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The Humanistic Burden of Head and Neck Cancer: A Systematic Literature Review

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Abstract

Background

Head and neck cancer (HNC) and its treatment can affect communication, nutrition, and physical appearance, and the global impact of this disease on patients’ quality of life may be substantial.

Objective

The aim of this systematic literature review was to describe the impact of HNC and its treatment on the physical, emotional, and social well-being of patients over time, by examining longitudinal studies of patient-reported outcomes (PRO) evaluating these domains.

Methods

Databases (MEDLINE and Embase) were searched to identify studies published in English between January 2004 and January 2014 analyzing the humanistic aspects of HNC in adult patients. Additional relevant publications were identified through manual searches of abstracts from recent conference proceedings.

Results

Of 1,566 studies initially identified, 130 met the inclusion criteria and were evaluated in the assessment. Investigations using a variety of PRO instruments in heterogeneous patient populations consistently reported that PRO scores decrease significantly from diagnosis through the treatment period, but generally recover to baseline in the first year post-treatment. This trend was observed for many functional domains, although some side effects, such as xerostomia, persisted well beyond 1 year. In addition, considerable evidence exists that baseline PRO scores can predict clinical endpoints such as overall and progression-free survival.

Conclusions

Many aspects of HNC, both disease and treatment specific, profoundly affect patients’ quality of life. Improved knowledge of these effects on PRO may allow for more informed treatment decisions and can help physicians to better prepare patients for changes they may experience during therapy. Furthermore, the predictive value of baseline PRO data may enable healthcare providers to identify at-risk patients in need of more intensive intervention.

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Conflicts of interest

This research was funded in part by Boehringer Ingelheim International GmbH. The authors have no conflicts of interest relevant to the content of this report, and the opinions expressed herein are those of the authors. Dr. Chris Pashos, as corresponding author, takes responsibility for the scientific content of the study. Dr. Pashos was an employee of UBC at the time the work was done. The authors acknowledge the valuable contributions of Amy McDonough who assisted with data collection; Rachel Huelin, who assisted with editing and reviewing the draft manuscript; Marissa Blieden, who assisted with development of the tables; and Tiffany Pokora, who provided project management assistance.

Author contributions

All authors were involved in conception and planning of the systematic review. EW, MB, and KT interpreted and synthesized the results of the review and drafted the paper. IG, JL, and CP contributed to critical review and revisions of drafts. All authors approved the final submitted version of the manuscript.

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Authors and Affiliations

  1. Evidera, Lexington, MA, USA

    Erika Wissinger, Michael Byrnes & Karin Travers

  2. Boehringer Ingelheim GmbH, Ingelheim, Germany

    Ingolf Griebsch & Juliane Lungershausen

  3. Takeda Pharmaceuticals International, Inc., 40 Landsdowne Street, Cambridge, MA, 02139, USA

    Chris L. Pashos

Authors
  1. Erika Wissinger
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  2. Ingolf Griebsch
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  3. Juliane Lungershausen
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  4. Michael Byrnes
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  5. Karin Travers
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  6. Chris L. Pashos
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Corresponding author

Correspondence to Chris L. Pashos.

Appendix: Search Strategy for MEDLINE

Appendix: Search Strategy for MEDLINE

MEDLINE-indexed publications were reviewed for this systematic literature review on the humanistic burden of HNC using the below search strategy.

The limits for the search included the following criteria: published in the last 10 years (search conducted on 9 January 2014), English-language, only items with abstracts, and studies conducted in humans.

See Appendix Table 5.

Table 5 Summary of MEDLINE search results
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Wissinger, E., Griebsch, I., Lungershausen, J. et al. The Humanistic Burden of Head and Neck Cancer: A Systematic Literature Review. PharmacoEconomics 32, 1213–1229 (2014). https://doi.org/10.1007/s40273-014-0199-x

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