Residual deficits in quality of life one year after intensity-modulated radiotherapy for patients with locally advanced head and neck cancer: Results of a prospective study.

Abstract

PURPOSE:

Patients with locally advanced head and neck cancer (LAHNC) undergo life-changing treatments that can seriously affect quality of life (QoL). This prospective study examined the key QoL domains during the first year after intensity-modulated radiotherapy (IMRT) and identified predictors of these changes in order to improve patient outcomes.

PATIENTS AND METHODS:

A consecutive series of patients with LAHNC completed the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core module (QLQ-C30) and the HNC-specific QLQ-HN35 before (t0) and at the end (t1) of definitive or adjuvant IMRT, then at 6-8 weeks (t2), 6 months (t3), and 1 year (t4) after IMRT.

RESULTS:

Patients (n = 111) completing questionnaires at all five time points were included (baseline response rate: 99%; dropout rate between t0 and t4: 5%). QoL deteriorated in all domains during IMRT and improved slowly during the first year thereafter. Many domains recovered to baseline values after 1 year but problems with smelling and tasting, dry mouth, and sticky saliva remained issues at this time. Increases in problems with sticky saliva were greater after 1 year in patients with definitive versus adjuvant IMRT (F = 3.5, P = 0.05).

CONCLUSION:

QoL in patients with LAHNC receiving IMRT takes approximately 1 year to return to baseline; some domains remain compromised after 1 year. Although IMRT aims to maintain function and QoL, patients experience long-term dry mouth and sticky saliva, particularly following definitive IMRT. Patients should be counseled at the start of therapy to reduce disappointment with the pace of recovery.

• Authors: Silke Tribius, Marieclaire Raguse, Christian Voigt, Adrian Münscher, Alexander Gröbe, Cordula Petersen, Andreas Krüll, Corinna Bergelt, Susanne Singer
• Journal: Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] (Strahlenther Onkol) Vol. 191 Issue 6 Pg. 501-10 (Jun 2015) ISSN: 1439-099X [Electronic] Germany
• PMID: 25747264 (Publication Type: Clinical Trial, Journal Article)

Topics

• Adult
• Aged
• Aged, 80 and over
• Female
• Head and Neck Neoplasms (diagnosis, psychology, radiotherapy)
• Humans
• Longitudinal Studies
• Male
• Middle Aged
• Prognosis
• Psychometrics (methods)
• Quality of Life (psychology)
• Radiation Injuries (etiology, psychology)
• Radiotherapy, Conformal (adverse effects, psychology)
• Reproducibility of Results
• Sensitivity and Specificity
• Surveys and Questionnaires
• Taste Disorders (etiology, psychology)
• Treatment Outcome
• Xerostomia (etiology, psychology)