prediction of survival in palliative patiënts with head neck cancer

Head and Neck oncology is a rare disease: it concerns 2000-2500 patients a year
in the Netherlands. The disease itself and the treatment are often very radical
and mutulating and visible for both the patient and his relatives. This
largely influences the self perception and the social functioning of the
patient. The mean 5-years survival is 50%. Sometimes recurrence of the disease
after treatment is curable, but often a palliative phase has te be chosen. This
phase of the disease is characterised by a long duration and is very disabling
for the patient due to losses of vital functions. Furthermore, during this
phase a large appeal is done to relatives and health care.
The exact duration of the palliative phase is hard to predict. This period is
characterised with uncertainty for the patient and his relatives and a hard
decision-making with respect to potential interventions for optimal quality of
life.
Prof Baatenburg de Jong (ENT, ErasmusMC) and colleagues have developed a
prognostic model for newly diagnosed patients with head and neck cancer. This
results in an accurate estimate of the survival. This model can however not be
used for a palliative patient because different factors probably play a role in
the survival of a palliative patient. Until now only a few studies have been
published to prognostic models in palliative patients.
With this study, we expect to be able to estimate the prognosis of a palliative
patient much more accurate. The patient (and his relatives) will have an
improved treatment and care and also the medical decision-making (utilisation
of interventions aiming at highest quality of life) will improve.

Primary:
development of a prognostic model for head and neck cancer patients in the
palliative phase.

Secundary:
comparison of the prediction of the survival of palliative patients by the
treating physician with both the prediction of the model as well as the real
survival.

Prospective cohort-study collecting data systematically from the medical file
and additional questionnaires.

The following items belong to the standard procedure of a palliative patient,
anamnestic data, physical examination, estimation of the prognosis of the
treating physician, VAS-score on pain, blood tests and a chest X-ray.
Therefore the extra burden of a patient is restricted to answering standard
questionnaires during a home visit.