Título :	Impacto de desfechos relacionados ao tratamento na qualidade de vida de pacientes com câncer de cabeça e pescoço
Autor :	Silva, Luis Felipe Oliveira e
Orientador(es)::	Ramos, Doralina do Amaral Rabello
Coorientador(es)::	Santos, Marcos Antônio dos
Assunto::	Câncer de cabeça e pescoço Carcinoma de células escamosas Radioterapia de Intensidade Modulada (IMRT)
Fecha de publicación :	29-jun-2026
Data de defesa::	18-abr-2024
Citación :	SILVA, Luis Felipe Oliveira e. Impacto de desfechos relacionados ao tratamento na qualidade de vida de pacientes com câncer de cabeça e pescoço. 2024. 125 f., il Tese (Doutorado em Ciências Médicas) — Universidade de Brasília, Brasília, 2024.
Abstract:	Objective: To evaluate the impact of head and neck cancer, as well as treatment outcomes, on health-related quality of life (HRQoL) in patients with head and neck cancer who underwent different combinations of surgery, chemotherapy, and radiotherapy.Methods: Two prospective, multicentric studies were conducted in 18 Brazilian medical institutions. Included were patients diagnosed with squamous cell carcinoma of the head and neck in stages I to IVB, with primary tumors located in various regions, excluding patients with a history of prior radiotherapy and those with distant metastasis. Treatment protocols followed the guidelines of each participating institution, including surgeries, systemic therapies, and radiotherapy. Data collection occurred from June 2014 to December 2019, and patients provided written informed consent. HRQoL was assessed using the cancer-specific questionnaire from the European Organization for Research and Treatment of Cancer (EORTC QLQ-C30) and a specialized module for head and neck cancer patients (EORTC QLQ-H&N43).Results: The first study included 917 patients, with most cases in stage IV and tumors most frequent in the oral cavity. The majority of patients were in advanced stages of the disease, with the most common tumors in the oral cavity, oropharynx, and larynx. It was identified that daily activities and speech problems were the main factors impacting HRQoL, in addition to pain, dysphagia, and concerns about body image. In the second study, which involved 570 patients, it was observed that the IMRT technique resulted in a significant improvement in HRQoL compared to 3DCRT and 2DRT. Additionally, patients who received 2DRT showed worse overall survival (OS), possibly due to more frequent interruptions in treatment.Conclusions: The findings of this thesis emphasize the need for a holistic approach in treating head and neck cancer, which considers the need to adapt and evolve treatment strategies to not only extend survival but also to improve the quality of that survival, taking into account the socioeconomic context of patients. The choice of radiotherapy technique has direct implications on the HRQoL and, possibly, on the OS. Equitable access to advanced treatments is essential for improving health outcomes. Furthermore, recovery of HRQoL after treatment requires ongoing support and long-term monitoring. The studies presented provide evidence to support clinical and health policy decisions and reinforce the need to improve access to and the quality of radiotherapy treatments and care for patients with head and neck cancer in Brazil.
metadata.dc.description.unidade:	Faculdade de Medicina (FM)
Descripción :	Tese (doutorado) — Universidade de Brasília, Faculdade de Medicina, Programa de Pós-Graduação em Ciências Médicas, 2024.
metadata.dc.description.ppg:	Programa de Pós-Graduação em Ciências Médicas
Aparece en las colecciones:	Teses, dissertações e produtos pós-doutorado

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