title: Functional outcomes and quality of life after chemoradiotherapy: baseline and 3 and 6 months post-treatment.
abstract: Concomitant chemoradiotherapy provides organ preservation for those patients with head and neck cancer. We report the results of a prospective study that examined functional outcomes and quality of life (QOL) after chemoradiotherapy over the first 6 months post-treatment (tx). Twenty-nine patients with head and neck cancer were treated with chemoradiotherapy. All were seen baseline and 3 and 6 months post-tx. Assessments included the performance status scale (PSS), Karnofsky performance status scale, tongue strength, jaw opening, and saliva weight. QOL was patient-rated using the eating assessment tool (EAT-10), MD Anderson dysphagia inventory, speech handicap index (SHI), and the EORTC H&N35 scale. Repeated-measures ANOVAs were used, with significance at p < 0.05. PSS scores were significantly different across time points. Tongue strength, jaw range of motion (ROM), and saliva weight were significantly lower at 3 and 6 months than at baseline. QOL was significantly worse after tx, although it improved by 6 months as rated with the EAT-10 and the SHI scores were significantly worse at 3 and 6 months. EORTC domains of swallowing, senses, speech, dry mouth, and sticky saliva were significantly worse at 3 and 6 months. Concomitant chemoradiotherapy for treatment of head and neck tumors can result in impaired performance outcomes and QOL over the first 6 months post-tx. However, performance status, tongue strength, jaw ROM, and eating QOL were only mildly impaired by 6 months post-tx. Saliva production and speech QOL remained significantly impaired at 6 months post-treatment. Current studies are examining outcomes at 12 and 24 months post-treatment to better predict outcomes over time in this population.
authors.affiliation: Thyroid Head and Neck Cancer Foundation, Mount Sinai Beth Israel, 10 Union Square East, Suite 5B, New York, NY, 10003, USA, clazarus@chpnet.org.
authors.forename: C L
authors.initials: CL
authors.lastname: Lazarus
authors.forename: H
authors.initials: H
authors.lastname: Husaini
authors.forename: K
authors.initials: K
authors.lastname: Hu
authors.forename: B
authors.initials: B
authors.lastname: Culliney
authors.forename: Z
authors.initials: Z
authors.lastname: Li
authors.forename: M
authors.initials: M
authors.lastname: Urken
authors.forename: A
authors.initials: A
authors.lastname: Jacobson
authors.forename: M
authors.initials: M
authors.lastname: Persky
authors.forename: T
authors.initials: T
authors.lastname: Tran
authors.forename: C
authors.initials: C
authors.lastname: Concert
authors.forename: D
authors.initials: D
authors.lastname: Palacios
authors.forename: R
authors.initials: R
authors.lastname: Metcalfe-Klaw
authors.forename: M
authors.initials: M
authors.lastname: Kumar
authors.forename: B
authors.initials: B
authors.lastname: Bennett
authors.forename: L
authors.initials: L
authors.lastname: Harrison
mesh_terms: D000328:Adult; D000368:Aged; D059248:Chemoradiotherapy; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D007822:Laryngeal Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000628:therapy*; D011446:Prospective Studies; D011788:Quality of Life; D016059:Range of Motion, Articular; D012463:Saliva / Q000502:physiology; D013060:Speech / Q000502:physiology; D013704:Temporomandibular Joint / Q000503:physiopathology; D013997:Time Factors; D014059:Tongue / Q000503:physiopathology; D016896:Treatment Outcome