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Freerk Prenzel1,2 *, Regina Treudler1,3 *, Tobias Lipek,1,2 Maike vom Hove,1,2 Paula Kage,1,3 Simone Kuhs,1,4 Thorsten Kaiser,1,4 Maximilian Bastl,5 Jan Bumberger,6– 8 Jon Genuneit,9,10 Thomas Hornick,8,11 Stefan Klotz,8,12 Julia Zarnowski,1,3 Maren Boege,1,13 Veit Zebralla,1,13 Jan-Christoph Simon,1,3 Susanne Dunker8,11 1Leipziger Interdisciplinary Center for Allergy (LICA), Comprehensive Allergy Center, Leipzig, Germany; 2University of Leipzig, Medical Center, Department of Pediatrics, Leipzig, Germany; 3University of Leipzig, Medical Center, Department of Dermatology, Venerology and Allergy, Leipzig, Germany; 4University of Leipzig, Medical Center, Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Leipzig, Germany; 5Medical University of Vienna, Department of Otorhinolaryngology, Vienna, Austria; 6Helmholtz-Centre for Environmental Research (UFZ), Department Monitoring and Exploration Technologies, Leipzig, Germany; 7Helmholtz-Centre for Environmental Research (UFZ), Research Data Management, Leipzig, Germany; 8German Centre for Integrative Biodiversity Research (iDiv) Halle, Jena, Leipzig, Germany; 9Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany; 10German Center for Child and Youth Health, Leipzig/ Dresden, Dresden, Germany; 11Helmholtz-Centre for Environmental Research (UFZ), Department Physiological Diversity, Leipzig, Germany; 12Helmholtz-Centre for Environmental Research (UFZ), Department Community Ecology, Halle, Germany; 13University of Leipzig, Medical Center, Department of Otorhinolaryngology, Head and Neck Surgery, Leipzig, Germany*These authors contributed equally to this workCorrespondence: Susanne Dunker, Helmholtz Centre for Environmental Research – UFZ, Leipzig, Germany, Tel +49 341 9733170, Email susanne.dunker@ufz.dePurpose: Ailanthus altissima is one of the world’s most invasive species with a globally problematic spread. Pollen is dispersed locally and partially airborne. We aimed at investigating if (i) A. altissima pollen can be detected in relevant quantity in the air and if (ii) sensitization to A. altissima can be detected in patients with seasonal exacerbation of atopic diseases.Patients and Methods: We recorded distribution of A. altissima in Leipzig, Germany. In 2019 and 2020, pollen was collected with a Hirst-type pollen trap placed on the roof of the University Hospital. Specific IgE investigations were performed in children and adults with history of atopic diseases with deterioration between May and July. We analysed specific IgE for A. altissima, Alternaria sp., birch, grasses, profilins, polcalcins and crossreacting carbohydrates.Results: We found abundant growth of A. altissima and pollen was detected from early June to mid-July with a maximum pollen concentration of 31 pollen/m3. Out of 138 patients (63 female, 69 children/adolescents), 95 (69%) had seasonal allergic rhinitis, 84 (61%) asthma, and 43 (31%) atopic dermatitis. Sensitization to A. altissima was shown in 59 (42%). There were no significant differences between age groups. In 59% of patients sensitized (35/59), there was no sensitization to possibly cross-reacting structures.Conclusion: Sensitization to A. altissima pollen could be detected in 42% of our patients with atopic diseases, suggesting allergenic potential of this neophyte. In the context of further spread with climate change, eradication strategies and population-based sensitization studies are needed.Keywords: allergy, invasive species, neophyte, pollinosis, pollen count

In the near future, immunotherapy with checkpoint inhibitors will not only reach the relevant ENT clinics, but also the oncologically integrated ENT practice, since more and more patients under long-term therapy (currently up to 2 years) also have to be seen during clinical follow-up in the specialist practice. In this respect, we also consider as necessary that the basics of immuno-oncology in head and neck tumors are already taught as part of the ENT specialist training. In this review article, the background and the definitions of the therapy sections (first, second line treatment, marker, etc.) should be discussed in detail and the basic tools for understanding this new therapy option should be provided. Since 2017, we have been experiencing a high level of approval dynamics for checkpoint inhibitors in Germany, which is to be assessed as an expression of a new effective principle of action and, after surgery, radiation and chemotherapy, is establishing a fourth strong pillar in the multimodal spectrum against head and neck tumors. Right from the start, the checkpoint inhibitors in the first phase 1b, 2 and 2b studies achieved overall response rates of 16-22 % with overall survival rates of 6-8 months in seriously ill patients with HNSCC who already had a first- and/or even second-line therapy. Nivolumab and Pembrolizumab are currently approved in Germany for the first and second line therapy of relapsed/metastatic squamous cell carcinoma of the head and neck region (HNSCC), Cemiplimab for recurrent/metastatic cutaneous squamous cell carcinoma and Avelumab for metastatic recurrent Merkel-cell carcinoma. The synopsis article about immune checkpoint inhibitors is intended to convey the basic understanding of the principle of action, the indication, toxicity management and the further development within trials in head and neck oncology.

In September 2021, the first version of the German S3 guideline on adult soft tissue sarcomas, version 1.0 (AWMF register number 032/044OL) was presented as part of the oncology guideline program of the DKG, German Cancer Aid and the AWMF. After the basic features of soft tissue sarcomas were presented in Part 1, Part 2 describes the specific options for surgical therapy depending on the location in the head and neck area.

Detection of p16 through immunohistochemistry (IHC) is the standard for determining the HPV status of the tumor according the TNM eighth edition released in 2017 and has become crucial for determining the HPV status of oropharyngeal squamous cell carcinomas (OPSCC) with direct impact on staging and prognostication. In recent years, detection of HPV DNA in mouthwashes has been proposed as a noninvasive alternative, both for OPSCCs and for other head and neck squamous cell carcinomas (HNSCCs). However, the prospect of using the mouthwashes to monitor the response to therapy is unclear. To evaluate the effect of curative therapy on the detection of HPV DNA, we performed a prospective study comparing the detection frequency of high-risk HPV DNA (HR-HPV-DNA) in pre- and post-therapy mouthwashes. We collected 137 mouthwashes from 88 pathologically confirmed HNSCC patients for DNA isolation and HPV genotyping with the Inno-LiPA assay. We show that HPV DNA in pretherapeutic mouthwashes can detect HPV-driven HNSCCs with a sensitivity of 50.0% and specificity of 85.4%, alongside a high negative predictive value of 79.5% and an accuracy of 74.5%. Furthermore, we observed a notable decrease in the detection frequency of HR-HPV-DNA after successful treatment (pre-therapy 50.0% (9/18) versus post-therapy 9.7% (3/28)). However, the comparatively low sensitivity regarding detection of HPV-driven OPSCC argues against its use in clinical routine.

Background: Patient-reported outcomes (PRO) assess disease burden and indicate unmet needs. Home-based electronic PRO measures (ePROMs) can support tumor aftercare (TAC). Creating an ePROM is the next step after implementing the software “OncoFunction” to assess PROs during TAC of head- and neck-cancer patients (HNC). Therefore, internet use and perception on ePROMs of ENT and TAC patients were evaluated. Methods: From May–July 2020, ENT patients at a high-volume outpatient department aged >18 without need for emergency treatment were invited to complete a questionnaire concerning internet use and access, hardware, and opinion on the chances, requirements, and designs of ePROMs. Results: 415 questionnaires were evaluated; 46.3% of the respondents visited the common consultation hour (CCH) and 44.3% TAC; 71.9% were internet users, being younger than non-internet users; and 36.4% of TAC patients were non-internet users and 16.3% of them were without a web-enabled device. Significant differences existed in age and assessment of future perspectives between internet-/non-internet users and TAC/CCH patients, respectively. Regarding the design of ePROMs, patients preferred quarterly and short surveys. Data safety and feedback were important. Conclusions: ePROMs are not suitable for everyone because of missing internet access and experience. A tailored approach to implement ePROMs in TAC is needed.

Purpose Head and neck cancer (HNC) and its treatment can leave devastating side effects with a relevant impact on physical and emotional quality of life (QoL) of HNC patients. The objectives were to examine the amount of dysphagia, voice problems, and pain in HNC patients, the impact of sociodemographic, behavioral, and clinical factors on these symptoms, the psychometric properties of the EAT-10, and the relationship between these symptoms and QoL variables. Methods HNC patients attending for regular follow-up from 07/2013 to 09/2019 completed questionnaires (Eating Assessment Tool-10 (EAT-10); questions from the EORTC QLQ-C30 and EORTC H&N35) on dysphagia, voice problems, pain, fatigue, and QoL collected with the software OncoFunction. Associations between prognostic factors and symptoms were tested with analyses of variance (ANOVAs). Associations between the symptom scales and QoL variables were expressed with Pearson correlations. Results Of 689 patients, 54.9% suffered from dysphagia, the EAT-10 proved to be a reliable measure. The mean voice score was 37.6 (± 33.9) [range 0–100], the mean pain score 1.98 (± 2.24) [range 0–10]. Trimodality treatment was associated with the highest dysphagia scores. Dysphagia, voice problems, and pain significantly correlated with each other, the highest association was found for dysphagia and pain (r = 0.51). QoL was strongly correlated with dysphagia and pain (r = − 0.39 and r = − 0.40, respectively), while the association with voice problems was weaker (r = − 0.28). Conclusion Dysphagia is an important symptom in HNC patients greatly affecting patients’ QoL and significantly correlating with voice problems and pain.

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Zusammenfassung Einleitung Komorbidität beeinflusst die für die kurative Therapie von Kopf-Hals-Karzinomen (HNC) verfügbaren Optionen. Das manuelle Zusammentragen der Nebenerkrankungen vor der Anmeldung im interdisziplinären Tumorboard (TB) ist zeitintensiv und oft unvollständig. Eine automatisierte Erfassung von nach ICD-10 kodierten Komorbiditätsdaten und deren Darstellung könnte die therapeutische Entscheidungsfindung im TB verbessern sowie bestehenden Informationsbedarf aufzeigen. Material und Methoden Die ICD-10-Codes unserer Patienten wurden aus 4 Datenbanken (hospital-information-system (HIS*-MED), der klinikinternen Tumordatenbank, OncoFlow® und OncoFunction®) extrahiert. Nach der Datensatzverknüpfung mittels der Python-Programmbibliotheken Pandas und Record Linkage wurden die ICD-10-Codes bezüglich des Charlson-Scores gewichtet und für die Implementierung in OncoFlow visualisiert. Die Kodierqualität wurde am Beispiel Diabetes an einer 1:1 gematchten Stichprobe von 240 Patienten überprüft. Ergebnisse 29 073 ICD-10-Codes von 2087 Patienten mit HNC wurden extrahiert. Die Anmeldung eines Patienten im TB triggert die sofortige automatische Erfassung und Visualisierung der Daten als Piktogramm in OncoFlow. Dies ermöglicht die schnelle Erfassung und Bewertung der Komorbidität sowie erforderlicher Diagnostik zur Komplettierung der Daten. Die klinikinterne Validationsstudie ergab eine Präzision der durch Datenimport verfügbaren Information zu Diabetes von 95,0 %. Diskussion Patienten mit HNC weisen häufig für die Therapieentscheidung relevante Nebenerkrankungen auf. Die automatisierte Erfassung der Komorbidität aus administrativen Daten und deren intuitive Darstellung ist ressourcen- und kostengünstig möglich. Voraussetzung ist eine präzise, vollständige Verschlüsselung der Krankheitsdiagnosen.

Zusammenfassung Hintergrund Die Reintegration von Tumorpatienten in die Erwerbsfähigkeit ist ein bedeutender sozialer und ökonomischer Faktor. Für maligne Kopf-Hals-Tumoren (KHT) sind hierzu, verglichen mit anderen Tumorentitäten, bislang wenige Daten zusammengetragen und veröffentlicht worden. Material und Methoden In einer selektiven Literaturrecherche wurden Originalarbeiten zwischen 1997 und 2018 zum Thema „Rückkehr in das Erwerbsleben nach Therapie von Kopf-Hals-Karzinomen“ eingeschlossen und analysiert. Ergebnisse Es konnten 18 Originalarbeiten zum Thema berufliche Reintegration nach KHT identifiziert werden. Posttherapeutisch scheiden 10–52 % der vormals berufstätigen Patienten aus dem Berufsleben aus. Hinsichtlich der Tumorlokalisation, der Therapiemodalität und des Geschlechts als Prädiktoren der Rückkehr ins Erwerbsleben zeigte sich in den Studien ein inhomogenes Bild. Es scheinen Alter, sozioökonomischer Status, therapiebedingte Einschränkungen (z. B. Fatigue, Depression) und Nebenerkrankungen einen signifikanten Einfluss auf die berufliche Wiedereingliederung zu haben. Rehabilitationsmaßnahmen bewirken positive Effekte. Schlussfolgerungen Patienten mit KHT haben ein hohes Risiko aus dem Berufsleben auszuscheiden. Die wenigen bisher zum Thema publizierten Studien sind wegen heterogener Methodik, den uneinheitlichen Messzeitpunkten und inhomogener Verteilung untersuchter Tumorlokalisationen nur schwer miteinander vergleichbar. Es zeigt sich weiterhin ein unzureichend adressierter Forschungsbedarf, um evidenzbasierte Konzepte zur Förderung der beruflichen Rehabilitation von KHT-Patienten entwickeln zu können

Zusammenfassung Einleitung Komorbidität beeinflusst die für die kurative Therapie von Kopf-Hals-Karzinomen (HNC) verfügbaren Optionen. Das manuelle Zusammentragen der Nebenerkrankungen vor der Anmeldung im interdisziplinären Tumorboard (TB) ist zeitintensiv und oft unvollständig. Eine automatisierte Erfassung von nach ICD-10 kodierten Komorbiditätsdaten und deren Darstellung könnte die therapeutische Entscheidungsfindung im TB verbessern sowie bestehenden Informationsbedarf aufzeigen. Material und Methoden Die ICD-10-Codes unserer Patienten wurden aus 4 Datenbanken (hospital-information-system (HIS*-MED), der klinikinternen Tumordatenbank, OncoFlow® und OncoFunction®) extrahiert. Nach der Datensatzverknüpfung mittels der Python-Programmbibliotheken Pandas und Record Linkage wurden die ICD-10-Codes bezüglich des Charlson-Scores gewichtet und für die Implementierung in OncoFlow visualisiert. Die Kodierqualität wurde am Beispiel Diabetes an einer 1:1 gematchten Stichprobe von 240 Patienten überprüft. Ergebnisse 29 073 ICD-10-Codes von 2087 Patienten mit HNC wurden extrahiert. Die Anmeldung eines Patienten im TB triggert die sofortige automatische Erfassung und Visualisierung der Daten als Piktogramm in OncoFlow. Dies ermöglicht die schnelle Erfassung und Bewertung der Komorbidität sowie erforderlicher Diagnostik zur Komplettierung der Daten. Die klinikinterne Validationsstudie ergab eine Präzision der durch Datenimport verfügbaren Information zu Diabetes von 95,0 %. Diskussion Patienten mit HNC weisen häufig für die Therapieentscheidung relevante Nebenerkrankungen auf. Die automatisierte Erfassung der Komorbidität aus administrativen Daten und deren intuitive Darstellung ist ressourcen- und kostengünstig möglich. Voraussetzung ist eine präzise, vollständige Verschlüsselung der Krankheitsdiagnosen.

Introduction: Frailty represents a complex geriatric syndrome associated with elevated rates of postoperative complications as shown for several malignant entities, including head and neck cancer. A specific screening instrument to assess frailty in head and neck patients does not exist. Both the FRAIL Scale and the G8 questionnaire are well-established and easy to use as screening tools. The present study’s aim was to assess the potential of frailty screening to predict postoperative complications in head and neck patients prior to surgery. Patients and methods: We recorded demographic data, pre-existing medical conditions and clinical characteristics in a prospective cohort of 104 head and neck cancer patients undergoing major head and neck surgery and assessed frailty prospectively on the day of admission utilizing the G8 questionnaire and the FRAIL Scale. We analyzed the link between occurrence of postoperative complications up to the twenty-first postoperative day and age, frailty and other covariates using χ2 tests and receiver operating characteristic (ROC) curves. Results: There was no significant correlation between patients’ pre-existing medical conditions and postoperative complications. Whereas chronological age alone did not predict the occurrence of postoperative complications, frailty posed the highest risk for complications. Frailty according to either the G8 questionnaire or the FRAIL Scale predicted occurrence of complications with an area under the curve (AUC) of 0.64 (p = 0.018) and 0.62 (p = 0.039) and severe complications with an AUC of 0.72 (p = 0.014) and 0.69 (p=0.031), respectively. Neither frailty score correlated with age or with each other. Conclusion: Prospective screening using the FRAIL Scale or the G8 questionnaire reliably detected frailty in our sample group. Frailty is linked to increased risk of postoperative complications. The correct prediction of severe postoperative complications as shown identifies vulnerable cases and triggers awareness of potential complications. Anticipating risk allows for a more comprehensive view of the patient and triggers decision making towards risk adjustment, and therefore a selective view of alternative treatment modalities.

In the near future, immunotherapy with checkpoint inhibitors will not only reach the relevant ENT clinics, but also the oncologically integrated ENT practice, since more and more patients under long-term therapy (currently up to 2 years) also have to be seen during clinical follow-up in the specialist practice. In this respect, we also consider as necessary that the basics of immuno-oncology in head and neck tumors are already taught as part of the ENT specialist training. In this review article, the background and the definitions of the therapy sections (first, second line treatment, marker, etc.) should be discussed in detail and the basic tools for understanding this new therapy option should be provided. Since 2017, we have been experiencing a high level of approval dynamics for checkpoint inhibitors in Germany, which is to be assessed as an expression of a new effective principle of action and, after surgery, radiation and chemotherapy, is establishing a fourth strong pillar in the multimodal spectrum against head and neck tumors. Right from the start, the checkpoint inhibitors in the first phase 1b, 2 and 2b studies achieved overall response rates of 16-22 % with overall survival rates of 6-8 months in seriously ill patients with HNSCC who already had a first- and/or even second-line therapy. Nivolumab and Pembrolizumab are currently approved in Germany for the first and second line therapy of relapsed/metastatic squamous cell carcinoma of the head and neck region (HNSCC), Cemiplimab for recurrent/metastatic cutaneous squamous cell carcinoma and Avelumab for metastatic recurrent Merkel-cell carcinoma. The synopsis article about immune checkpoint inhibitors is intended to convey the basic understanding of the principle of action, the indication, toxicity management and the further development within trials in head and neck oncology.

Background Compared with other malignancies, head and neck cancer (HNC) increases the risk of not returning to work (RTW). Methods Within a cross-sectional study, patients with HNC filled out the OncoFunction questionnaire, a version of the International Classification of Functioning Core Sets for HNC. In 231 patients below 65 years of age, associations of sociodemographic, clinical, functional, and psychological factors with employment and participation in rehabilitation program were explored. Results Unemployed patients reported more swallowing difficulties and speaking problems. Being unemployed was associated with higher levels of depressive and anxiety symptoms, fatigue, and lower global health. Rehabilitation participation was not significantly associated with any of the assessed factors except for smoking. Conclusions Unemployed patients with HNC are more burdened than employed patients with HNC regarding clinical, psychological, and functional factors. These differences are more evident later in recovery. Rehabilitation participation was not associated with psychological and functional burden which indicates the need for tailored HNC rehabilitation programs.

The disease and treatment of patients with head and neck cancer can lead to multiple late and long-term sequelae. Especially pain, psychosocial problems, and voice issues can have a high impact on patients' health-related quality of life. The aim was to show the feasibility of implementing an electronic Patient-Reported Outcome Measure (PROM) in patients with head and neck cancer (HNC). Driven by our department's intention to assess Patient-Reported Outcomes (PRO) based on the International Classification of Functioning during tumor aftercare, the program ""OncoFunction"" has been implemented and continuously refined in everyday practice. The new version of ""OncoFunction"" was evaluated by 20 head and neck surgeons and radiation oncologists in an interview. From 7/2013 until 7/2017, 846 patients completed the PROM during 2,833 of 3,610 total visits (78.5%). The latest software version implemented newly developed add-ins and increased the already high approval ratings in the evaluation as the number of errors and the time required decreased (6 vs. 0 errors, 1.35 vs. 0.95 min; p

Comorbidity reduces treatment options for patients with head and neck cancer (HNC). Utilization of ICD-10 codes instead of manual research may facilitate estimation of comorbidity relevant for decision-making in the interdisciplinary tumor board (TB). Providing this information immediately in an intuitively ascertainable way whenever registering a patient for the TB would trigger awareness for comorbidities and shows potentially missing information.Administrative data was extracted of four databases at our clinic (hospital information system (HIS*-MED), the clinic's tumor database, OncoFlow29 073 ICD-10 codes of 2087 HNC patients were extracted. Matched data are immediately made available whenever registering a patient for the TB and are visualized in a pictogram within OncoFlowThe high prevalence of comorbidities in HNC patients with impact on their eligibility for particular treatment indicates the usefulness of our algorithm for providing automatic comorbidity assessment from administrative data for clinical routine and requires high quality of coding diagnoses.Komorbidität beeinflusst die für die kurative Therapie von Kopf-Hals-Karzinomen (HNC) verfügbaren Optionen. Das manuelle Zusammentragen der Nebenerkrankungen vor der Anmeldung im interdisziplinären Tumorboard (TB) ist zeitintensiv und oft unvollständig. Eine automatisierte Erfassung von nach ICD-10 kodierten Komorbiditätsdaten und deren Darstellung könnte die therapeutische Entscheidungsfindung im TB verbessern sowie bestehenden Informationsbedarf aufzeigen.Die ICD-10-Codes unserer Patienten wurden aus 4 Datenbanken (hospital-information-system (HIS*-MED), der klinikinternen Tumordatenbank, OncoFlow29 073 ICD-10-Codes von 2087 Patienten mit HNC wurden extrahiert. Die Anmeldung eines Patienten im TB triggert die sofortige automatische Erfassung und Visualisierung der Daten als Piktogramm in OncoFlow. Dies ermöglicht die schnelle Erfassung und Bewertung der Komorbidität sowie erforderlicher Diagnostik zur Komplettierung der Daten. Die klinikinterne Validationsstudie ergab eine Präzision der durch Datenimport verfügbaren Information zu Diabetes von 95,0 %.Patienten mit HNC weisen häufig für die Therapieentscheidung relevante Nebenerkrankungen auf. Die automatisierte Erfassung der Komorbidität aus administrativen Daten und deren intuitive Darstellung ist ressourcen- und kostengünstig möglich. Voraussetzung ist eine präzise, vollständige Verschlüsselung der Krankheitsdiagnosen.

The voice range profile (VRP) is composed of the speaking VRP (spVRP) and the singing VRP (siVRP). Different examination methods of VRP and effects of interobserver variability were evaluated to define a standard operating procedure (SOP) suitable for the specific use in epidemiological studies. Subsequently the feasibility of the SOP was investigated in a larger number of participants.Cross-sectional study.In a first phase both the spVRP and the siVRP of 51 female students were measured by four differently experienced examiners. Using a cross-over study design the effects of two different recording methods (manual vs automatic) and three different types of instructions given by the examiner (none vs before vs during recording) were investigated. In a second phase, the SOP for VRP recording was tested in the framework of a feasibility study in 110 (55 female and 55 male) participants.The average total investigation time was significantly (P = 0.001) higher for the manual recording method (6.1 minutes ± 1.0) in comparison to the automated (5.5 minutes ± 0.7) recording method. The manual recording method led to significantly lower values of minimum frequency (F0min) (P = 0.013) and minimum intensity (SPLmin) (P0.001) and higher values of the maximum frequency (F0max) (P = 0.005) of the siVRP. The maximum phonation time, F0max, SPLmax of the siVRP and the frequency and intensity of the shouting voice (Level IV) of the spVRP showed significantly (P0.001) higher values when the examiner was allowed to give instructions and advise during the recording. Voice parameters of the siVRP did not show significant associations with the experience of the examiner.Standardization of VRP measurements is important to obtain correct and reproducible data in a reasonable examination time. The SOP proposed here proved to be feasible in the setting of an epidemiological study.

Patients treated for head and neck cancer (HNC) often suffer from severe and visible loss of function as the cancer itself and the side effects of aggressive treatments have the potential to severely affect quality of life. Therefore, the aim of follow-up is not only the early detection of potentially curable recurrences and second primary tumors but also the diagnosis and rehabilitation of functional impairments. Clear guidelines determining the frequency of follow-up visits are missing, and the impact of follow-up visits on patient's prognosis is unclear. An intensive post-treatment follow-up is needed to detect functional impairments and to initiate their treatment. The aim is an optimal rehabilitation of the patients. This article focusses on goals of aftercare treatment and describes the spectrum of long-term sequelae, and the impact of Patient Reported Outcome (PRO) instruments of which three will be introduced.

Einleitung: Die Nachsorge von Kopf-Hals-Tumoren (KHT) fokussiert bisher auf die Therapiekontrolle. Daneben ist die Langzeitfunktionalitat sehr wichtig. Diese wird beobachtet, aber nicht standardisiert erfasst. Zusatzlich bestehen bei den Patienten oft psychoonkologische Komorbiditaten, die die objektive Bewertung erschweren. Aus diesem Grunde wurde von Tschiesner et al. ein auf dem „ICF Core Set for Head and Neck Cancer“ basierender Leitfaden zur Erfassung von funktionellen Beeintrachtigungen bei Patienten mit KHT entwickelt und ein Screening-Tool vorgestellt. Mit den positiven Erfahrungen bei anderen Tumorentitaten wurde eine elektronische Version des Tools entwickelt (OncoFunction). Methoden: In einer Machbarkeitsuntersuchung wurden alle KHT-Patienten der Klinik von 07/13 bis 03/14 eingeschlossen. OncoFunction wurde auf Tablet-PCs zum Selbstausfullen angeboten. Die Ergebnisse standen dem Arzt zu Beginn der Konsultation zur Verfugung und wurden durch den Arztfragebogen erganzt. Bei 202 Patienten wurde die Nutzerfreundlichkeit evaluiert. Ergebnisse: Es fanden 682 Kontakte im Beobachtungszeitraum statt. 530 (77,7%) mal fullten die Patienten den Fragebogen aus. Zudem wurden 470 Arztchecklisten vollstandig ausgefullt. Insgesamt liegen von 68,9% der Kontakte vollstandige Datensatze vor. Zwischen Teilnehmern und Nicht-Teilnehmern wurden keine Unterschiede gesehen. Zusammenfassung: Die Nutzung eines computergestutzten Screening- und Feedbacksystems (OncoFunction) im Alltag war machbar und wurde von den Patienten gut angenommen. Die Patientendaten werden sofort fur den Arzt aufbereitet und ruckgekoppelt, so dass fur Arzt wie Patienten ein sofortiger Nutzen entsteht. Die Daten stehen fur zusatzliche Anwendungen und fur eine standardisierte Verlaufsdokumentation zur Verfugung.

Quality of life measurements are well established in cancer clinical trials. In daily clinical practice, where cancer patients often suffer from disease-specific symptoms and report unmet needs regarding their treatment, these measurements are not systematically implemented. The systematic (often computer-based) assessment of quality of life in daily cancer care has shown to be beneficial for patient-physician communication, symptom management, shared decision-making, and in creating a learning health system. Unfortunately, to date, routine electronic quality of life assessments are usually limited to large cancer facilities. Patient and physician barriers as well as barriers from the administrative side in particular are currently hindering the implementation of these systems into the broad spectrum of clinical cancer care. Cost-effectiveness analyses of existing systems, the inclusion of all relevant stakeholders, and clear implementation guidelines are required to introduce quality of life measurements in clinical cancer practice to improve the treatment of cancer survivors and to create a health care system that addresses all their disease-related needs.