Differences in health related quality of life in the randomised ARTSCAN study; accelerated vs. conventional radiotherapy for head and neck cancer. A five year follow up

Johanna Nyqvist; Per Fransson; Göran Laurell; Eva Hammerlid; Elisabeth Kjellén; Lars Franzén; Karin Söderström; Gun Wickart-Johansson; Signe Friesland; Helena Sjödin; Eva Brun; Anders Ask; Per Nilsson; Lars Ekberg; Thomas Björk-Eriksson; Jan Nyman; Britta Lödén; Freddi Lewin; Johan Reizenstein; Erik Lundin; Björn Zackrisson

doi:10.1016/j.radonc.2015.12.024

Differences in health related quality of life in the randomised ARTSCAN study; accelerated vs. conventional radiotherapy for head and neck cancer. A five year follow up

Radiother Oncol. 2016 Feb;118(2):335-41. doi: 10.1016/j.radonc.2015.12.024. Epub 2016 Jan 6.

Authors

Johanna Nyqvist¹, Per Fransson², Göran Laurell³, Eva Hammerlid⁴, Elisabeth Kjellén⁵, Lars Franzén⁶, Karin Söderström⁶, Gun Wickart-Johansson⁷, Signe Friesland⁷, Helena Sjödin⁷, Eva Brun⁵, Anders Ask⁵, Per Nilsson⁵, Lars Ekberg⁵, Thomas Björk-Eriksson⁸, Jan Nyman⁸, Britta Lödén⁹, Freddi Lewin¹⁰, Johan Reizenstein¹¹, Erik Lundin¹⁰, Björn Zackrisson⁶

Affiliations

¹ Department of Otolaryngology and Head and Neck Surgery, Skåne University Hospital, Lund, Sweden; Department of Clinical Science Otolaryngology and Head and Neck Surgery, Umeå University, Sweden. Electronic address: [email protected].
² Department of Nursing, Umeå University, Sweden.
³ Department of Clinical Science Otolaryngology and Head and Neck Surgery, Umeå University, Sweden; Department of Otolaryngology and Head and Neck Surgery, Uppsala University Hospital, Sweden.
⁴ Department of Otolaryngology and Head and Neck Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
⁵ Department of Oncology and Radiation Physics, Skåne University Hospital, Lund University, Sweden.
⁶ Department of Radiation Sciences, Oncology, Umeå University, Sweden.
⁷ Department of Oncology, Karolinska University Hospital, Stockholm, Sweden.
⁸ Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden.
⁹ Department of Clinical Oncology, Karlstad Central Hospital, Sweden.
¹⁰ Department of Oncology, Ryhov County Hospital, Jönköping, Sweden.
¹¹ Department of Oncology, Örebro University Hospital, Sweden.

PMID: 26777124
DOI: 10.1016/j.radonc.2015.12.024

Abstract

Background and purpose: Health related quality of life (HRQoL) was assessed in the randomised, prospective ARTSCAN study comparing conventional radiotherapy (CF) with accelerated radiotherapy (AF) for head and neck cancer.

Material and methods: 750 patients with squamous cell carcinoma (of any grade and stage) in the oral cavity, oro-, or hypopharynx or larynx (except T1-2, N0 glottic carcinoma) without distant metastases were randomised to either conventional fractionation (2 Gy/day, 5 days/week in 49 days, total dose 68 Gy) or accelerated fractionation (1.1+2.0 Gy/day, 5 days/week in 35 days, total dose 68 Gy). HRQoL was assessed with EORTC QLQ-C30, QLQ-H&N35 and HADS at baseline, at end of radiotherapy (eRT) and at 3 and 6 months and 1, 2 and 5 years after start of treatment.

Results: The AF group reported HRQoL was significantly lower at eRT and at 3 months for most symptoms, scales and functions. Few significant differences were noted between the groups at 6 months and 5 years. Scores related to functional oral intake never reached baseline.

Conclusion: In comparison to CF, AF has a stronger adverse effect on HRQoL in the acute phase.

Keywords: Accelerated fractionation; Accelerated radiotherapy; Head and neck cancer; Health related quality of life; Quality of life.

Publication types

Comparative Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Aged, 80 and over
Carcinoma, Squamous Cell / radiotherapy*
Dose Fractionation, Radiation
Female
Follow-Up Studies
Head and Neck Neoplasms / radiotherapy*
Humans
Male
Middle Aged
Prospective Studies
Quality of Life*