title: Postradiotherapy quality of life for head-and-neck cancer patients is independent of xerostomia.
abstract: 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.
authors.affiliation: Department of Radiation Oncology, Princess Margaret Hospital and University of Toronto, Toronto, ON, Canada. jolie.ringash@rmp.ubn.on.ca
authors.forename: Jolie
authors.initials: J
authors.lastname: Ringash
authors.forename: Padraig
authors.initials: P
authors.lastname: Warde
authors.forename: Gina
authors.initials: G
authors.lastname: Lockwood
authors.forename: Brian
authors.initials: B
authors.lastname: O'Sullivan
authors.forename: John
authors.initials: J
authors.lastname: Waldron
authors.forename: Bernard
authors.initials: B
authors.lastname: Cummings
mesh_terms: 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
chemical_list: D018721:Muscarinic Agonists; D010862:Pilocarpine