Quality of life in patients cured from a carcinoma of the head and neck by radiotherapy: the importance of the target volume.
OBJECTIVE
To assess the health-related quality of life (QOL) of long-term survivors of carcinomas of different subsites of the head and neck following curative radiotherapy (RT).


METHODS
Patients continuously free from recurrence or second primary tumors treated 1988-1994 were contacted 5.1 to 5.9 years after RT and asked to fill in the EORTC QLQ-C30 core questionnaire and the H&N cancer module. RT had been restricted to the glottis (group A; carcinomas of the vocal cord T1-2 N0), or had included bilateral neck nodes and the primary tumor outside the nasopharynx (group B; AJC Stage II to IV) or within the nasopharynx, respectively (group C; Stage II to IV). Response rate was 97% (group A; n = 41), 69% (group B; n = 26) and 71% (group C; n = 12), respectively. The groups were different with respect to age (older in group A), alcohol consumption (absent in group C) and proportion of females (more in group C).


RESULTS
Patients with nasopharyngeal cancer reported the highest morbidity on the H&N module (dry mouth, sticky saliva, trismus, problems with teeth, trouble eating). However, these symptoms did not have a high impact on global QOL or function scores on the QLQ-C30 core questionnaire. Patients in group B reported a lower global QOL but less severe symptoms on the module.


CONCLUSIONS
The high morbidity of patients treated for a nasopharyngeal cancer may be explained by the location of the target volume which included the bilateral temporo-mandibular joints and the salivary glands. These patients require appropriate care during follow-up and will probably profit most from new RT techniques with sparing of normal tissues.
Huguenin
P U
PU
Department of Radiation Oncology, University Hospital, Zürich, Switzerland. pia.huguenin@dmr.usz.ch
Taussky
D
D
Moe
K
K
Meister
A
A
Baumert
B
B
Lütolf
U M
UM
Glanzmann
C
C
D000368:Aged; D002277:Carcinoma / Q000503:physiopathology* / Q000532:radiotherapy*; D003680:Deglutition Disorders / Q000209:etiology; D004435:Eating; D005260:Female; D006258:Head and Neck Neoplasms / Q000503:physiopathology* / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D017741:Survivors; D014987:Xerostomia / Q000209:etiology