Intensity-modulated radiotherapy is associated with improved global quality of life among long-term survivors of head-and-neck cancer.

Abstract

PURPOSE:

To compare the long-term quality of life among patients treated with and without intensity-modulated radiotherapy (IMRT) for head-and-neck cancer.

METHODS AND MATERIALS:

The University of Washington Quality of Life instrument scores were reviewed for 155 patients previously treated with radiation therapy for locally advanced head-and-neck cancer. All patients were disease free and had at least 2 years of follow-up. Eighty-four patients (54%) were treated with IMRT. The remaining 71 patients (46%) were treated with three-dimensional conformal radiotherapy (3D CRT) by use of initial opposed lateral fields matched to a low anterior neck field.

RESULTS:

The mean global quality of life scores were 67.5 and 80.1 for the IMRT patients at 1 and 2 years, respectively, compared with 55.4 and 57.0 for the 3D CRT patients, respectively (p < 0.001). At 1 year after the completion of radiation therapy, the proportion of patients who rated their global quality of life as "very good" or "outstanding" was 51% and 41% among patients treated by IMRT and 3DCRT, respectively (p = 0.11). At 2 years, the corresponding percentages increased to 73% and 49%, respectively (p < 0.001). On multivariate analysis accounting for sex, age, radiation intent (definitive vs. postoperative), radiation dose, T stage, primary site, use of concurrent chemotherapy, and neck dissection, the use of IMRT was the only variable independently associated with improved quality of life (p = 0.01).

CONCLUSION:

The early quality of life improvements associated with IMRT not only are maintained but apparently become more magnified over time. These data provide powerful evidence attesting to the long-term benefits of IMRT for head-and-neck cancer.

• Authors: Allen M Chen, D Gregory Farwell, Quang Luu, Esther G Vazquez, Derick H Lau, James A Purdy
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 84 Issue 1 Pg. 170-5 (Sep 01 2012) ISSN: 1879-355X [Electronic] United States
• PMID: 22300572 (Publication Type: Journal Article)
• Copyright: Copyright © 2012 Elsevier Inc. All rights reserved.

Topics

• Adult
• Aged
• Aged, 80 and over
• Carcinoma, Squamous Cell (radiotherapy)
• Female
• Head and Neck Neoplasms (radiotherapy)
• Health Status
• Humans
• Male
• Middle Aged
• Multivariate Analysis
• Quality Improvement (standards)
• Quality of Life
• Radiotherapy, Conformal (standards)
• Radiotherapy, Intensity-Modulated (standards)
• Survivors
• Young Adult