Quality of life following resection, free flap reconstruction and postoperative external beam radiotherapy for squamous cell carcinoma of the base of tongue1

Abstract

This study was conducted to evaluate quality of life in a cohort of patients with squamous cell carcinoma of the tongue base, treated with primary surgery, reconstruction and postoperative radiotherapy. Twelve patients were assessed in a cross-sectional study using the University of Washington Quality of Life Instrument (UW-QOL). All patients underwent external beam irradiation following primary resection of their tumour and reconstruction. Patients on average reported their overall and health related QOL to be good. Functionally they had good pain control, speech intelligibility, activity and recreational levels. There were some limitations in chewing, swallowing and taste. The results suggest that surgical resection can offer good functional and overall QOL results for advanced tumours when combined with reconstruction. The morbidity associated with postoperative radiotherapy includes reduced swallowing, taste, saliva production and difficulty chewing.

A systematic review of orofacial pain in patients receiving cancer therapy

“…UWQOL is a validated QOL tool, initially developed to assess complex outcomes in patients who received head and neck surgery; therefore, the UWQOL has been most often used in HNC patients with treatment that included surgery [13,14].…”

A systematic review of dysgeusia induced by cancer therapies

“…In another study which followed patients over time, the frequency of dysgeusia as a complaint decreased over time [22]. In all studies, the severity of dysgeusia was rated as mild [2,8,17,22,34]. In four before and after (i.e., quasi-experimental, noncontrolled, non-randomized) studies involving RT alone, the rate of dysgeusia ranged from 16-100% [7,8,19,22] and was usually reported as mild to moderate in severity.…”

Functional outcomes after surgical reconstruction of the base of tongue using the radial forearm free flap in patients with oropharyngeal carcinoma

“…More recently, surgical treatments for cancer of the tongue base have evolved from simple primary closure. For larger defects, rectus myocutaneous flaps, 15,16 pectoralis major myocutaneous flaps, 17 and fasciocutaneous flaps, 18 such as the radial forearm free flap, 12,15,19 have been used. Surgical reconstructive techniques have continued to advance such that the historical perspective of dismissing surgery because of poor functional outcomes must be revisited.…”