Patient-reported outcomes for dental health, shoulder-neck dysfunction, and overall quality of life after treatment with radiation for head and neck cancer.

Abstract

e23064 Background: The current exploratory cross-sectional study was designed to better characterize survivorship issues among patients treated with radiation for head and neck cancer with regard to dental health, shoulder-neck dysfunction, and overall quality of life. Methods: Patients (n = 58) being seen for follow-up at a radiation oncology clinic at least one year beyond the end of treatment completed three survey questionnaires: the EORTC Core Quality of Life Questionnaire (EORTC QLQ-C30), the EORTC Head and Neck module (EORTC QLQ-H&N35), and an original 18-item Dental Health and Shoulder Function questionnaire. The questionnaires were scored and univariate analyses were performed using the variables of age, radiation dosage, definitive radiation + neck dissection vs. definitive surgery + postoperative radiation, and chemotherapy. Results: Median follow-up was 2.5 years. Of patients surveyed, 35% reported having more problems with their general dental health as compared to before treatment and 38% reported having pain at night in the neck and shoulder; 79% of patients reported being counseled about their dental health prior to treatment while 31% reported being counseled about possible shoulder-neck dysfunction. Patients younger than 65, patients receiving higher doses of radiation, and patients undergoing definitive surgery + postoperative radiation reported a higher burden of functional and symptomatic issues. Conclusions: Patients treated with radiation for head and neck cancer face a number of survivorship issues, including problems with dental health and shoulder-neck dysfunction, and many do not feel that they are adequately counseled about these issues prior to treatment. Subsets of patients who may experience a higher burden of functional and symptomatic issues include patients younger than 65, patients receiving higher doses of radiation, and patients undergoing definitive surgery + postoperative radiation. Increasing pre-treatment counseling for all patients and placing a particular emphasis on supportive care for these subsets of patients may allow us to better support this growing population of cancer survivors.

Physical rehabilitation in patients with head and neck cancer: Impact on health‐related quality of life and suitability of a post‐treatment program

“…The post‐treatment period is normally characterized by gradual recovery and improvement; however, only global health status/QoL seems to reach pretreatment levels within 1 year after treatment completion . Thus, the following year(s) of HNC survivorship is characterized by persistent treatment‐related side effects accompanied by deteriorated functional status …”

A prospective evaluation of neck and shoulder function following treatments of early‐stage human papillomavirus‐associated oropharynx cancer

“…For instance, Verma et al previously found that in a population of patients treated for head and neck SCC, nearly 40% experienced nocturnal neck or shoulder pain but only 31% reported being counselled regarding potential shoulder problems prior to treatment. 17 Additionally, our study observation that patients primarily experienced decline in social and functional activities such as recreation, lifting objects, and performing daily work is especially notable given that persistent reductions in physical activity have been correlated with fatigue and reduced social and emotional well-being in head and neck cancer survivors. 26 Thus, understanding the severity of HPV + OPSCC treatment-induced neck and shoulder pain and identifying patients suitable for referral to physical therapy-based interventions can also help to improve survivorship care.…”

“…15,16 Regardless of aetiology, shoulder pain and dysfunction after oncologic treatment may greatly affect QOL and functional status, including ability to perform daily activity, sleep comfortably, and lift objects. 17 This QOL impact has been well-studied after ND with estimates that even 25%-50% of patients will demonstrate some degree of shoulder deficits postoperatively, even with selective NDs. [18][19][20] The effects of XRT and CXRT have been less well established with conflicting data regarding degree of impact on shoulder function.…”