47 results on '"Eerenstein, Simone E. J."'
Search Results
2. Role of eHealth application Oncokompas in supporting self-management of symptoms and health-related quality of life in cancer survivors: a randomised, controlled trial
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van der Hout, Anja, van Uden-Kraan, Cornelia F, Holtmaat, Karen, Jansen, Femke, Lissenberg-Witte, Birgit I, Nieuwenhuijzen, Grard A P, Hardillo, José A, Baatenburg de Jong, Robert J, Tiren-Verbeet, Nicolette L, Sommeijer, Dirkje W, de Heer, Koen, Schaar, Cees G, Sedee, Robert-Jan E, Bosscha, Koop, van den Brekel, Michiel W M, Petersen, Japke F, Westerman, Matthijs, Honings, Jimmie, Takes, Robert P, Houtenbos, Ilse, van den Broek, Wim T, de Bree, Remco, Jansen, Patricia, Eerenstein, Simone E J, Leemans, C René, Zijlstra, Josée M, Cuijpers, Pim, van de Poll-Franse, Lonneke V, and Verdonck-de Leeuw, Irma M
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- 2020
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3. Health-related and cancer-related Internet use by patients treated with total laryngectomy
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van Uden-Kraan, Cornelia F., Jansen, Femke, Lissenberg-Witte, Birgit I., Eerenstein, Simone E. J., Leemans, C. René, and Verdonck-de Leeuw, Irma M.
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- 2020
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4. Efficacy and cost-utility of the eHealth application ‘Oncokompas’, supporting patients with incurable cancer in finding optimal palliative care, tailored to their quality of life and personal preferences: a study protocol of a randomized controlled trial
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Schuit, Anouk S., Holtmaat, Karen, Hooghiemstra, Nienke, Jansen, Femke, Lissenberg-Witte, Birgit I., Coupé, Veerle M. H., van Linde, Myra E., Becker-Commissaris, Annemarie, Reijneveld, Jaap C., Zijlstra, Josée M., Sommeijer, Dirkje W., Eerenstein, Simone E. J., and Verdonck-de Leeuw, Irma M.
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- 2019
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5. Costs from a healthcare and societal perspective among cancer patients after total laryngectomy: are they related to patient activation?
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Jansen, Femke, Coupé, Veerle M. H., Eerenstein, Simone E. J., Leemans, C. René, and Verdonck-de Leeuw, Irma M.
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- 2018
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6. Predictive factors for pharyngocutaneous fistulization after total laryngectomy: a Dutch Head and Neck Society audit
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Lansaat, Liset, van der Noort, Vincent, Bernard, Simone E., Eerenstein, Simone E. J., Plaat, Boudewijn E. C., Langeveld, Ton A. P. M., Lacko, Martin, Hilgers, Frans J. M., de Bree, Remco, Takes, Robert P., van den Brekel, Michiel W. M., and On behalf of the Dutch Head and Neck Society
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- 2018
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7. Evaluation of vascular features of vocal cords proposed by the European Laryngological Society
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Šifrer, Robert, Rijken, Johannes A., Leemans, C. René, Eerenstein, Simone E. J., van Weert, Stijn, Hendrickx, Jan-Jaap, Bloemena, Elisabeth, Heuveling, Derrek A., and Rinkel, Rico N. P. M.
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- 2017
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8. The influence of closure technique in total laryngectomy on the development of a pseudo-diverticulum and dysphagia
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van der Kamp, Martine F., Rinkel, Rico N. P. M., and Eerenstein, Simone E. J.
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- 2017
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9. Cost-Utility of the eHealth Application ‘Oncokompas’, Supporting Incurably Ill Cancer Patients to Self-Manage Their Cancer-Related Symptoms: Results of a Randomized Controlled Trial
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Schuit, Anouk S., primary, Holtmaat, Karen, additional, Coupé, Veerle M. H., additional, Eerenstein, Simone E. J., additional, Zijlstra, Josée M., additional, Eeltink, Corien, additional, Becker-Commissaris, Annemarie, additional, van Zuylen, Lia, additional, van Linde, Myra E., additional, Menke-van der Houven van Oordt, C. Willemien, additional, Sommeijer, Dirkje W., additional, Verbeek, Nol, additional, Bosscha, Koop, additional, Nandoe Tewarie, Rishi, additional, Sedee, Robert-Jan, additional, de Bree, Remco, additional, de Graeff, Alexander, additional, de Vos, Filip, additional, Cuijpers, Pim, additional, Verdonck-de Leeuw, Irma M., additional, and Jansen, Femke, additional
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- 2022
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10. An online self-care education program to support patients after total laryngectomy: feasibility and satisfaction
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Cnossen, Ingrid C., van Uden-Kraan, Cornelia F., Eerenstein, Simone E. J., Jansen, Femke, Witte, Birgit I., Lacko, Martin, Hardillo, José A., Honings, Jimmie, Halmos, Gyorgy B., Goedhart-Schwandt, Noortje L. Q., de Bree, Remco, Leemans, C. René, and Leeuw, Irma M. Verdonck-de
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- 2016
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11. Symptom monitoring in cancer and fully automated advice on supportive care: Patients' perspectives on self‐management strategies and the eHealth self‐management application Oncokompas
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Schuit, Anouk S., primary, Zwieten, Valesca, additional, Holtmaat, Karen, additional, Cuijpers, Pim, additional, Eerenstein, Simone E. J., additional, Leemans, C. René, additional, Vergeer, Marije R., additional, Voortman, Jens, additional, Karagozoglu, Hakki, additional, Weert, Stijn, additional, Korte, Mira, additional, Frambach, Ruud, additional, Fleuren, Margot, additional, Hendrickx, Jan‐Jaap, additional, and Verdonck‐de Leeuw, Irma M., additional
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- 2021
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12. Computerized monitoring of patient-reported speech and swallowing problems in head and neck cancer patients in clinical practice
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Cnossen, Ingrid C., de Bree, Remco, Rinkel, Rico N. P. M., Eerenstein, Simone E. J., Rietveld, Derek H. F., Doornaert, Patricia, Buter, Jan, Langendijk, Johannes A., Leemans, C. René, and Verdonck-de Leeuw, Irma M.
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- 2012
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13. Molecular diagnosis of minimal residual disease in head and neck cancer patients
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Graveland, A. Peggy, Braakhuis, Boudewijn J. M., Eerenstein, Simone E. J., de Bree, Remco, Bloemena, Elisabeth, de Maaker, Michiel, van den Brekel, Michiel W. M., Dijk, Frederike, Mesker, Wilma E., Tanke, Hans J., Leemans, C. Rene, and Brakenhoff, Ruud H.
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- 2012
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14. the Prognostic Role of Comorbidity in Salivary Gland Carcinoma
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Terhaard, Chris H. J., van der Schroeff, Marc P., van Schie, Kim, Eerenstein, Simone E. J., Lubsen, Herman, Kaanders, Johannes H. A. M., Smeele, Ludwig E., Burlage, Fred R., van Den Ende, Piet L., and Baatenburg de Jong, Robert J.
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- 2008
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15. Long-term Results of VoiceMaster Voice Prosthesis Use in Laryngectomized Patients
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Eerenstein, SIMONE E. J. and Schouwenburg, PAUL F.
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- 2003
16. Downsizing of Voice Prosthesis Diameter in Patients With Laryngectomy: An In Vitro Study
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Eerenstein, Simone E. J., Grolman, Wilko, and Schouwenburg, Paul F.
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- 2002
17. Swallowing outcomes after transoral robotic surgery and adjuvant treatment in unknown primary.
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Scheer, Fennetta A., Jansen, Femke, Eerenstein, Simone E. J., Vergeer, Marije R., Leemans, C. René, Verdonck‐de Leeuw, Irma M., and Hendrickx, Jan‐Jaap
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SURGICAL robots , *CANCER of unknown primary origin , *HEAD & neck cancer , *DEGLUTITION , *PATIENTS' attitudes , *VIDEOFLUOROSCOPY , *RECTAL surgery - Abstract
Objectives Subjects and Methods Results Conclusion Robotic transoral mucosectomy of the base of tongue was introduced as a diagnostic procedure in patients treated for head and neck cancer with unknown primary (CUP), increasing the identification rate of the primary tumour. For the treatment of CUP, a considerable percentage of patients require adjuvant (chemo)radiation. The aim of this study was to investigate swallowing outcomes among CUP patients after TORS and adjuvant treatment.A systematic review was carried out on studies investigating the impact of TORS and adjuvant treatment on swallowing‐related outcomes among CUP patients In addition, a cross‐sectional study was carried out on swallowing problems (measured using the SWAL‐QOL questionnaire) among CUP patients in routine care who visited the outpatient clinic 1–5 years after TORS and adjuvant treatment.The systematic review (6 studies; n = 98) showed that most patients returned to a full oral diet. The cross‐sectional study (n = 12) showed that all patients were able to return to a full oral diet, nevertheless, 50% reported swallowing problems in daily life (SWAL‐QOL total score ≥14).Although after TORS and adjuvant treatment for CUP a full oral diet can be resumed, patients still experience problems with eating and drinking in daily life. [ABSTRACT FROM AUTHOR]
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- 2024
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18. A clinicopathological study and prognostic factor analysis of 177 salivary duct carcinoma patients from The Netherlands
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Boon, Eline, Bel, Miranda, van Boxtel, Wim, van der Graaf, Winette T. A., van Es, Robert J. J., Eerenstein, Simone E. J., Baatenburg de Jong, Robert J., van den Brekel, Michiel W. M., van der Velden, Lilly‐Ann, Witjes, Max J. H., Hoeben, Ann, Willems, Stefan M., Bloemena, Elisabeth, Smit, Laura A., Oosting, Sjoukje F., Jonker, Marianne A., Flucke, Uta E., van Herpen, Carla M. L., Guided Treatment in Optimal Selected Cancer Patients (GUTS), Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Damage and Repair in Cancer Development and Cancer Treatment (DARE), RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Interne Geneeskunde, MUMC+: MA Medische Oncologie (9), MKA AMC (OII, ACTA), MKA Vumc (OII, ACTA), and Otorhinolaryngology and Head and Neck Surgery
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Adult ,Male ,DATABASE ,Receptor, ErbB-2 ,receptor ,Receptor, ErbB-2/metabolism ,Receptors, Androgen/metabolism ,THERAPY ,survival ,Disease-Free Survival ,ErbB-2 ,Recurrence ,ErbB‐2 ,Journal Article ,FAILURE ,Humans ,Salivary Ducts ,Neoplasm Metastasis ,Carcinoma/pathology ,salivary duct carcinoma ,Aged ,Netherlands ,Aged, 80 and over ,OUTCOMES ,Carcinoma ,Palliative Care ,ANDROGEN RECEPTOR ,Salivary Ducts/pathology ,Chemoradiotherapy, Adjuvant ,Middle Aged ,Prognosis ,Salivary Gland Neoplasms ,Survival Rate ,androgen receptors ,Receptors, Androgen ,Lymphatic Metastasis ,immunohistochemistry ,Female ,in situ hybridization ,fluorescence ,Factor Analysis, Statistical ,Salivary Gland Neoplasms/pathology ,Cancer Epidemiology - Abstract
Salivary duct carcinoma (SDC) is a subtype of salivary gland cancer with a dismal prognosis and a need for better prognostication and novel treatments. The aim of this national cohort study was to investigate clinical outcome, prognostic factors, androgen receptor (AR) and human epidermal growth factor receptor 2 (HER2) expression. SDC patients diagnosed between 1990 and 2014 were identified by the Nationwide Network and Registry of Histo‐ and Cytopathology in the Netherlands (PALGA). Subsequently, medical records were evaluated and pathological diagnoses reviewed. Data were analyzed for overall survival (OS), disease‐free survival (DFS), distant metastasis‐free survival (DMFS) and prognostic factors. AR was evaluated by immunohistochemistry (IHC), HER2 by IHC and fluorescent in‐situ hybridization. A total of 177 patients were included. The median age was 65 years, 75% were male. At diagnosis, 68% presented with lymph node metastases and 6% with distant metastases. Median OS, DFS and DMFS were 51, 23 and 26 months, respectively. In patients presenting without distant metastases, the absolute number of positive lymph nodes was associated with poor OS and DMFS in a multivariable analysis. AR and HER2 were positive in 161/168 (96%) and 44/153 (29%) tumors, respectively, and were not prognostic factors. SDC has a dismal prognosis with primary lymph node involvement in the majority of patients. The absolute number of lymph node metastases was found to be the only prognostic factor for DMFS and OS. AR expression and—to a lesser extent—HER2 expression hold promise for systemic treatment in the metastatic and eventually adjuvant setting., What's new? Salivary duct carcinoma (SDC) is a rare and often fatal malignancy. Little is known about associations between its pathological features and clinical outcome. In this study, clinicopathological factors were analyzed for 177 patients diagnosed with SDC in The Netherlands between 1990 and 2014. The data show that median overall survival (OS) and distant metastasis‐free survival (DMFS) were 51 and 26 months, respectively. At diagnosis, 68% of patients presented with lymph node metastases. Lymph node positivity was associated with poor OS and poor DMFS. The absolute number of metastatic lymph nodes was the only significant prognostic factor for survival in a multivariate analysis. Androgen receptor and human epidermal growth factor 2 (HER2) were positive in 96% and 29%, respectively and were not a prognostic factor.
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- 2018
19. Health-related and cancer-related Internet use by patients treated with total laryngectomy
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van Uden-Kraan, Cornelia F., primary, Jansen, Femke, additional, Lissenberg-Witte, Birgit I., additional, Eerenstein, Simone E. J., additional, Leemans, C. René, additional, and Verdonck-de Leeuw, Irma M., additional
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- 2019
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20. Costs from a healthcare and societal perspective among cancer patients after total laryngectomy: are they related to patient activation?
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Jansen, Femke, primary, Coupé, Veerle M. H., additional, Eerenstein, Simone E. J., additional, Leemans, C. René, additional, and Verdonck-de Leeuw, Irma M., additional
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- 2017
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21. Silver Nitrate Aspiration: A Potentially Life-Threatening Complication
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Bekkers, Stijn, primary, Rijken, Johannes A., additional, Daniels, Johannes M. A., additional, Rinkel, Rico N. P. M., additional, Hendrickx, Jan-Jaap, additional, and Eerenstein, Simone E. J., additional
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- 2017
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22. The influence of closure technique in total laryngectomy on the development of a pseudo-diverticulum and dysphagia
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van der Kamp, Martine F., primary, Rinkel, Rico N. P. M., additional, and Eerenstein, Simone E. J., additional
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- 2016
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23. Swallowing and Voice Outcomes following Treatment of Hypopharyngeal Cancer: The Need for Supervised Rehabilitation.
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Eerenstein, Simone E J, Verdonck-de Leeuw, Irma M, and Leemans, C René
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- 2019
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24. Effectiveness and cost-utility of a guided self-help exercise program for patients treated with total laryngectomy: protocol of a multi-center randomized controlled trial
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Jansen, Femke, primary, Cnossen, Ingrid C., additional, Eerenstein, Simone E. J., additional, Coupé, Veerle M. H., additional, Witte, Birgit I., additional, van Uden-Kraan, Cornelia F., additional, Doornaert, Patricia, additional, Braunius, Weibel W., additional, De Bree, Remco, additional, Hardillo, José A. U., additional, Honings, Jimmie, additional, Halmos, György B., additional, Leemans, C. René, additional, and Verdonck-de Leeuw, Irma M., additional
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- 2016
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25. Evaluation of vascular features of vocal cords proposed by the European Laryngological Society.
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Šifrer, Robert, Rijken, Johannes A., Leemans, C. René, Eerenstein, Simone E. J., van Weert, Stijn, Hendrickx, Jan-Jaap, Bloemena, Elisabeth, Heuveling, Derrek A., and Rinkel, Rico N. P. M.
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VOCAL cord cancer ,BENIGN tumors ,BLOOD vessels ,LARYNGOSCOPY ,PAPILLOMA ,GLOTTIS ,FOLLOW-up studies (Medicine) ,DIAGNOSIS ,PHYSIOLOGY - Abstract
A newly proposed classification by the European Laryngological Society (ELS) of glottic lesions by narrow-band imaging (NBI) divides their vascular patterns into longitudinal and perpendicular ones. The latter are further subdivided into the wide and narrow patterns. The longitudinal, wide, and narrow patterns are characteristic of benign disease, papilloma, and malignancy, respectively. The aim of the study was to investigate the diagnostic effectiveness of the classification. Forty patients with glottic lesions underwent microlaryngoscopy. The vascular patterns of all vocal cords were defined with NBI. The affected vocal cords were histologically analysed and comprised the arm (A). Unaffected vocal cords were not histologically analysed but followed-up and comprised the arm (B) and were regarded as true negatives if no suspicious changes appeared during the follow-up. The vocal cords from the arm A were categorised into the benign and malignant group according to the histologic result. The ratio of vascular patterns was determined and the groups were statistically compared using the Chi-square test and Fisher's exact test. Perpendicular changes were observed in 36.6% (9/26) of benign diseases and in 100% (23/23) of cancer conditions ( p < 0.001). Wide perpendicular changes appeared only in papillomas (6/6) while narrow ones mostly in malignancies (23/26) and also in benign conditions (3/26) ( p < 0.001). The sensitivity, specificity, positive and negative predictive values, and accuracy were 100, 95, 88, 100 and 96%, respectively. The new ELS classification can be used effectively and safely to differentiate malignant from benign disease. [ABSTRACT FROM AUTHOR]
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- 2018
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26. A prospective randomized multicenter clinical trial of the Provox2 and Groningen Ultra Low Resistance voice prostheses in the rehabilitation of post-laryngectomy patients: a lifetime and preference study
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Harms, Kim, Post, Wendy J., van de Laan, Klaas T., van den Hoogen, Frank J. A., Eerenstein, Simone E. J., van der Laan, Bernard F. A. M., Erenstein, S.E., Otolaryngology / Head & Neck Surgery, CCA - Quality of life, Nieuwenhuis Institute (Pedagogical and Educational Sciences), Faculteit Medische Wetenschappen/UMCG, Damage and Repair in Cancer Development and Cancer Treatment (DARE), and Man, Biomaterials and Microbes (MBM)
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Male ,medicine.medical_specialty ,Cancer Research ,Patient Dropouts ,CARCINOMA ,TOTAL LARYNGECTOMY ,medicine.medical_treatment ,Groningen Ultra Low Resistance ,Laryngectomy ,Aetiology, screening and detection [ONCOL 5] ,Prosthesis Design ,Prosthesis ,Preference ,Internal medicine ,Surveys and Questionnaires ,Perception and Action [DCN 1] ,medicine ,Humans ,Prospective Studies ,Laryngeal Neoplasms ,RESTORATION ,Netherlands ,Rehabilitation ,business.industry ,Repeated measures design ,Surgery ,Prosthesis Failure ,Clinical trial ,Equipment Failure Analysis ,Oncology ,Patient Satisfaction ,High phonating resistance ,Provox2 ,EXPERIENCE ,Female ,Tracheo-esophageal shunt prosthesis ,Oral Surgery ,Low resistance ,business ,Larynx, Artificial ,Lifetime - Abstract
To prospectively study patients' preference for and the lifetime of the Groningen Ultra Low Resistance (GULR) and Provox2 tracheo-esophageal shunt prosthesis (TESP, plural TESPs) in post-laryngectomy patients. Eighty post-laryngectomy patients were included in 4 oncological centers in the Netherlands. We used a repeated measures design study with 4 randomized groups in a partial cross-over design using 3 consecutive TESPs (3 intervals) in different orders. (Group 1: GULR-GULR-GULR; Group 2: GULR-GULR-Provox2; Group 3: Provox2-Provox2-GULR; and Group 4: Provox2-Provox2-Provox2). Replacement dates and reasons for replacement were monitored with questionnaires as were patients' preferences for GULR or Provox2. A great variability of lifetime within and between groups was seen. Mean lifetimes found (all groups and intervals added) were 106.2 and 102.7 days, and median lifetimes were 76 and 65 days for GULR and Provox2, respectively. Lifetime showed no significant differences between groups, intervals, and TESP types. Many patients dropped out due to reasons having to do with GULR-characteristics (n = 21). The main dropout reason was "high phonating resistance (HPR)" (57.1%). Only 10 patients preferred GULR. A significantly larger number of patients (n = 39, 79.6%) preferred Provox2 either by choice or by dropping out due to GULR-characteristics (P
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- 2011
27. Effect of Early Individualized Dietary Counseling on Weight Loss, Complications, and Length of Hospital Stay in Patients With Head and Neck Cancer: A Comparative Study
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Leistra, Eva, primary, Eerenstein, Simone E. J., additional, van Aken, Loes H., additional, Jansen, Femke, additional, de van der Schueren, Marian A. E., additional, Twisk, Jos W. R., additional, Visser, Marjolein, additional, and Langius, Jacqueline A. E., additional
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- 2015
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28. An online self-care education program to support patients after total laryngectomy: feasibility and satisfaction
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Cnossen, Ingrid C., primary, van Uden-Kraan, Cornelia F., additional, Eerenstein, Simone E. J., additional, Jansen, Femke, additional, Witte, Birgit I., additional, Lacko, Martin, additional, Hardillo, José A., additional, Honings, Jimmie, additional, Halmos, Gyorgy B., additional, Goedhart-Schwandt, Noortje L. Q., additional, de Bree, Remco, additional, Leemans, C. René, additional, and Leeuw, Irma M. Verdonck-de, additional
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- 2015
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29. Molecular Detection of Minimal Residual Cancer in Surgical Margins of Head and Neck Cancer Patients
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Graveland, A. Peggy, primary, Maaker, Michiel de, additional, Braakhuis, Boudewijn J. M., additional, de Bree, Remco, additional, Eerenstein, Simone E. J., additional, Bloemena, Elisabeth, additional, Leemans, C. René, additional, and Brakenhoff, Ruud H., additional
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- 2009
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30. Secondary Tracheoesophageal Puncture With Local Anesthesia
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Eerenstein, Simone E. J., primary and Schouwenburg, Paul F., additional
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- 2002
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31. Molecular detection of minimal residual cancer in surgical margins of head and neck cancer patients.
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Graveland, A. Peggy, de Maaker, Michiel, Braakhuis, Boudewijn J. M., de Bree, Remco, Eerenstein, Simone E. J., Bloemena, Elisabeth, Leemans, C. René, and Brakenhoff, Ruud H.
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HEAD & neck cancer ,ONCOLOGIC surgery ,SQUAMOUS cell carcinoma ,POLYMERASE chain reaction - Abstract
A great disappointment in head and neck cancer surgery is that 10–30% of head and neck squamous cell carcinoma (HNSCC) patients develop local recurrences despite histopathologically tumor-free surgical margins. These recurrences result from either minimal residual cancer (MRC) or preneoplastic lesions that remain behind after tumor resection. Distinguishing MRC from preneoplasic lesions is important to tailor postoperative radiotherapy more adequately. Here we investigated the suitability of quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) using human Ly-6D (hLy-6D) transcripts as molecular marker to detect MRC in surgical margins. Submucosal samples of deep surgical margins were collected from 18 non-cancer control patients and 67 HNSCC patients of whom eight had tumor-positive surgical margins. The samples were analyzed with hLy-6D qRT-PCR, and the data were analyzed in relation to the clinicohistological parameters. A significant difference was shown between the group of patients with histopathological tumor-positive surgical margins and the non-cancer control group (p<0.001), and the group of patients with histopathological tumor-free surgical margins (p=0.001). This study shows a novel approach for molecular analysis of deep surgical margins in head and neck cancer surgery. The preliminary data of this approach for detection of MRC in deep margins of HNSCC patients are promising. [ABSTRACT FROM AUTHOR]
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- 2009
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32. Decisional Conflict in Patients with Advanced Laryngeal Carcinoma: A Multicenter Study.
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Heirman AN, de Kort DP, Petersen JF, Al-Mamgani A, Eerenstein SEJ, de Kleijn BJ, Hoebers F, Tijink BM, Stuiver MM, van der Molen L, Dirven R, Halmos GB, and van den Brekel MWM
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- Humans, Male, Female, Prospective Studies, Middle Aged, Aged, Surveys and Questionnaires, Conflict, Psychological, Decision Making, Shared, Quality of Life, Decision Making, Adult, Counseling, Laryngeal Neoplasms psychology, Laryngeal Neoplasms therapy, Laryngeal Neoplasms pathology, Laryngeal Neoplasms surgery, Laryngectomy psychology
- Abstract
Objectives: Decision-making for patients with a locally advanced laryngeal carcinoma (T3 and T4) is challenging due to the treatment choice between organ preservation and laryngectomy, both with different and high impact on function and quality of life (QoL). The complexity of these treatment decisions and their possible consequences might lead to decisional conflict (DC). This study aimed to explore the level of DC in locally advanced laryngeal carcinoma patients facing curative decision-making, and to identify possible associated factors., Methods: In this multicenter prospective cohort study, participants completed questionnaires on DC, level of shared decision-making (SDM), and a knowledge test directly after counseling and 6 months after treatment. Descriptive statistics and Spearman correlation tests were used to analyze the data., Results: Directly after counseling, almost all participants (44/45; 98%) experienced Clinically Significant DC score (CSDC >25, scale 0-100). On average, patients scored 47% (SD 20%) correct on the knowledge test. Questions related to radiotherapy were answered best (69%, SD 29%), whilst only 35% (SD 29%) of the questions related to laryngectomy were answered correctly. Patients' perceived level of SDM (scale 0-100) was 70 (mean, SD 16.2), and for physicians this was 70 (SD 1.7)., Conclusion: Most patients with advanced larynx cancer experience high levels of DC. Low knowledge levels regarding treatment aspects indicate a need for better patient counseling., Level of Evidence: 4 Laryngoscope, 134:3604-3610, 2024., (© 2024 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.)
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- 2024
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33. Circulating T cell status and molecular imaging may predict clinical benefit of neoadjuvant PD-1 blockade in oral cancer.
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Wondergem NE, Miedema IHC, van de Ven R, Zwezerijnen GJC, de Graaf P, Karagozoglu KH, Hendrickx JJ, Eerenstein SEJ, Bun RJ, Mulder DC, Voortman J, Boellaard R, Windhorst AD, Hagers JP, Peferoen LAN, de Gruijl TD, Bloemena E, Brakenhoff RH, Leemans CR, and Menke-van der Houven van Oordt CW
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- Humans, Male, Female, Middle Aged, Aged, Immune Checkpoint Inhibitors therapeutic use, Immune Checkpoint Inhibitors pharmacology, Molecular Imaging methods, Nivolumab therapeutic use, Nivolumab pharmacology, T-Lymphocytes immunology, T-Lymphocytes metabolism, Programmed Cell Death 1 Receptor antagonists & inhibitors, Positron-Emission Tomography methods, Adult, Mouth Neoplasms drug therapy, Mouth Neoplasms diagnostic imaging, Mouth Neoplasms pathology, Neoadjuvant Therapy methods
- Abstract
Background: Addition of neoadjuvant immune checkpoint inhibition to standard-of-care interventions for locally advanced oral cancer could improve clinical outcome., Methods: In this study, 16 evaluable patients with stage III/IV oral cancer were treated with one dose of 480 mg nivolumab 3 weeks prior to surgery. Primary objectives were safety, feasibility, and suitability of programmed death receptor ligand-1 positron emission tomography (PD-L1 PET) as a biomarker for response. Imaging included
18 F-BMS-986192 (PD-L1) PET and18 F-fluorodeoxyglucose (FDG) PET before and after nivolumab treatment. Secondary objectives included clinical and pathological response, and immune profiling of peripheral blood mononuclear cells (PBMCs) for response prediction. Baseline tumor biopsies and postnivolumab resection specimens were evaluated by histopathology., Results: Grade III or higher adverse events were not observed and treatment was not delayed in relation to nivolumab administration and other study procedures. Six patients (38%) had a pathological response, of whom three (19%) had a major (≥90%) pathological response (MPR). Tumor PD-L1 PET uptake (quantified using standard uptake value) was not statistically different in patients with or without MPR (median 5.3 vs 3.4). All major responders showed a significantly postnivolumab decreased signal on FDG PET. PBMC immune phenotyping showed higher levels of CD8+ T cell activation in MPR patients, evidenced by higher baseline expression levels of PD-1, TIGIT, IFNγ and lower levels of PD-L1., Conclusion: Together these data support that neoadjuvant treatment of advanced-stage oral cancers with nivolumab was safe and induced an MPR in a promising 19% of patients. Response was associated with decreased FDG PET uptake as well as activation status of peripheral T cell populations., Competing Interests: Competing interests: RvdV has received research funding from Genmab BV. TDdG is scientific advisor to Immunicum, GE Health, and Lava Therapeutics, holds stock from LAVA Therapeutics and received research funding from Idera Pharmaceuticals (now Aceragen). RHB received research grants from KWF Kankerbestrijding/Dutch Cancer Society, Cancer Center Amsterdam Foundation, ZonMW and NWO, Genmab BV and the Hanarth Foundation and is on the advisory board of Nanobiotix. He has a scientific collaboration with Orfenix BV and Qialix DoT. CRL received research grants from KWF Kankerbestrijding/Dutch Cancer Society, Cancer Center Amsterdam Foudation, Genmab BV, BMS and the Hanarth Foundation and is on the advisory board of Merck & Co. CWM-vdHvO received research grants from BMS, Boeringher Ingelheim, GSK, Pfizer and AstraZeneca and consulted for GE Health Care, Novartis and EliLilly. All other authors report no competing interests., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)- Published
- 2024
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34. Swallowing outcomes after transoral robotic surgery and adjuvant treatment in unknown primary.
- Author
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van der Scheer FA, Jansen F, Eerenstein SEJ, Vergeer MR, Leemans CR, Verdonck-de Leeuw IM, and Hendrickx JJ
- Abstract
Objectives: Robotic transoral mucosectomy of the base of tongue was introduced as a diagnostic procedure in patients treated for head and neck cancer with unknown primary (CUP), increasing the identification rate of the primary tumour. For the treatment of CUP, a considerable percentage of patients require adjuvant (chemo)radiation. The aim of this study was to investigate swallowing outcomes among CUP patients after TORS and adjuvant treatment., Subjects and Methods: A systematic review was carried out on studies investigating the impact of TORS and adjuvant treatment on swallowing-related outcomes among CUP patients In addition, a cross-sectional study was carried out on swallowing problems (measured using the SWAL-QOL questionnaire) among CUP patients in routine care who visited the outpatient clinic 1-5 years after TORS and adjuvant treatment., Results: The systematic review (6 studies; n = 98) showed that most patients returned to a full oral diet. The cross-sectional study (n = 12) showed that all patients were able to return to a full oral diet, nevertheless, 50% reported swallowing problems in daily life (SWAL-QOL total score ≥14)., Conclusion: Although after TORS and adjuvant treatment for CUP a full oral diet can be resumed, patients still experience problems with eating and drinking in daily life., (© 2024 The Author(s). Oral Diseases published by Wiley Periodicals LLC.)
- Published
- 2024
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35. [Implications of total laryngectomy].
- Author
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Fockens MM, van der Scheer FA, and Eerenstein SEJ
- Subjects
- Humans, Dyspnea, Laryngectomy adverse effects, Deglutition Disorders
- Abstract
This clinical lesson describes three patients with problems after a total laryngectomy. Patient A suffered from acute tracheitis and narrowing of the tracheostoma. Patient B experienced acute dyspnea due to thick mucus plugs. Patient C had progressive symptoms of deteriorating speech and dysphagia, which resolved after dilatation of a pharyngeal stenosis. A total laryngectomy leads to definitive changes in anatomy and physiology. In case of respiratory symptoms, it is important to recognize the tracheostoma is the only entrance to the airway. Speech is generally well rehabilitated with a speech valve in a tracheoesophageal fistula.
- Published
- 2024
36. The development of a decision aid for patients with operable oropharyngeal carcinoma in the Netherlands - A mixed methods study.
- Author
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Heirman AN, Dirven R, van der Molen L, Schreuder WH, Hoebers F, Honings J, Al-Mamgani A, de Bree R, Eerenstein SEJ, Halmos GB, and van den Brekel MWM
- Subjects
- Humans, Netherlands, Decision Support Techniques, Robotic Surgical Procedures, Oropharyngeal Neoplasms surgery, Oropharyngeal Neoplasms radiotherapy, Carcinoma
- Abstract
Objective: The aim of this project is to create an interactive online patient decision aid (PDA) for oropharyngeal cancer (OPSCC) patients, eligible for transoral (robotic) surgery with an ultimate goal to assist both physicians and patients in making treatment choices., Materials and Methods: Following the International Patient Decision Aid Standards, a mixed-methods approach was employed. The study involved semi-structured in-depth interviews with patients and physicians, thinking-out-loud sessions, and study-specific questionnaires. Thematic coding and analysis were conducted on verbatim transcriptions of audio-recorded interviews., Results: The PDA drafts were evaluated by twenty OPSCC survivors and twenty multidisciplinary specialists. Significant revisions were made after phase 1 to enhance readability and reduce text, whilst incorporating videos and graphics. Following all phases, both patients and specialists rated the PDA as comprehensible, feasible, and a valuable addition to regular counseling., Conclusion: This study showcases the development of a PDA for early stage oropharyngeal cancer patients considering surgery and radiotherapy options. The decision aid emphasizes the disparities in short- and long-term side effects between the two treatments. Patients and physicians found the decision aid to be understandable, user-friendly, and helpful for future patients. The PDA is available on https://beslissamen.nl/., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2024
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37. Management of the brachial plexus in head and neck cancer.
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Fockens MM, Kraak JT, Leemans CR, and Eerenstein SEJ
- Subjects
- Humans, Quality of Life, Neck Muscles, Brachial Plexus anatomy & histology, Brachial Plexus injuries, Head and Neck Neoplasms, Peripheral Nerve Injuries, Radiation Injuries
- Abstract
Purpose of Review: The brachial plexus is an important anatomical structure that is regularly encountered by head and neck surgeons and radiation oncologists. Surgical or radiation-induced brachial plexus injury have great impact on arm function and quality of life. Anatomical variations and management of the brachial plexus in head and neck cancer treatment are discussed., Recent Findings: The brachial plexus consists of spinal roots from C5-C8 and T1. The most prevalent anatomical variations in brachial plexus anatomy include the prefixed brachial plexus (additional contribution from C4) in 11%, the roots of C5 and C6 piercing the belly of the anterior scalene muscle in 6.8%, and presence of the scalenus minimus muscle in 4.1-46%. Due to its location, the brachial plexus is at risk of inadvertent division or neuropraxia during surgical procedures such as neck dissection or robot-assisted transaxillary thyroid surgery (RATS). In case of inadvertent division, nerve reconstruction surgery is warranted and may lead to improved function. The risk of radiation-induced brachial plexus injury is dose-dependent and occurs in approximately 12-22%. Currently, no successful treatment options exist for radiation-induced injury., Summary: Knowledge of anatomical variations is important for head and neck surgeons to minimize the risk of brachial plexus injury. Limiting radiation therapy dose to the brachial plexus is desirable to decrease the risk of brachial plexus injury., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2023
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38. Efficacy of the eHealth application Oncokompas, facilitating incurably ill cancer patients to self-manage their palliative care needs: A randomized controlled trial.
- Author
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Schuit AS, Holtmaat K, Lissenberg-Witte BI, Eerenstein SEJ, Zijlstra JM, Eeltink C, Becker-Commissaris A, van Zuylen L, van Linde ME, Menke-van der Houven van Oordt CW, Sommeijer DW, Verbeek N, Bosscha K, Tewarie RN, Sedee RJ, de Bree R, de Graeff A, de Vos F, Cuijpers P, and Verdonck-de Leeuw IM
- Abstract
Background: Many patients with incurable cancer have symptoms affecting their health-related quality of life. The eHealth application 'Oncokompas' supports patients to take an active role in managing their palliative care needs, to reduce symptoms and improve health-related quality of life (HRQOL). This randomized controlled trial was conducted to determine the efficacy of Oncokompas compared to care as usual among incurably ill cancer patients with a life expectancy of more than three months., Methods: Patients were recruited in six hospitals in the Netherlands. Eligible patients were randomly assigned to the intervention (direct access to Oncokompas) or the control group (access to Oncokompas after three months). The primary outcome measure was patient activation (i.e., patients' knowledge, skills and confidence for self-management). Secondary outcomes were general self-efficacy and HRQOL. Measures were assessed at baseline, two weeks after randomization, and three months after the baseline measurement. Linear mixed models were used to compare longitudinal changes between both groups from baseline to the three-month follow-up., Findings: In total, 219 patients were eligible of which 138 patients completed the baseline questionnaire (response rate 63%), and were randomized to the intervention (69) or control group (69). There were no significant differences between the intervention and control group over time in patient activation (estimated difference in change T0-T2; 1·8 (90% CI: -1·0 to 4·7)), neither in general self-efficacy and HRQOL. Of the patients in the intervention group who activated their account, 74% used Oncokompas as intended. The course of patient activation, general self-efficacy, and HRQOL was not significantly different between patients who used Oncokompas as intended versus those who did not., Interpretation: Among incurably ill cancer patients with a life expectancy of more than three months and recruited in the hospital setting, Oncokompas did not significantly improve patient activation, self-efficacy, or HRQOL., Funding: ZonMw, Netherlands Organization for Health Research and Development (844001105)., Competing Interests: IVdL reports grants from the Netherlands Organization for Health Research and Development (ZonMw), the Dutch Cancer Society (KWF Kankerbestrijding), Bristol Myers Squibb, Danone Ecofund/Nutricia. ABC reports grants from Roche. FdV reports grants from Foundation STOPbraintumors.org and AbbVIe, BMS, Novartis, EORTC, Vaximm and BioClin Therapeutics. FdV reports participation on a DSMB during the conduct of this study, and leaderships or fiduciary roles in other boards and commissions. All other authors declare no competing interests., (© 2022 The Author(s).)
- Published
- 2022
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39. Cost-utility and cost-effectiveness of a guided self-help head and neck exercise program for patients treated with total laryngectomy: Results of a multi-center randomized controlled trial.
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Jansen F, Coupé VMH, Eerenstein SEJ, Cnossen IC, van Uden-Kraan CF, de Bree R, Doornaert P, Halmos GB, Hardillo JAU, van Hinte G, Honings J, Leemans CR, and Verdonck-de Leeuw IM
- Subjects
- Cost-Benefit Analysis, Deglutition Disorders etiology, Exercise Therapy, Humans, Quality of Life, Quality-Adjusted Life Years, Laryngectomy adverse effects, Laryngectomy economics, Laryngectomy methods
- Abstract
Objectives: The guided self-help exercise program called In Tune without Cords (ITwC) is effective in improving swallowing problems and communication among patients treated with a total laryngectomy (TL). This study investigated the cost-utility and cost-effectiveness of ITwC., Materials and Methods: Patients within 5 years after TL were included in this randomized controlled trial. Patients in the intervention group (n = 46) received access to the self-help exercise program with flexibility, range-of-motion and lymphedema exercises, and a self-care education program. Patients in the control group (n = 46) received access to the self-care education program only. Healthcare utilization (iMCQ), productivity losses (iPCQ), health status (EQ-5D-3L, EORTC QLU-C10D) and swallowing problems (SwalQol) were measured at baseline, 3- and 6-months follow-up. Hospital costs were extracted from medical files. Mean total costs and effects (quality-adjusted life-years (QALYs) or SwalQol score) were compared with regression analyses using bias-corrected accelerated bootstrapping., Results: Mean total costs were non-significantly lower (-€685) and QALYs were significantly higher (+0.06) in the intervention compared to the control group. The probability that the intervention is less costly and more effective was 73%. Sensitivity analyses with adjustment for baseline costs and EQ-5D scores showed non-significantly higher costs (+€119 to +€364) and QALYs (+0.02 to +0.03). A sensitivity analysis using the QLU-C10D to calculate QALYs showed higher costs (+€741) and lower QALYs (-0.01) and an analysis that used the SwalQol showed higher costs (+€232) and higher effects (improvement of 6 points on a 0-100 scale)., Conclusion: ITwC is likely to be effective, but possibly at higher expenses., Trial Registration: NTR5255., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2021
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40. Effectiveness of a guided self-help exercise program tailored to patients treated with total laryngectomy: Results of a multi-center randomized controlled trial.
- Author
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Jansen F, Eerenstein SEJ, Cnossen IC, Lissenberg-Witte BI, de Bree R, Doornaert P, Halmos GB, Hardillo JAU, van Hinte G, Honings J, van Uden-Kraan CF, Leemans CR, and Verdonck-de Leeuw IM
- Subjects
- Female, Humans, Male, Prospective Studies, Exercise Therapy methods, Laryngectomy methods, Patient Reported Outcome Measures
- Abstract
Objective: To investigate the effectiveness of a guided self-help exercise program on swallowing, speech, and shoulder problems in patients treated with total laryngectomy (TL)., Materials and Methods: This randomized controlled trial included patients treated with TL in the last 5 years. Patients were randomized into the intervention group (self-help exercise program with flexibility, range-of-motion and lymphedema exercises and self-care education program) or control group (self-care education program). Both groups completed measurements before and 3 and 6-months after randomization. The primary outcome was swallowing problems (SWAL-QOL). Secondary outcomes were speech problems (SHI), shoulder problems (SDQ), self-management (patient activation: PAM) and health-related quality of life (HRQOL: EORTC QLQ-C30/H&N35). Adherence was defined as moderate-high in case a patient exercised >1 per day. Linear mixed model analyses were conducted to investigate the effectiveness of the intervention and to investigate whether neck dissection, treatment indication (primary/salvage TL), time since treatment, severity of problems, and preferred format (online/booklet) moderated the effectiveness., Results: Moderate-high adherence to the exercise program was 59%. The intervention group (n = 46) reported less swallowing and communication problems over time compared to the control group (n = 46) (p-value = 0.013 and 0.004). No difference was found on speech, shoulder problems, patient activation and HRQOL. Time since treatment moderated the effectiveness on speech problems (p-value = 0.025): patients within 6 months after surgery benefitted most from the intervention. Being treated with a neck dissection, treatment indication, severity of problems and format did not moderate the effectiveness., Conclusion: The guided self-help exercise program improves swallowing and communication., Trial Registration: NTR5255., Competing Interests: Declaration of Competing Interest IV obtained funding for research related to In Tune without Cords from the Michel Keijzer Fund (institutional funding). The other authors declare that they have no competing interests., (Copyright © 2020 Elsevier Ltd. All rights reserved.)
- Published
- 2020
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41. A clinicopathological study and prognostic factor analysis of 177 salivary duct carcinoma patients from The Netherlands.
- Author
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Boon E, Bel M, van Boxtel W, van der Graaf WTA, van Es RJJ, Eerenstein SEJ, Baatenburg de Jong RJ, van den Brekel MWM, van der Velden LA, Witjes MJH, Hoeben A, Willems SM, Bloemena E, Smit LA, Oosting SF, Jonker MA, Flucke UE, and van Herpen CML
- Subjects
- Adult, Aged, Aged, 80 and over, Carcinoma surgery, Carcinoma therapy, Chemoradiotherapy, Adjuvant, Disease-Free Survival, Factor Analysis, Statistical, Female, Humans, Lymphatic Metastasis, Male, Middle Aged, Neoplasm Metastasis, Netherlands, Palliative Care, Prognosis, Receptor, ErbB-2 metabolism, Receptors, Androgen metabolism, Recurrence, Salivary Ducts surgery, Salivary Gland Neoplasms radiotherapy, Salivary Gland Neoplasms surgery, Salivary Gland Neoplasms therapy, Survival Rate, Carcinoma pathology, Salivary Ducts pathology, Salivary Gland Neoplasms pathology
- Abstract
Salivary duct carcinoma (SDC) is a subtype of salivary gland cancer with a dismal prognosis and a need for better prognostication and novel treatments. The aim of this national cohort study was to investigate clinical outcome, prognostic factors, androgen receptor (AR) and human epidermal growth factor receptor 2 (HER2) expression. SDC patients diagnosed between 1990 and 2014 were identified by the Nationwide Network and Registry of Histo- and Cytopathology in the Netherlands (PALGA). Subsequently, medical records were evaluated and pathological diagnoses reviewed. Data were analyzed for overall survival (OS), disease-free survival (DFS), distant metastasis-free survival (DMFS) and prognostic factors. AR was evaluated by immunohistochemistry (IHC), HER2 by IHC and fluorescent in-situ hybridization. A total of 177 patients were included. The median age was 65 years, 75% were male. At diagnosis, 68% presented with lymph node metastases and 6% with distant metastases. Median OS, DFS and DMFS were 51, 23 and 26 months, respectively. In patients presenting without distant metastases, the absolute number of positive lymph nodes was associated with poor OS and DMFS in a multivariable analysis. AR and HER2 were positive in 161/168 (96%) and 44/153 (29%) tumors, respectively, and were not prognostic factors. SDC has a dismal prognosis with primary lymph node involvement in the majority of patients. The absolute number of lymph node metastases was found to be the only prognostic factor for DMFS and OS. AR expression and-to a lesser extent-HER2 expression hold promise for systemic treatment in the metastatic and eventually adjuvant setting., (© 2018 The Authors International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.)
- Published
- 2018
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42. A Participatory Design Approach to Develop a Web-Based Self-Care Program Supporting Early Rehabilitation among Patients after Total Laryngectomy.
- Author
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Cnossen IC, van Uden-Kraan CF, Eerenstein SE, Rinkel RN, Aalders IJ, van den Berg K, de Goede CJ, van Stijgeren AJ, Cruijff-Bijl Y, de Bree R, Leemans CR, and Verdonck-de Leeuw IM
- Subjects
- Aged, Community-Based Participatory Research, Female, Focus Groups, Humans, Laryngeal Neoplasms rehabilitation, Larynx, Artificial, Male, Middle Aged, Needs Assessment, Olfaction Disorders rehabilitation, Postoperative Complications rehabilitation, Quality Assurance, Health Care, Speech Therapy, Speech, Alaryngeal methods, Tracheostomy rehabilitation, Video Recording, Internet, Laryngeal Neoplasms surgery, Laryngectomy rehabilitation, Self Care, Software, Therapy, Computer-Assisted
- Abstract
Aim: To develop a Web-based self-care program for patients after total laryngectomy according to a participatory design approach., Methods: We conducted a needs assessment with laryngectomees (n = 9) and their partners (n = 3) by means of a focus group interview. In 4 focus group sessions, a requirement plan was formulated by a team of health care professionals (n = 10) and translated into a prototype. An e-health application was built including illustrated information on functional changes after total laryngectomy as well as video demonstrations of skills and exercises. Usability of the prototype was tested by end users (n = 4) and expert users (n = 10). Interviews were held to elicit the intention to use and the desired implementation strategy., Results: Six main self-care topics were identified: (1) nutrition, (2) tracheostomy care, (3) voice prosthesis care, (4) speech rehabilitation, (5) smell rehabilitation, and (6) mobility of head, neck, and shoulder muscles. Expert users expressed concerns regarding tailored exercises, indicated a positive intent to implement the intervention in routine care, and expressed a need for guidance when implementing the intervention. End users and expert users appreciated the content completeness and multimedia-based information built into the application., Conclusion: The participatory design is a valuable approach to develop a self-care program to help meet users' needs., (© 2016 S. Karger AG, Basel.)
- Published
- 2015
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43. Effect of nutritional interventions on nutritional status, quality of life and mortality in patients with head and neck cancer receiving (chemo)radiotherapy: a systematic review.
- Author
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Langius JA, Zandbergen MC, Eerenstein SE, van Tulder MW, Leemans CR, Kramer MH, and Weijs PJ
- Subjects
- Adult, Foods, Specialized, Head and Neck Neoplasms therapy, Humans, Malnutrition etiology, Malnutrition prevention & control, Nutritional Sciences education, Nutritional Support, Nutritionists, Patient Education as Topic, Precision Medicine, Randomized Controlled Trials as Topic, Chemoradiotherapy adverse effects, Head and Neck Neoplasms diet therapy, Nutritional Status, Quality of Life
- Abstract
Background and Aims: We performed a systematic review to examine the effect of nutritional interventions on nutritional status, quality of life (QoL) and mortality in patients with head and neck squamous cell cancer (HNSCC) receiving radiotherapy or chemoradiotherapy., Methods: We searched Pubmed, EMBASE, CENTRAL and Cinahl from inception through January 3rd, 2012 to identify randomized controlled trials (RCTs) from a broad range of nutritional interventions in patients with HNSCC during (chemo)radiotherapy. Two reviewers independently assessed study eligibility and risk of bias, and extracted data., Results: Of 1141 titles identified, 12 study reports were finally included, describing 10 different studies with 11 interventions. Four out of 10 studies examined the effects of individualized dietary counseling, and showed significant benefits on nutritional status and QOL compared to no counseling or general nutritional advice by a nurse (p < 0.05). Three studies on oral nutritional supplements (ONS) were inconsistent about the effect on nutritional status compared with no supplementation. One study showed that nasogastric tube feeding had beneficial effects on nutritional status compared to ONS, but not in all patient groups (p < 0.04). One study showed benefits of percutaneous endoscopic gastronomy (PEG) feeding on nutritional status shortly after RT compared with nasogastric feeding (p = 0.001). Two studies showed that prophylactic PEG feeding was not superior over tube feeding if required., Conclusions: This review shows beneficial effects of individualized dietary counseling on nutritional status and QoL, compared to no counseling or standard nutritional advice. Effects of ONS and tube feeding were inconsistent., (Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)
- Published
- 2013
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44. Vocal efficiency in tracheoesophageal phonation.
- Author
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Grolman W, Eerenstein SE, Tange RA, Canu G, Bogaardt H, Dijkhuis JP, Dreschler WA, and Schouwenburg PF
- Subjects
- Aged, Female, Humans, Laryngeal Neoplasms pathology, Larynx, Artificial, Male, Middle Aged, Neoplasm Staging, Phonation, Signal Processing, Computer-Assisted, Software, Sound Spectrography, Transducers, Pressure, User-Computer Interface, Laryngeal Neoplasms surgery, Laryngectomy rehabilitation, Pulmonary Ventilation, Speech Acoustics, Speech, Esophageal
- Abstract
Objective: Voice rehabilitation after total laryngectomy is challenging. In order to investigate and understand the function of the neoglottis sophisticated measurements need to be made. During voice production, aerodynamic energy is transformed into sound energy. In non-laryngectomized patients, the voice production efficiency is called the vocal efficiency. Vocal efficiency is an indication of how efficient the transformation of energy takes place. Vocal efficiency is calculated by dividing the output sound power by the aerodynamic power., Patients and Methods: In a group of eight laryngectomees with tracheoesophageal voice, we measured aerodynamic and acoustic quantities and calculated vocal efficiency. We used a computer setup with airflow transducers, pressure transducers, mikrotip transducers and sound intensity measurement to allow calculation of the needed parameters., Results: The tables show the results of the power used and produced in various phonatory tasks. Relatively high levels of aerodynamic power are interpreted as increased effort to speak., Conclusion: The aerodynamic power is an indication of the effort needed for voice generation. The efficiency of TE-voice production is lower compared to laryngeal voice production but does show an increase when sound intensity increases, a known phenomenon in healthy laryngeal voice production.
- Published
- 2008
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45. Aerodynamic and sound intensity measurements in tracheoesophageal voice.
- Author
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Grolman W, Eerenstein SE, Tan FM, Tange RA, and Schouwenburg PF
- Subjects
- Aged, Air, Female, Humans, Laryngectomy, Male, Middle Aged, Tracheostomy, Larynx, Artificial, Phonation, Sound, Speech, Esophageal, Trachea surgery, Voice Quality
- Abstract
Background: In laryngectomized patients, tracheoesophageal voice generally provides a better voice quality than esophageal voice. Understanding the aerodynamics of voice production in patients with a voice prosthesis is important for optimizing prosthetic designs and successful voice rehabilitation., Objectives: To measure the aerodynamics and sound intensity in tracheoesophageal voice production., Study Design and Methods: We built a special setup, which consisted of a Pentium 200 MHz computer with an AD-DA interface card and Labview 4.01 software. In an oral/nasal mask we constructed several mass flow sensors and a microphone. This measured both the oral airflow and the level of sound. For the measurement of endotracheal pressure, which is the driving force behind the airflow, we used a transducer which was connected to the tracheostoma. The endoesophageal pressure was measured at the level of the prosthesis in the esophagus by a Mikrotip transducer. Using this we could determine how much the voice prosthesis contributes to the overall pressure drop of the phonatory tract. Furthermore, the average airflow rate as a function of the sound pressure levels could be determined., Results: In our population, 6 out of 7 patients showed a positive relationship between trans-source airflow and generated sound intensity. We compared our prosthesis pressure drop values with in vitro data and found that there are some differences, possibly due to difference in age of the prosthesis and physiological circumstances in vivo. The overall contribution of the voice prosthesis to the airway resistance depends on the level of phonation and the type of device. In our patient group it is apparent that the pharyngoesophageal (PE) segment has the greatest share of the total pressure drop, especially at higher airflow rates. We measured a 27% pressure drop in airflow over the voice prosthesis. Different tracheostoma occlusion methods did not have any effect on the aerodynamics and sound intensity. One patient that had had a jejunal graft for reconstruction showed, not unexpectedly, extremely different aerodynamic values. We were unable to define optimal airflow rates or optimal resistance values for sound production in the PE segment., Conclusion: The aerodynamic characteristics of voice production in laryngectomized patients with voice prostheses are determined by both prosthetic factors and PE segment tissue factors. In our patient group the PE segment is responsible for the greatest pressure drop. We found no significant difference in pressure drop and sound intensity for different tracheostoma occlusion methods.
- Published
- 2007
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46. Prognostic factors in adult soft tissue sarcomas of the head and neck: a single-centre experience.
- Author
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de Bree R, van der Valk P, Kuik DJ, van Diest PJ, Doornaert P, Buter J, Eerenstein SE, Langendijk JA, van der Waal I, and Leemans CR
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Combined Modality Therapy, Epidemiologic Methods, Female, Head and Neck Neoplasms radiotherapy, Head and Neck Neoplasms surgery, Humans, Lymphatic Metastasis, Male, Middle Aged, Prognosis, Radiotherapy Dosage, Soft Tissue Neoplasms radiotherapy, Soft Tissue Neoplasms secondary, Soft Tissue Neoplasms surgery, Treatment Outcome, Head and Neck Neoplasms pathology, Soft Tissue Neoplasms pathology
- Abstract
Adult soft tissue sarcomas of the head and neck are rare and consist of a variety of histopathological subtypes and sites. The purpose of this study was to review patients treated for adult soft tissue sarcomas of the head and neck at our institute. The medical records of 41 adult patients treated for head and neck soft tissue sarcomas between 1983 and 2004 were reviewed. Thirty-six tumours were histologically reviewed. Histopathological revision showed that 7% of the original sarcomas were found not to be sarcomas and 39% of the sarcoma subtypes changed. Multivariate analysis showed that surgical margin status and lymph node metastases are the most important prognostic factors. Review of histopathological examination of tumours showed a change in subtype in a substantial number of head and neck sarcomas. Negative surgical margins are an important prognostic factor, but are difficult to obtain in head and neck sarcomas.
- Published
- 2006
- Full Text
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47. Downsizing of voice prosthesis diameter in patients with laryngectomy: an in vitro study.
- Author
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Eerenstein SE, Grolman W, and Schouwenburg PF
- Subjects
- Dilatation, Pathologic, Humans, In Vitro Techniques, Phonation physiology, Prosthesis Design, Respiratory Mechanics, Tracheoesophageal Fistula pathology, Laryngectomy rehabilitation, Larynx, Artificial
- Abstract
In patients with laryngectomy, voice prostheses inserted into a tracheoesophageal fistula (TEF) are widely used for vocal rehabilitation. Gradual dilation of the TEF may cause bothersome leakage around voice prostheses. Prosthesis-related weight and mechanical trauma possibly exacerbate TEF dilation. If prosthesis size were to be decreased, with a concomitant decrease in prosthesis weight and diameter, dilation of the TEF would probably lessen. We performed in vitro tests to study the effects on aerodynamic prosthesis function when the prosthesis size-in particular, the inner diameter-was decreased. The effects on airflow and pressure were specifically studied in the airflow range of patients with laryngectomy. A 1-mm decrease of the regular inner prosthesis diameter from 5 mm to 4 mm showed no significant aerodynamic consequences at the average laryngectomized airflow point. Also, such a 1-mm decrease in diameter involved a prosthesis weight reduction of 18%. In view of these findings, downsizing the standard prosthetic diameter should be considered in future voice prosthesis development.
- Published
- 2002
- Full Text
- View/download PDF
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