Background
The rising number of cancer patients and the increased use of aggressive multimodal treatment and modern radiotherapy techniques have changed the characteristics of cancer survivors. Cancer treatment may affect patients' quality of life, daily living, and oral health. The emergence of targeted and immune therapies and the increased use of bone-modifying agents in cancer have resulted in new oral toxicities.
Outcomes
PhD-thesis evolved from this project:
Petter Wilberg (2016) – “Oral adverse effects during and after treatment in patients and survivors of cancers outside the head and neck region”
One paper of the Thesis of Håvard Hynne (2022) – “Clinical aspects and potential biomarkers in dry mouth and dry eye disease”
Kristine Eidal Tanem (2023) – “Oral and dental late effects after treatment of cancer at a young age”
Kristine Løken Westgaard (ongoing PhD-project)
Ongoing studies
- The Norwegian multidisciplinary head and neck survivorship project; Survivorship and late effects in head and neck cancer survivors
- Oral health in head and neck cancer survivors
- The European Organisation for Research and Treatment of Cancer – Late toxicity and long-term quality of life in head and neck cancer survivors
Study 1. The Norwegian multidisciplinary head and neck survivorship project; Survivorship and late effects in head and neck cancer survivors
Scientific knowledge about late effects in head and neck cancer (HNC) survivors of today is scarce. This knowledge gap hampers initiation of preventive measures in patients at risk and proper management of late effects in the growing population of HNC survivors.
The rising proportion of human papillomavirus (HPV) induced cancer, increased use of aggressive multimodal treatment and modern radiotherapy techniques have changed the characteristics of the HNC survivors. They are now younger, with less tobacco and alcohol-induced comorbidity and probably, the range of late effects is different from before. Based on clinical experience some of these survivors experience a wide range of late effects that negatively affect their quality of life and daily function.
This project will provide new knowledge on late effects also in the oral cavity after modern treatment in long-term (more than five years post-treatment) survivors of HNC.
Project participants
Cecilie Delphin Amdal (Principal Investigator)
Tien Maria Huynh (PhD-student)
Bente Brokstad Herlofson
Kristine Løken Westgaard (PhD-student)
Aass HCD
Ragnhild Sørum Falk
Guro L. Astrup
Åse Helland
Trine Bjøro
Kristin Bjordal
Einar Dale
Taran P Hellebust
Eirik Malinen
Cecilie E Kiserud
Terje Osnes
Study 2. Oral health in head and neck cancer survivors
This PhD project is focusing on oral health and prevalence of, and factors associated with, oral late effects in HNC survivors beyond five years of survival. The lack of knowledge on oral late effects in long-term HNC survivors leaves this group at significant risk of having persistent symptoms without appropriate follow-up.
It is part of the Norwegian multidisciplinary HNC survivorship project that will include the characterization of a broad range of late effects. The current project is also part of project number 3; International EORTC (European Association of Research and Treatment of Cancer) multi-center study on late toxicity and health-related quality of life (HRQL) in HNC survivors that will investigate long-term HRQL, healthcare use and employment. Fifty of the Norwegian patients will be included in the international study.
This project will increase the awareness and focus on oral health as an integrated aspect of general health and wellbeing. The results may also lead to tailored intervention studies to improve symptom management in HNC survivors in general, with a specific focus on oral health related quality of life.
This PhD project falls into the Faculty`s priority research area; “Health promotion and prevention activities”.
Project participants
Kristine Løken Westgaard, PhD-student
Bente Brokstad Herlofson, main supervisor
Cecilie Delphin Amdal, co-supervisor
Ragnhild Sørum Falck, co-supervisor
Petter Wilberg, co-supervisor
Katherine Taylor, Mainz, Germany
Susanne Singer, Mainz, Germany
Frederic Duprez, Ghent, Belgium
Eva Hammerlid, Gothenburg, Sweden
Max Krueger, Mainz, Germany
Carmen Stromberger, Berlin, Germany
Orlando Guntinas-Lichius, Jena, Germany
Noa Stempler, Tel Aviv, Israel
Noam Yarom, Tel Aviv, Israel
Maria Kouri, Athens, Greece
Study 3. The European Organisation for Research and Treatment of Cancer – Late toxicity and long-term quality of life in head and neck cancer survivors
This is an International EORTC (European Association of Research and Treatment of Cancer) multi-center study on late toxicity and health-related quality of life (HRQL) in HNC survivors that will investigate long-term HRQL, health care use and employment.
Little is known about late effects of head and neck cancer (HNC) treatment on quality of life. HNC accounts for approximately 550,000 new cases each year worldwide. In Europe, an estimated number of 39,900 new cases of laryngeal cancer and 99,600 new cases of oral cavity and pharyngeal cancers occur per year. About 30% of them survive up to 10 years, 20% up to 15 years post-diagnosis.
For the first year after treatment, good evidence on toxicity and QoL is available. HNC and its treatments affect a variety of body functions, most notably salivary function, breathing, swallowing, and speaking. As these functions are highly relevant for daily life, HNC can cause considerable physical, emotional and social problems.
The aim of this project is to investigate the toxicity and QoL of long-term (> 5 years) HNC survivors to identify factors that can improve QoL and decrease toxicity and to be able to inform patients about potential late sequelae.
Project participants
Principal Investigators
Susanne Singer, Mainz, Germany
Vincent Grégoire, Brussels, Belgium
Study Coordinator
Katherine Taylor, Mainz, Germany
Researcher Cost Evaluations
Femke Jansen, Amsterdam, The Netherlands
Sub-Project Leaders
- Toxicity: Paolo Bossi, Lisa Licitra, Milan, Italy
- Oral Health: Bente Brokstad Herlofson, Oslo, Norway
- Cost Evaluations: Irma Verdonck-de Leeuw, Amsterdam, The Netherlands
Project Manager at EORTC Headquarters
Melanie Beauvois, Brussels, Belgium
EORTC Survivorship Programme coordinator
Lifang Liu, Brussels, Belgium
Co-Investigators
Dina Aly, Cairo, Egypt
Cecilie Delphin Amdal, Oslo, Norway
Guro Astrup, Oslo, Norway
Amin Ayman, Cairo, Egypt
Emilie Beulque, Nancy, France
Kristin Bjordal, Oslo, Norway
Andreas Boehm, Leipzig, Germany
Pierluigi Bonomo, Florence, Italy
Paolo Bossi, Milano, Italy
Bente Brokstad Herlofson, Oslo, Norway
Joaquim Castro Silva, Porto, Portugal
Andreas Dietz, Leipzig, Germany
Gilles Dolivet, Nancy, France
Tatiana Dragan, Brussels, Belgium
Fréderic Duprez, Ghent, Belgium
Zeinab Elsayed, Cairo, Egypt
Cherry Estilo, New York, USA
Razvan Galalae, Gelsenkirchen, Germany
Rachel Galot, Brussels, Belgium
Cesare Grandi, Trento, Italy
Thordis Granitzka, Jena, Germany
Vincent Grégoire, Brussels, Belgium
Orlando Guntinas-Lichius, Jena, Germany
Eva Hammerlid, Gothenburg, Sweden
Marcus Hezel, Hamburg, Germany
Johanna Inhestern, Jena, Germany
Femke Jansen, Amsterdam, The Netherlands
René Leemans, Amsterdam, The Netherlands
Lisa Licitra, Milano, Italy
Jean-Pascal Machiels, Brussels, Belgium
Siano Marco, St. Gallen, Switzerland
Atsushi Motegi, Chiba, Japan
Sjoukje Oosting, Groningen, The Netherlands
Monica Pinto, Naples, Italy
Katja Polz, Gelsenkirchen, Germany
Aron Popovtzer, Tel Aviv, Israel
Judith Raber-Durlacher, Amsterdam, The Netherlands
Eva Remenar, Budapest, Hungary