Long‐term quality of life after definitive treatment of sinonasal and nasopharyngeal malignancies

Abstract

Objective: To evaluate long-term global and site-specific health-related quality of life (HRQoL) in patients treated for sinonasal and nasopharyngeal malignancies.Study Design: Cross-sectional. Methods: One hundred fourteen patients with sinonasal and nasopharyngeal malignancies received surgery, radiation, systemic chemotherapy, or a combination thereof, with curative intent. Validated global ([EuroQol-5D] Visual Analogue Scale [EQ-5D VAS]) and disease-specific instruments (MD Anderson Symptom Inventory-Head and Neck [MDASI-HN], Anterior Skull Base Questionnaire [ASBQ]) were administered to patients who were both free of disease and had completed treatment at least 12 months previously. Associations between instruments, instrument domains, and specific clinical parameters were analyzed.Results: The median age was 55 years. The mean EQ-5D VAS, MDASI-22 composite score, and ASBQ score were 74 (standard deviation [SD] 21), 48 (SD 36), and 130 (SD 27), respectively. The most frequently reported high-severity items in MDASI-HN were dry mouth and difficulty tasting food. The most frequently reported high-severity items in ASBQ were difficulty with smell and nasal secretions. Advanced Tumor (T) classification was associated with worse overall ASBQ sum score (P = 0.02). ASBQ performance at home and MDASI-HN drowsy symptom items independently predicted worse global HRQoL as measured by the EQ-5D VAS (P < 0.001).Conclusion: Global HRQoL for survivors of sinonasal and nasopharyngeal malignancies after multimodality treatment approximates that of the U.S. population for the same age group. ASBQ and MDASI-HN correlate well with global HRQoL outcomes as measured by EQ-5D VAS. MDASI-HN and ASBQ elicited unique symptoms, highlighting the complex symptom burden experienced by these patients. Further studies should identify patients predisposed to reduced long-term QOL.

Quality of Life Outcomes in Patients With Sinonasal Malignancy After Definitive Treatment

“…Recently, the Anterior Skull Base Surgery Questionnaire (ASBSQ) was developed and validated as a multidimensional measure of QOL in patients with anterior skull base tumors treated with surgery. 4,7,20 The domains involved in the ASBSQ include performance, physical function, vitality, pain, influence on emotions, and specific symptoms related to skull base tumors. Similarly, this study evaluates the morbidity of SNM in the domains of psychiatric, emotional, functional, physical, social, and site-specific impact.…”

“…FACT-NP subscale score distribution. The median physical, social, emotional, and functional well-being scores were 25 (21)(22)(23)(24)(25)(26)(27), 24 (19.9-27), 20 (16)(17)(18)(19)(20)(21)(22)(23), and 20 (14.5-27), respectively. The median subsite specific score was 47 (39-53.7).…”

“…The median of the 4 general subscales ranged from 20 to 25 with physical well-being subscale having the highest median score, 25 (21-27) (Fig. 2) and the emotional and functional well-being subscale having the lowest median scores, 20 (16)(17)(18)(19)(20)(21)(22)(23) and 20 (14.5-27), respectively. The nasopharyngeal subscale median score was 47 (39-53.7).…”

Radiooncological View on Therapy Outcome after Multidisciplinary Treatment of Sinonasal Tumors

“…Xerostomia and dysgeusia are the most frequent late radiation side effects than changes in the sense of smell and dry nose after RT [ 30 ]. Chronic side effects influence the quality of life (QoL) of long-term survivors [ 30 ].…”

“…Xerostomia and dysgeusia are the most frequent late radiation side effects than changes in the sense of smell and dry nose after RT [ 30 ]. Chronic side effects influence the quality of life (QoL) of long-term survivors [ 30 ]. Before treatment decisions are made, all cases should be discussed within a multidisciplinary team to ascertain the best treatment option for the individual patient.…”