Factors influencing quality of life in patients during radiotherapy for head and neck cancer

Abstract

IntroductionRadiotherapy (RT) in combination with chemotherapy is a standard of care for patients with head and neck squamous cell carcinoma (HNSCC). The RT is associated with side effects, which impact on quality of life (QoL). Thus, the aim of this prospective longitudinal study was to investigate the impact of RT on the QoL of patients with HNSCC during RT.Material and methodsFrom September 2008 to February 2010, 205 patients with locally advanced HNSCC were enrolled. The data pertaining to their QoL were collected using the EORTC QLQ-C30 and the EORTC Head and Neck Module (QLQ-H&N35) and then all items were transformed to a 0-100 scale according to the guidelines of the EORTC. The following clinical factors were chosen to study their potential influence on the QoL; site of primary, clinical stage, and methods of therapy: RT vs. chemoradiotherapy (CRT). Additionally, the sociodemographic factors (age, gender, education, habit of smoking) were studied.ResultsDeterioration of almost all scales and items in the QLQ-C30 and QLQ-H&N35 questionnaire were noted at the end of RT. The following factors negatively influenced the QoL: age < 60 years (p < 0.05), female gender (p < 0.05), habit of smoking (p < 0.01), advanced clinical stage (III and IV) (p < 0.05), site of primary (larynx, hypopharynx) (p < 0.01), and CRT (p < 0.01).ConclusionsOur study showed that RT significantly negatively influenced QoL at the end of the RT course. Additionally, this study demonstrated that age, gender, smoking habit, tumor site, and clinical stage of disease showed a significant effect on the QoL of HNSCC patients during RT.

Symptom burden and patient characteristics: Association with quality of life in patients with head and neck cancer undergoing radiotherapy

“…There are conflicting reports on the associations between demographic and clinical characteristics and QOL in previous studies, and a number of studies found no associations. Among those that did, age seemed to be related to different QOL aspects; younger patients reported better physical functioning but poorer emotional functioning, global health status, and overall QOL . Being unmarried, having less social support, unemployment, smoking, and alcohol abuse were associated with poorer QOL in previous studies, whereas conflicting results were reported for the effect of education and socioeconomic status .…”

“…Among those that did, age seemed to be related to different QOL aspects; younger patients reported better physical functioning but poorer emotional functioning, global health status, and overall QOL . Being unmarried, having less social support, unemployment, smoking, and alcohol abuse were associated with poorer QOL in previous studies, whereas conflicting results were reported for the effect of education and socioeconomic status . In terms of clinical characteristics, tumor site, advanced stage of disease, comorbidity, lower physical functioning, and having a feeding tube or tracheostomy were associated with decrements in different QOL dimensions.…”

“…Nine longitudinal studies in patients with head and neck cancer undergoing RT evaluated limited numbers of mostly demographic and clinical factors for associations with QOL. Most of them found that QOL deteriorated after initiation; however, several studies did not include assessments during RT . Therefore, the purposes of this study were to evaluate changes in overall physical and mental QOL from initiation of RT through the following 6 months, and examine which factors were associated with physical and mental QOL scores during this time period, with a specific focus on the impact of symptoms.…”

Burden of treatment: Reported outcomes in a head and neck cancer survivorship clinic

“…Although gender is not commonly considered a predictive variable for QOL or symptoms burden, previous studies have shown that the female gender has a negative influence on QOL and emotional distress . However, the results of our study and previous studies may be related to the unequal distribution of gender, which creates a site and treatment effect; moreover, the symptoms scores for anxiety and depression utilized for this analysis were based on the two‐question version. Although these tools have been validated, more variability in scores may have been seen if the full version was provided to each survivor.…”

Chlorin e6-Encapsulated Polyphosphoester Based Nanocarriers with Viscous Flow Core for Effective Treatment of Pancreatic Cancer

“…2 As the unique approved treatment agent for pancreatic cancer in clinical, unfortunately, gemcitabine show poor efficacy, drug resistance, and side effects. [3][4][5] It is desired to develop effective methods to improve the therapeutic efficacy in clinic.…”