Longitudinal changes in quality of life and costs in long-term survivors of tumors of the oropharynx treated with brachytherapy or surgery.
OBJECTIVE
Based on earlier studies we were interested in finding out if longitudinal assessment of quality of life (QoL) and costs in long-term survivors of oropharyngeal cancers treated with external beam radiation therapy and brachytherapy (BT) or surgery and postoperative radiotherapy showed a change in QoL over the years. Besides, we were curious to know how much the costs per life year and the QALY would be for this patient group.


METHODS
Performance status scales: eating in public, understandability of speech, normalcy of diet, xerostomia and ability to swallow were determined in 2003 and 2005. In 2005, the responses to EORTC QLQ-C30, EORTC H&N35, and the Euroqol questionnaire were also measured. Costs and quality-adjusted life years (QALYs) were calculated.


RESULTS
Eating in public, understandability of speech, and normalcy of diet significantly differed in favor of BT. Surgical patients experienced more speech, teeth, and mouth-opening problems. Mean costs and QALYs for BT were 16,112 euros and 56,060 euros and for surgery 26,590 euros and 93,275 euros, respectively.


CONCLUSIONS
QoL scores don't change over time. Due to the number of admission days, surgery is more costly. Difference in costs for QALYs in favor of BT was observed.
Nijdam
Wideke M
WM
Department of Radiation-Oncology, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands. w.nijdam@erasmusmc.nl
Levendag
Peter C
PC
Noever
Inge
I
Schmitz
Paul I M
PI
Uyl-de Groot
Carin A
CA
D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects* / Q000191:economics; D005260:Female; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019647:Oral Surgical Procedures / Q000009:adverse effects* / Q000191:economics; D009959:Oropharyngeal Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D017741:Survivors