title: Quality of life following chemoradiation and postoperative radiation for locally advanced head and neck cancer.
abstract: BACKGROUND
  To evaluate the impact of chemoradiation and postoperative radiation on patients' quality of life (QOL) in a single institution.
  
  
  METHODS
  A retrospective analysis of 101 patients who had treatment for locally advanced head and neck cancer in a single institution. Forty-seven patients had chemotherapy and radiation, 54 patients underwent postoperative radiation. QOL was assessed with the University of Washington (UW), and the Hospital Anxiety (HA) and Depression (HD) questionnaires. All patients were free of disease at the survey time.
  
  
  RESULTS
  Mean and median UW scores were not different between the 2 groups: chemoradiation (65/67), postoperative radiation (62/63). Mean and median HA scores were 7.6/7 (chemoradiation), and 8.3/8 (postoperative radiation). Mean and median HD scores were 6.7/7 (chemoradiation), and 7.1/7 (postoperative radiation). Forty-four patients developed complications, with mean/median UW, HA, and HD scores of 55/55, 9.9/8, and 8.9/9, respectively. These scores were significantly different compared to the 57 patients without complications: 70/70 (p = 0.0001), 6.5/6 (p = 0.001), and 8.9/9 (p = 0.0001).
  
  
  CONCLUSIONS
  There was no significant difference in QOL between chemoradiation and postoperative radiation in this retrospective study with a relatively short follow-up in the chemoradiation group. In addition, there were more patients with resectable disease in the postoperative group which may explain the lack of difference in QOL between the two groups. Patients who developed complications following treatment experienced lower QOL, more anxiety and depression. Our study raised the need to conduct a prospective randomized study to assess the real impact of chemoradiation and postoperative radiation on patients' QOL.
authors.affiliation: Department of Radiation Oncology, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA.
authors.forename: Nam P
authors.initials: NP
authors.lastname: Nguyen
authors.forename: Paul
authors.initials: P
authors.lastname: Vos
authors.forename: Ulf
authors.initials: U
authors.lastname: Karlsson
authors.forename: Phuc
authors.initials: P
authors.lastname: Nguyen
authors.forename: Suresh
authors.initials: S
authors.lastname: Dutta
authors.forename: Claire
authors.initials: C
authors.lastname: Lemanski
authors.forename: Adir
authors.initials: A
authors.lastname: Ludin
authors.forename: Sue
authors.initials: S
authors.lastname: Rose
authors.forename: Ly M
authors.initials: LM
authors.lastname: Nguyen
authors.forename: Harold
authors.initials: H
authors.lastname: Ward
authors.forename: Shawn
authors.initials: S
authors.lastname: Huang
authors.forename: Sabah
authors.initials: S
authors.lastname: Sallah
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003131:Combined Modality Therapy; D004940:Esophageal Stenosis / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy* / Q000534:rehabilitation; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011788:Quality of Life / Q000523:psychology*; D011878:Radiotherapy / Q000009:adverse effects; D012189:Retrospective Studies; D017695:Soft Tissue Injuries / Q000209:etiology; D011795:Surveys and Questionnaires