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patients in the cultural context and valuable systems where number of surveys just reflects that any of them is well
they live in relation with their expectations, standards and validated, there are not common criteria, but all of them must
concerns. be easy to understand and quickly to complete in no more
than 10 min.
HRQOL is the assessment of the effect of a disease or
treatment of a patient’s wellbeing and daily function. It is One of them is the University of Washington Quality of Life
[25]
a multidimensional tool reflecting the self-perception of the (UW-QOL), this questionnaire is short and easy to response
patients. and has been validated in many studies published. It includes
12 domains: pain, appearance, activity, recreation, swallowing,
Evaluating the HRQOL of patients can be a helpful tool for chewing, speech, shoulder, taste, saliva, mood and anxiety.
physicians before taking decisions about the effectiveness This questionnaire also added final global question where the
of treatments, clarifying and helping to decide according patient could explain which factors secondary to the tumour
to the side effects, can be used as a prognostic factor to affected mostly in their daily activity giving them the chance
analyse symptoms and evolution, identifying factors which to add several aspects not asked before. Each domain has 5
can interfere the survival of patients, useful to estimate possible answers, with the score ranging from 0 (worst) to
cost-effectively of therapies, helping to organize and 100 (best). [29]
maintain the quality of therapies. It helps to develop new
drugs and reveal patients priorities. [26] Some of the disadvantages that we find is due to most of
studies are retrospective, and there are just a few prospective
[30]
There are amounts of questionnaires used to determine the results. Visacri et al. elaborated a study including
impact of cancer or treatments on patients. In contrast, just a prospectively 32 patients who underwent RT/CMT and they
few other surveys are designed specifically for patients with evaluated the quality of life using UW-QOL questionnaire.
HNSCC [Table 1]. There was a reduction in overall QOL that was significant after
cycle 2 of chemotherapy and the sixth week of radiotherapy
In our daily practice is common ask to the patient about when compared with baseline. There was a significant
how they feel but we do not usually spend time in complete improvement in some domains, such as pain and anxiety. The
questionnaires unless for some specific researches. domain most affected after the start of treatment was taste. [30]
Complete a survey means leave the patient alone in a proper
environment without the influence of distractors to avoid bias Another study analysed the QOL in a group including
or incorrect results. Many authors tried to solve the problem 82 patients who completed the EORTC QLQ-H%N35
making online questionnaires, by this way we do not miss questionnaire in 4 different times: before starting the
time and we let the patient a comfortable moment to do the radiotherapy, in the middle (15th or 20th fraction the
questionnaire and value how the cancer affects them daily. radiotherapy), at the end, at 1 month and at 6 months after
the treatment. In the middle, at the end the radiotherapy,
Specifically, patients’ concerns about HNSCC can depend on one and six-month after the treatment, compared to before
individual factors such as age, comorbidity and psychosocial starting the radiotherapy, all symptom scales of the quality
situation, stage and side effects. Motorization of the QOL can of life were affected negatively. However, 6 months after
be a value tool to measure effectiveness of the treatment like radiotherapy, all of them show an improvement excepting,
how determine the intensity of chemotherapy. Information dental problems, dryness of the mouth and the viscosity
obtained from questionnaires could be useful to make of the saliva. According to the localization, stickiness of
decisions and management of patients, give priority to saliva and dry mouth were significantly more frequent in
some important factors for their life such as pain, organ the tumours of the nasopharynx, the oral cavity and the
preservation, speech, physical appearance and their worries oropharynx, compared to the tumours of the larynx area.
about recurrences. Regarding age, groups over 65 years demonstrated better
results than young people. Also, the group with high radiation
The term QOL includes many factors related with life was affected more in terms of shortage of social interaction,
conditions, subjective reflection about the individual speech problems, eating in social environment, opening the
well-being rate. During the last years, a lot of studies have mouth, sticky saliva, feeling sick, weight loss and additional
been published about QOL, which is consequence of the nutrient intake. [31]
great response to the treatment. Professionals must be
[29]
concerned not only about surgery, therapeutic treatment Qiu et al. compared the impact in QOL of patients with
and complication rate, also about psychosocial aspect of HNSCC treated with surgery and adjuvant therapies versus
people. For many authors QOL is an independent survival those treated with radical RT alone. A total of 30 patients
factor. [27,28] Due to the subjectivity of the term and how fulfilled the UW-QOL questionnaire at least after 1 year of
difficult is to measure, value the QOL is challenging, that follow up. According to the results, pain due to treatment
is why many questionnaires have been developed. recreation activities and shoulder weakness were well
tolerated by most patients. But, chewing and taste were the
There are many questionnaires in the literature, such as domains with the worst scores in both groups. Significant
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