospitals in Germany), a total of 146 patients with laryngeal carcinomas (UICC stages: I-IV) underwent different surgical treatments (32 total laryngectomies, 81 CO(2) laser microsurgical partial laryngectomies, 33 open partial laryngectomies). Postoperative radiotherapy was performed in 44 patients. QL data were obtained by using the EORTC QLQ-C30 questionnaire (developed by the European Organization for Research and Treatment of Cancer). Impaired QL data were seen after total laryngectomy and after radiotherapy. Radiotherapy seemed to have more impact on QL than surgical treatment. Global QL was not affected by any treatment. In general, the QL data were not as discriminating as presumed. To evaluate coping abilities, objective measures (voice, swallowing, breathing) should be obtained for comparison in further investigations.

[Influence of ML-1 standardized mistletoe extract on the quality of life in head and neck cancer patients]. / Einfluss eines ML-1-normierten Mistelextraktes auf die Lebensqualität bei Patienten mit Kopf-Hals-Karzinomen.

BACKGROUND: ML-1 standardized mistletoe extracts have been recommended for increasing the health-related quality of life in cancer patients. PATIENTS AND METHODS: The EORTC questionnaire QLQ-C30((V2)) was given to a randomly chosen subgroup of 399 patients of a prospective, randomized, open, multi-center trial. A total of 200 patients from this trial were randomized for ML-1 treatment (1 ng/kg body weight ML-1 was injected subcutaneously twice weekly over a 60-week period. Treatment cycles of 12 weeks were followed by a break of 4 weeks (between weeks 12-16, 28-32, and 44-48)). The remaining 199 patients formed the control group. RESULTS: Patients completed questionnaires before the start of their treatments at week 0 and continued until week 156. The compliance rate was high: 3611 questionnaires were available, which equals a median of nine longitudinal measurements per patient between weeks 0 and 156. Analysis did not indicate any improvement in the quality of life for either group. A significant decrease in quality of life, however, was seen in patients undergoing radiotherapy. In these patients, the global state of health was reduced and four symptom scales were significantly worse. CONCLUSION: Our results demonstrated no improvement in the quality of life in head and neck cancer patients when treated with ML-1 extract.

[The interesting case--case no. 59]. / Der interessante Fall Nr. 59. Z. n. endonasler Nassenebenhöhlenoperation einer chronischen Sinusitis maxillaris et ethmoidalis beidseits und Bilaterale chronische sudurale Hämatome.

UNLABELLED: Complications after endoscopic sinus surgery are rare and occur in about 0.5 % of all cases. However postoperative symptoms such as severe cephalgia and nasal discharge of clear fluids indicate a cerebrospinal fluid leakage. CASE: A 64 year-old-patient presented to our clinic four months after an endoscopic sinus surgery complaining of the two above mentioned symptoms for about 4 weeks. In a computed tomography study of the frontobasis there was no evidence of an osseous defect. An MRI of the head revealed a bilateral temporal fluid collection as seen in bilateral chronic subdural hematoma. Therefore the present illness was no consequence of the preceding surgery. CONCLUSION: Significant symptoms of severe postoperative complications after endoscopic sinus surgery can still be misleading. Therefore accurate diagnostic and imaging procedures are always crucial to support the initial diagnosis.

[Clinical and epidemiological data of patients with malignomas of the head and neck]. / Klinische und epidemiologische Daten zu Malignomen des Kopf-Hals-Bereichs.

BACKGROUND: The present study describes clinical and epidemiological data of patients with malignomas of the head and neck documented in the Munich Cancer Register. PATIENTS AND METHODS: Data of head and neck cancer patients treated at four departments of head and neck surgery and one of oral-maxillo-facial surgery in the area of Munich from 1978 up to now are reported. RESULTS: Incidence and mortality as a function of age, sex, and tumor localization are described in comparison to clinical and epidemiological data as specified in tumor registers of the Saarland and the USA. Moreover, TNM stages, survival, recurrence, and metastasis rates are presented. CONCLUSION: Based on the documentation of the Munich Cancer Register our study is the first to present a detailed description of clinical and epidemiological data of patients suffering from head and neck malignomas.

The effect of an adjuvant mistletoe treatment programme in resected head and neck cancer patients: a randomised controlled clinical trial.

The effect of an adjuvant mistletoe extract treatment was tested in a prospective, randomised controlled clinical trial involving 477 patients with head and neck squamous cell carcinoma. The patients were stratified into two treatment groups that underwent surgery or surgery followed by radiotherapy and both groups were randomised for additional treatment with mistletoe extract. Patients treated with a mistletoe lectin-1 (ML-1) standardised mistletoe preparation had no lower risk of local/locoregional recurrences, distant metastases or second primaries. In the main analysis based on 202 patients treated with surgery and 275 patients treated with surgery and radiotherapy the adjusted hazard ratio for the disease-free survival (DFS) was 0.959 (95% confidence interval (CI) 0.725-1.268). The 5-year survival rates of patients from the mistletoe group were no better than the survival rates of patients from the control group. Furthermore, no significant changes in the cellular immune reaction or in quality of life could be detected. We conclude that the used mistletoe preparation has no indication in the adjuvant treatment of patients with head and neck cancer.