title: Pretreatment factors predicting quality of life after treatment for head and neck cancer.
abstract: BACKGROUND
  Quality of life (QOL) has become an important issue in head and neck cancer. Explanation of factors predicting QOL after treatment has important implications for patient management.
  
  
  METHODS
  In this prospective study we analyzed which pretreatment factors predicted QOL after surgery and/or radiotherapy with curative intent in a cohort of 153 patients with cancer of the oral cavity, oropharynx, hypopharynx, or larynx. The patients completed the EORTC Core Questionnaire, the EORTC Head and Neck Cancer module, and the Center for Epidemiologic Studies Depression scale before treatment and 6 and 12 months later. The influence of gender, age, performance status, and depressive symptoms at baseline, site, stage, and treatment on QOL (and its dimensions) and depressive symptoms after 6 and 12 months was studied, using linear regression analysis.
  
  
  RESULTS
  A high level of depressive symptoms and a low performance status at baseline and combination treatment were significant predictors of increased severity of symptoms and poor functioning after treatment. Treatment was a predictor of head and neck symptoms, whereas performance status and depressive symptoms were predictors of general symptoms and functioning. Gender and age had little predictive value.
  
  
  CONCLUSIONS
  Patients with depressive symptoms or a low performance status who receive combination treatment for cancer of the head and neck are at risk for physical and psychologic morbidity after treatment. Special attention should be given to these patients in rehabilitation programs.
authors.affiliation: Department of Internal Medicine, University Medical Center Utrecht, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: de Graeff
authors.forename: J R
authors.initials: JR
authors.lastname: de Leeuw
authors.forename: W J
authors.initials: WJ
authors.lastname: Ros
authors.forename: G J
authors.initials: GJ
authors.lastname: Hordijk
authors.forename: G H
authors.initials: GH
authors.lastname: Blijham
authors.forename: J A
authors.initials: JA
authors.lastname: Winnubst
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D017677:Age Distribution; D000368:Aged; D015331:Cohort Studies; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000453:epidemiology* / Q000523:psychology* / Q000628:therapy; D006801:Humans; D017567:Karnofsky Performance Status; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011184:Postoperative Period; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D011788:Quality of Life; D017678:Sex Distribution; D012803:Sick Role