Predictors of functional decline in locally advanced head and neck cancer patients from south Brazil.


Journal Article

BACKGROUND: Functional decline in Brazilian patients with head and neck squamous cell carcinoma (HNSCC) is associated with impaired recovery, quality of life, and health care costs. METHODS: Sixty patients enrolled at the regional oncology center in Curitiba, Brazil, were assessed over 6 months for toxicities, nutritional status, anthropometry, fatigue, stress, and functionality. RESULTS: Severe mid-arm and mid-calf circumference depletion accompanied weight loss. Total fatigue score increased 64% (p < .001), as did perceived stress and serum cortisol (p = .01). Instrumental activities of daily living (IADL) dependence doubled, and activities of daily living (ADL) dependence quadrupled (p < .001). Difficulty chewing or swallowing, weight loss, fatigue, perceived stress, and IADL dependence accounted for 48.2% of ADL dependence. CONCLUSIONS: The physical and psychological impact of HNSCC and its treatment are universally experienced; yet, screening and intervention for symptoms such as fatigue and stress are not typical clinical practice. Moreover, assessment of functional status is usually limited to chewing and swallowing. This study identified symptoms that require systematic intervention and randomized trials with functional independence as the outcome.

Full Text

Cited Authors

  • Silver, HJ; de Campos Graf Guimaraes, C; Pedruzzi, P; Badia, M; Spuldaro de Carvalho, A; Oliveira, BV; Ramos, GHA; Dietrich, MS; Pietrobon, R

Published Date

  • September 2010

Published In

Volume / Issue

  • 32 / 9

Start / End Page

  • 1217 - 1225

PubMed ID

  • 20054850

Pubmed Central ID

  • 20054850

Electronic International Standard Serial Number (EISSN)

  • 1097-0347

International Standard Serial Number (ISSN)

  • 1043-3074

Digital Object Identifier (DOI)

  • 10.1002/hed.21322


  • eng