title: Changes in quality of life over 1 year in patients with head and neck cancer.
abstract: OBJECTIVE
  To characterize and compare quality of life (QOL) in patients with head and neck cancer shortly before initial treatment and 1 year later and to study the predictors of changes in QOL over 1 year.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Three otolaryngology clinics.
  
  
  METHODS
  Three hundred sixteen patients having newly diagnosed squamous cell head and neck cancer.
  
  
  METHODS
  Health-related QOL was assessed using the 36-item Short-Form Health Survey and a head and neck cancer-specific QOL scale.
  
  
  RESULTS
  Over 1 year, QOL decreased for physical functioning measures and eating but improved for mental health QOL. Depression and smoking were major predictors of poor QOL at baseline. Major predictors of change in QOL from baseline to 1 year were treatment factors, especially feeding tube placement (9 scales), chemotherapy (3 scales), and radiation therapy (3 scales). Baseline smoking and depressive symptoms also remained significant predictors of several QOL scales at 1 year.
  
  
  CONCLUSIONS
  Health-related physical QOL tended to decline over 1 year and mental health QOL improved. The major predictors of change in QOL were treatment factors, smoking, and depressive symptoms. Physicians should alert patients to the relative effects on QOL one may experience with different treatments.
authors.affiliation: Veterans Affairs Ann Arbor Healthcare System, Ann Arbor Veterans Affairs Health Services Research & Development, Center of Excellence, Ann Arbor, MI 48113-0170, USA. dronis@umich.edu
authors.forename: David L
authors.initials: DL
authors.lastname: Ronis
authors.forename: Sonia A
authors.initials: SA
authors.lastname: Duffy
authors.forename: Karen E
authors.initials: KE
authors.lastname: Fowler
authors.forename: Mumtaz J
authors.initials: MJ
authors.lastname: Khan
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Terrell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000523:psychology* / Q000628:therapy; D003863:Depression / Q000453:epidemiology; D005260:Female; D006258:Head and Neck Neoplasms / Q000523:psychology* / Q000628:therapy; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D011795:Surveys and Questionnaires