Predictors of quality of life in head and neck cancer survivors up to 5 years after end of treatment: a cross-sectional survey

Abstract

Abstract:Purpose This study aimed to assess quality of life (QoL) in head and neck cancer (HNC) survivors, and determine factors predictive of poor QoL in the first five years after the end of treatment. Methods A cross-sectional survey, including the Quality of Life in Adult Cancer Survivors (QLACS) measure, was sent to HNC survivors in three Scottish health regions, with responses linked to routinely collected clinical data. Independent sample t-tests, ANOVAs, Pearson correlations and multiple hierarchical regressions were used to explore associations between and to determine the contribution made by demographic, lifestyle and clinical factors to predicting 'generic' and 'cancer-specific' quality of life. Results 280 patients (65%) returned questionnaires. After adjustment, multivariate analysis showed that younger age, lower socio-economic status, unemployment and selfreported comorbidity independently contributed to poorer generic and cancer-specific quality of life. In addition to these factors, having had a feeding tube or a diagnosis of oral cavity cancer were independently predictive of poorer cancer-specific quality of life. Conclusions Socio-economic factors and co-morbidity are important predictors of QoL in HNC survivors. These factors and the detrimental long-term effects of feeding tubes need Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporationfurther attention in research and practice.

Preradiotherapy dental extractions and health-related quality of life

“…This is in keeping with the literature showing head and neck cancer patients present with high dental needs and unmanaged risk factors, poor oral health literacy and low engagement with the dental profession, often persisting post-treatment [4,15,16]. 15.5% (20) of those having pre-RT dental extractions went on to have post-RT dental extractions, with only 10 participants having post-RT extractions alone.…”

“…Smoking status has been found to be a predictor of not only post-treatment oral health related quality of life, but general health related quality of life in head and neck cancer survivors [20], and the current study confirms this relationship extends to a tiered system where current smokers, ex-smokers and non-smokers have improving quality of life. Additionally, our study confirms the previous findings that p16 positive cases have better quality of life over their counterparts [21], often attributed to improved survival, younger age and lack of smoking, although other studies have found no difference [22].…”

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 .…”

Pre-radiotherapy dental extractions and osteoradionecrosis: a retrospective analysis and cross-sectional study on quality of life

“…Smoking status has been found to be a predictor of not only post-treatment oral health related quality of life, but general health related quality of life in head and neck cancer survivors [8], and the current study confirms this relationship extends to a tiered system where current smokers, ex-smokers and non-smokers have improving quality of life.…”

“…Additionally, RT as a treatment modality is highly morbid, with impacts on speech, mastication, appearance and social interaction [7]. While treatments are designed to reduce disease and prolong survival, there has been a recent emphasis on the quality of life effects of treatment [8,9]. A healthy dentition may appear secondary to prolonged survival, however it should not be disregarded as an important factor in quality of life, as the stomatognathic system is central in aesthetics, communication and diet.…”