Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-23T05:45:02.850Z Has data issue: false hasContentIssue false
  • English
  • Français

Palliative intent treatment for head and neck cancer: an analysis of practice and outcomes

Published online by Cambridge University Press:  01 April 2019

F D Begbie ,
C M Douglas ,
F Finlay  and
J Montgomery
F D Begbie*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
C M Douglas
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
F Finlay
Affiliation:
Department of Palliative Medicine, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
J Montgomery
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
*
Author for correspondence: Mr Finn D Begbie, Department of Otolaryngology – Head and Neck Surgery, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF, Scotland, UK E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

There is little consensus on how best to manage head and neck cancer with palliative intent. Predicting outcome is difficult and reported survival varies. The present study sought to delineate local practice and outcomes in patients treated with palliative intent.

Methods

The clinical records of all head and neck cancer patients treated with palliative intent presenting between 2015 and 2016 to our multidisciplinary team were reviewed.

Results

Eighty-four patients (21.5 per cent) were treated with palliative intent. All had squamous cell carcinoma. Mean survival time was 151 days (standard deviation = 121.1; range, 8–536 days). Of the patients, 83.3 per cent had a palliative care referral; 74.1 per cent had a hospice referral. Patients received a variety of interventions, and there was an associated complication in 8.2 per cent. The mean number of days spent in hospital for interventions was 11.9 days (standard deviation = 12.5; range, 0–41 days).

Conclusion

Different interventions are used to manage head and neck cancer patients with palliative intent, and these may be associated with significant morbidity. Survival time is variable, often several months; thus, any treatment must take into account morbidity in conjunction with the patient's wishes.

Keywords

Palliative CareHead And Neck NeoplasmsCarcinoma, Squamous CellPrognosis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 4 , April 2019 , pp. 313 - 317
Copyright
Copyright © JLO (1984) Limited, 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Mr F D Begbie takes responsibility for the integrity of the content of the paper

Presented orally at the ENT Scotland Winter Meeting, 10 November 2017, Stirling, Scotland, UK, and as a poster at the Scottish Partnership for Palliative Care Annual Conference, 20 September 2017, Edinburgh, Scotland, UK.

References

1Schenker, Y, Arnold, RM, Bauer, JE. An enhanced role for palliative care in the multidisciplinary approach to high-risk head and neck cancer. Cancer 2015;122:340–3Google Scholar
2Irvin, W, Muss, HB, Mayer, DK. Symptom management in metastatic breast cancer. Oncologist 2011;16:1203–14Google Scholar
3Sanford, MT, Greene, KL, Carroll, PR. The argument for palliative care in prostate cancer. Transl Androl Urol 2013;2:278–80Google Scholar
4Siegel, RL, Miller, KD, Jemal, A. Cancer statistics, 2015. CA Cancer J Clin 2015;65:5–29Google Scholar
5National Institute for Health and Care Excellence. Improving outcomes in head and neck cancers. Cancer service guideline [CSG6]. In: https://www.nice.org.uk/guidance/csg6 [15 January 2018]Google Scholar
6Kowalski, LP, Carvalho, AL. Natural history of untreated head and neck cancer. Eur J Cancer 2000;36:1032–7Google Scholar
7Cocks, H, Ah-See, K, Capel, M, Taylor, P. Palliative and supportive care in head and neck cancer: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol 2016;130(suppl 2):198–207Google Scholar
8McMahon, JD, Robertson, GA, Liew, C, McManners, J, Mackenzie, FR, Hislop, WS et al. Oral and oropharyngeal cancer in the West of Scotland--long-term outcome data of a prospective audit 1999–2001. Br J Oral Maxillofac Surg. 2011;49:92–8Google Scholar
9Pracy, P, Loughran, S, Good, J, Parmar, S, Goranova, R. Hypopharyngeal cancer: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol 2016;130(suppl 2):104–10Google Scholar
10Ledeboer, QC, van der Schroeff, MP, Pruyn, JF. Survival of patients with palliative head and neck cancer. Head Neck 2011;33:1021–6Google Scholar
11National Institute for Health and Care Excellence. Sore throat (acute): antimicrobial prescribing. NICE guideline [NG84]. In: https://www.nice.org.uk/guidance/ng84 [15 February 2018]Google Scholar
12Zeitler, M, Fingland, P, Tikka, T, Douglas, CM, Montgomery, J. Deprivation in relation to urgent suspicion of head and neck cancer referrals in Glasgow. Clin Otolaryngol 2018;43:861–7Google Scholar
13National Records of Scotland. Life Expectancy for Administrative Areas within Scotland 2014–2016. In: https://www.nrscotland.gov.uk/statistics-and-data/statistics/statistics-by-theme/life-expectancy/life-expectancy-in-scottish-areas/2014-2016 [15 February 2018]Google Scholar
14Perri, F, Ionna, F, Pavone, E, Longo, F, Caponigro, F. Treatment approaches in elderly patients with head and neck cancer. Anticancer Agents Med Chem 2013;13:1383–90Google Scholar
15Szturz, P, Vermorken, JB. Treatment of elderly patients with squamous cell carcinoma of the head and neck. Front Oncol 2016;31:199Google Scholar
16Hughley, BB, Sperry, SM, Thomsen, TA, Charlton, ME, Pagedar, NA. Survival outcomes in elderly patients with untreated upper aerodigestive tract cancer. Head Neck 2017;39:215–18Google Scholar
17Young, D, Xiao, CC, Murphy, B, Moore, M, Fakhry, C, Day, TA. Increase in head and neck cancer in younger patients due to human papilloma virus (HPV). Oral Oncol 2015;51:727–30Google Scholar
18Temel, JS, Greer, JA, Muzikansky, A, Gallagher, ER, Admane, S, Jackson, VA et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med 2010;363:733–42Google Scholar
19Chan, JY, To, VS, Wong, ST, Wei, WI. Quality of dying in head and neck cancer patients: the role of surgical palliation. Eur Arch Otorhinolaryngol 2013;270:681–8Google Scholar
20Paleri, V, Stafford, FW, Sammut, MS. Laser debulking in malignant upper airway obstruction. Head Neck 2005;27:296–301Google Scholar
21Davies, E, Linklater, KM, Jack, RH. How is place of death from cancer changing and what affects it? Analysis of cancer registration and service data. Br J Cancer 2006;95:593–600Google Scholar
22Scottish Government. Practising Realistic Medicine: Summary. In: https://www.gov.scot/publications/summary-practising-realistic-medicine/ [15 January 2019]Google Scholar