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Objectives: To identify correlates of psychological distress and to investigate how coping skills, anxiety and depression are related in a group of head and neck cancer patients 6-12 months after their diagnosis. Methods: We evaluated in 107 head and neck cancer patients their anxiety and depression levels using the Hospital Anxiety and Depression Scale, and their Coping strategies using the Ways of Coping Checklist. Results: There were statistically significant associations between gender and anxiety level, and between living arrangements, cancer site, time since treatment, tumor stage and depressive symptoms. Results also showed that patients used a variety of coping strategies. Different coping strategies were used in subjects with high versus those with low levels of anxiety or depressive symptoms. Conclusion: Data show several correlates of psychological distress in head and neck cancer patients. They also suggest that coping strategies of these patients vary according to their level of psychological distress.

No description available.

The purpose of this study was to estimate the CTV-PTV margin required for prostate and head and neck cancer treatments at the radiotherapy departments of Karolinska University Hospital.    Portal image data from patients treated at the radiotherapy departments during the period of 2009-2011 was used to estimate the set-up displacements for each treatment area. By using the acquired images the magnitude of the systematic, i.e. preparatory, and random, i.e. execution, error was determined in the anterior-posterior (AP), superior-inferior (SI) and right-left (RL) direction. The calculated PTV margin is based on the systematic and random errors of the entire patient populations. A total of 40 patients were used for the analysis of prostate treatments and 47 patients for head and neck treatments. The evaluation of the PTV margin was done for three different matching protocols; no matching (skin marker alignment), five day matching and daily matching.      With no image verification in prostate treatments the calculated PTV margin taking both inter- and intrafractional errors into account was 13.6, 9.2 and 7.9 mm in AP, SI, and RL direction respectively. The corresponding PTV margin in head and neck treatments was found to be 6.7, 5.3 and 4.9 mm. Using a five day matching protocol of the bony anatomy showed no considerable reductions in margins for neither prostate nor head and neck treatments. With daily matching of the bony anatomy in prostate treatments the calculated margins was reduced to 8.1, 7.9 and 2.4 mm in the AP, SI and RL direction respectively.  Measurements of the residual deviations of individual cervical vertebrae after daily image verification and correction in head and neck cancer treatments showed that all matching protocols will require larger margins in the lower vertebrae in order to account for the set-up error in the AP direction. The corresponding margins needed using daily matching of the bony anatomy would be 3.9, 5.4 and 6.0 mm for C1, C4 and C5 respectively in the AP direction.    In the absence of daily imaging the currently used PTV margins might be inadequate for covering to movement of the targets. The deviations in the AP direction of the cervical vertebrae in head and neck cancer treatments should be investigated further in order to ensure that the motion of the target is covered and that no risk organs are subjected to harmful dose levels.

Thesis (doctoral)--Umeå University, Sweden, 1995. / Added t.p. with thesis statement inserted. Includes bibliographical references.

Thesis (doctoral)--Umeå University, Sweden, 1995. / Added t.p. with thesis statement inserted. Includes bibliographical references.

No / Objective : To describe the common themes in the experiences and expressed information needs of patients undergoing head and neck surgery. Summary background data : Patients who suffer head and neck cancers and undergo surgery often report considerable psychological distress and impaired social functioning. To optimise survival, the decision about what treatment option to follow is often made quickly, with little support in terms of counselling or the provision of information. There is inadequate previous work exploring the content and delivery of information required by patients at this time. Patients and Methods : Participants included patients who had undergone surgery for head or neck cancer (n = 29) and their immediate relatives who were present at the initial consultation with the surgeon (n = 13). Patients were recruited from out-patient departments in two hospitals in the north of England. All interviews were conducted in participants' homes and were guided by a semistructured interview schedule devised both from literature and a pilot study. Results : Whilst most participants felt well informed about the surgical procedure they were undergoing, many reported feeling unprepared for the long-term lifestyle changes that occurred. Information, support and advice throughout the 3-6 months postoperative period was reported to be inadequate. The majority of participants did not ask any questions and did not perceive there was a choice regarding treatment. Individuals who wanted to take an active role in decisionmaking reported difficulties accessing information to enable them to do so. Conclusion : The findings of this study emphasise the need for individualised information provision defined not exclusively by the surgical procedure.

BACKGROUND:To evaluate the feasibility of image-guided radiotherapy based on helical Tomotherapy to spare the contralateral parotid gland in head and neck cancer patients with unilateral or no neck node metastases.METHODS:A retrospective review of 52 patients undergoing radiotherapy for head and neck cancers with image guidance based on daily megavoltage CT imaging with helical tomotherapy was performed.RESULTS:Mean contralateral parotid dose and the volume of the contralateral parotid receiving 40Gy or more were compared between radiotherapy plans with significant constraint (SC) of less than 20Gy on parotid dose (23 patients) and the conventional constraint (CC) of 26Gy (29 patients). All patients had PTV coverage of at least 95% to the contralateral elective neck nodes. Mean contralateral parotid dose was, respectively, 14.1Gy and 24.7Gy for the SC and CC plans (p<0.0001). The volume of contralateral parotid receiving 40Gy or more was respectively 5.3% and 18.2% (p<0.0001)CONCLUSION:Tomotherapy for head and neck cancer minimized radiotherapy dose to the contralateral parotid gland in patients undergoing elective node irradiation without sacrificing target coverage.