Postradiotherapy quality of life for head-and-neck cancer patients is independent of xerostomia.
OBJECTIVE
To determine the relationship between quality of life (QOL) and xerostomia over time for patients undergoing radiotherapy (RT) for head-and-neck cancer in a prospective clinical trial.


METHODS
Patients with head-and-neck cancer were randomized to pilocarpine (n = 65) vs. placebo (n = 65) during RT. QOL was measured using the McMaster Head and Neck Radiotherapy Questionnaire (HNRQ). Xerostomia was measured on a linear analog scale. No statistically significant differences were observed between arms; all 130 patients were analyzed together.


RESULTS
Baseline QOL data were obtained for 98.5% of participants. The baseline HNRQ score of 5.7 declined significantly to 4.0 (p <0.0001) by RT Week 6 and returned to baseline (5.8) by 6 months after treatment. This represents a large, clinically important change of 1.7 of 7 (24%; effect size 1.34). The decline in HNRQ score during RT paralleled the onset of xerostomia on the linear analog scale (r = 0.36 at 1 month). After treatment, the QOL scores recovered without improvement in xerostomia. The trajectory of the linear analog scale score resembled that of the HNRQ's single xerostomia question (r = 0.75 at 1 month).


CONCLUSIONS
Quality of life recovers to baseline after RT, despite persistent xerostomia. Either a response shift occurs or xerostomia in the absence of acute mucositis has a relatively small influence on overall QOL.
Ringash
Jolie
J
Department of Radiation Oncology, Princess Margaret Hospital and University of Toronto, Toronto, ON, Canada. jolie.ringash@rmp.ubn.on.ca
Warde
Padraig
P
Lockwood
Gina
G
O'Sullivan
Brian
B
Waldron
John
J
Cummings
Bernard
B
D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy*; D016001:Confidence Intervals; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006304:Health Status; D006801:Humans; D008297:Male; D018721:Muscarinic Agonists / Q000627:therapeutic use; D010862:Pilocarpine / Q000627:therapeutic use; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors; D014987:Xerostomia / Q000150:complications* / Q000517:prevention & control
D018721:Muscarinic Agonists; D010862:Pilocarpine