Importance of patient, tumour and treatment related factors on quality of life in head and neck cancer patients after definitive treatment

Abstract

The purpose of this study is to assess patient, tumour and treatment related factors on quality of life (QoL) outcomes of patients who received definitive or postoperative radiotherapy +/- chemotherapy for head and neck (H&N) cancer. In this cross-sectional study, 110 H&N cancer patients were evaluated in follow-up visit and were asked to fill out the European Organisation for Research and Treatment of Cancer QoL Core Questionnaire (QLQ-C-30) and H&N Module (QLQ-H&N35). Patients were also graded for their late side effects using EORTC/RTOG scoring system. The QLQ C-30 and QLQ-H&N35 mean scores were compared using ANOVA analysis for these variables: age, gender, occupation, educational status, social security status, place of residence, tumour localization, clinical stage, comorbidity, Karnofsky performance score, treatment modality and side effects. Median follow-up was 29 (4-155) months. Tumour localization was significant factor affecting physical (P = 0.03), social (P = 0.01), cognitive (P = 0.002) functioning. Treatment modality had significant impact on the physical (P = 0.02) and cognitive scores (P = 0.008). Global QoL was affected significantly by disease stage (P = 0.01) and occupation (P = 0.01). The QLQ-H&N35 scores were found significantly higher in patients with moderate/severe late morbidity. Tumour localization and the treatment modality are the most important factors affecting the QoL of H&N cancer patients treated definitively.

Mode of treatment affects quality of life in head and neck cancer survivors: Implications for holistic care

“…Data from the validated Cantonese version of EORTC QLQ-H&N35 supported the findings of Alicikus and co-workers [3] that patients receiving combination therapy suffered greater impairment of quality of life than single-therapy patients. The Turkish study did not include a surgery-only group, offering most information about the effects of radiotherapy.…”

“…Swallowing difficulties were an independent predictor of low total quality of life score, while trouble with social contact and having a dry mouth were two significant independent predictors of low global general health [1]. Previous work in this patient group has evaluated quality of life from the perspective of disease severity before intervention, according to the site of the primary and in response to specific treatments [2,3]. However, since the H&N cancer presenting to our institution is usually either late stage or large in size, appropriate treatment is multimodal.…”

Influence of social factors on patient‐reported late symptoms: Report from a controlled trial among long‐term head and neck cancer survivors in Denmark

“…As in our study, an effect of educational level and marital status was found with these overall measures; however, detailed information on late effects was not available, which may limit the usefulness of those results in a clinical context, in view of the wide individual diversity in the occurrence, severity, and social consequences of late symptoms after head and neck cancer. An exception is a study by Alicikus et al who used the EORTC‐QLQ‐C‐30 and the QLQ‐H&N35 to investigate the associations among patient, tumor, and treatment‐related factors and QOL in 110 patients with head and neck cancer a median of 29 months after treatment; the patients were also graded for late effects with the Radiation Therapy Oncology Group scoring system. QLQ‐H&N35 scores were significantly higher in patients with moderate‐to‐severe late morbidity and were associated with age, sex, and Karnofsky performance score for functional impairment, whereas social security status and length of education had no significant effect on any of the assessed symptoms.…”

ICF Core Set for head and neck cancer

“…Different tumour locations in the upper aerodigestive tract have influence on both survival rates and functional outcome (Laenger and Laenger, 2004;Alicikus et al, 2009). Larger tumour stages at the point of diagnosis are related not only to decreased survival but also worse functional outcome and specific rehabilitation needs later on (Laenger and Laenger, 2004;Borggreven et al, 2007;Weymuller and Bhama, 2007;Alicikus et al, 2009).…”