Clinical Predictors of Quality of Life in Patients With Head and Neck Cancer

Abstract

To identify clinical predictors of quality of life (QoL) in a head and neck cancer patient population.Design, Patients, and Setting: A convenience sample of 570 patients with upper aerodigestive tract cancers were surveyed at a tertiary care oncology clinic and Veterans Affairs otolaryngology clinic.Interventions: A self-administered health survey was constructed to collect demographic, health, smoking, alcohol, depression symptom, and QoL information. Tumor site and tumor stage, clinical, and treatment data were abstracted from the patient medical records.Main Outcome Measures: Quality of life was assessed using the Medical Outcomes Study Short-Form 36-Item Health Survey (SF-36) and the Head and Neck QoL (HNQoL) instrument.Results: Of the 570 eligible respondents, the presence of a feeding tube had the most negative impact on QoL, with significant decrements in 6 of the 8 SF-36 scales and all 4 HNQoL scales (PϽ.01). In descending order of severity, medical comorbid conditions, presence of a tracheotomy tube, chemotherapy, and neck dissection were also associated with significant (PϽ.05) decrements in QoL domains. Patients who took the survey more than 1 year after diagnosis had improved QoL in 7 of 12 domains. Hospital site, age, education level, sex, race, and marital status were also significant predictors of QoL. Conclusion:There are at least 13 demographic and clinical characteristics that are significant predictors of QoL in patients with head and neck cancer, which should be considered when treating patients and conducting QoL studies in the future.

Long-Term Quality of Life After Swallowing and Salivary-Sparing Chemo–Intensity Modulated Radiation Therapy in Survivors of Human Papillomavirus–Related Oropharyngeal Cancer

“…The low frequency of late adverse HRQOL outcomes in the present study contrasts with prior reports demonstrating frequent severe long-term swallowing toxicity after HN chemoradiation using conventional radiotherapy techniques (18), 3D-conformal techniques (1), and IMRT without specific sparing of the swallowing structures (19). Wang et al in a pooled systematic review, for example, reported pharyngoesophageal stricture formation in 17% of 648 patients treated with IMRT for HNC (19).…”

The Experience of Head and Neck Cancer Patients With a Percutaneous Endoscopic Gastrostomy Tube at a Canadian Cancer Center

“…Interestingly, of the respondents who chose a negative answer for the 11 questions related to QoL, very rarely did they pick the extreme negative option. This is in contrast to recent literature revealing a predominantly negative effect on QoL 7 , 11 . Exceptions to the lack of negative responses were noted for the intimacy question.…”

Prognostic indicators of improved survival and quality of life in surgically treated oral cancer

“…35,36 On the other hand, to avoid this risk, 70% to 80% of patients would have to be overtreated, with a likely increase in surgical morbidity. Furthermore, neck dissection is associated with lower QoL scores, as reported in several studies [37][38][39][40][41] and also confirmed by our results. In particular, there were statistically significant differences between QoL and neck dissection type, confirming that more extensive surgery in the neck is associated with greater postoperative morbidity.…”