The course of health-related quality of life in head and neck cancer patients treated with chemoradiation: a prospective cohort study

Radiother Oncol. 2014 Mar;110(3):422-8. doi: 10.1016/j.radonc.2014.01.002. Epub 2014 Feb 25.

Abstract

Background and purpose: To evaluate the course of health-related quality of life (HRQOL) from diagnosis to 2 years follow-up in patients with head and neck cancer (HNSCC) treated with chemoradiation (CRT).

Materials and methods: 164 patients completed the EORTC QLQ-C30 and QLQ-H&N35 questionnaires 1 week before and 6 weeks and 6, 12, 18, and 24 months after CRT. Patients were compared to a reference group. A linear mixed-model analysis was used to assess changes in HRQOL over time, and whether this was associated with age, gender, comorbidity, and tumor sublocation.

Results: Significant differences for the majority of HRQOL scales were observed between patient and reference group at baseline, and follow-up. The course of HRQOL was different for survivors compared to non-survivors. In survivors, improvement over time was observed (in global quality of life, physical, role, and social function, fatigue, pain, swallowing, speech, social eating, and social contacts), while in non-survivors the pattern over time was either no changes in HRQOL or a deterioration (in physical function, social eating and contacts). In both survivors and non-survivors, emotional functioning improved after treatment, but deteriorated in the longer term. Patients with comorbidity reported worse physical function, and patients with oral/oropharyngeal cancer (compared to hypopharyngeal/laryngeal cancer) reported more oral pain and sexual problems, but fewer speech problems.

Conclusions: The course of HRQOL of HNSCC patients during the first 2 years after CRT is different for survivors compared to non-survivors and is associated with comorbidity and tumor subsite.

Keywords: Chemoradiation; Head and neck cancer; Quality of life; Radiotherapy; Survival.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / psychology
  • Carcinoma, Squamous Cell / therapy*
  • Chemoradiotherapy*
  • Cohort Studies
  • Female
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / psychology
  • Head and Neck Neoplasms / therapy*
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Quality of Life*
  • Squamous Cell Carcinoma of Head and Neck
  • Surveys and Questionnaires
  • Survivors