Residual deficits in quality of life one year after intensity-modulated radiotherapy for patients with locally advanced head and neck cancer: Results of a prospective study.
OBJECTIVE
Patients with locally advanced head and neck cancer (LAHNC) undergo life-changing treatments that can seriously affect quality of life (QoL). This prospective study examined the key QoL domains during the first year after intensity-modulated radiotherapy (IMRT) and identified predictors of these changes in order to improve patient outcomes.


METHODS
A consecutive series of patients with LAHNC completed the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core module (QLQ-C30) and the HNC-specific QLQ-HN35 before (t0) and at the end (t1) of definitive or adjuvant IMRT, then at 6-8 weeks (t2), 6 months (t3), and 1 year (t4) after IMRT.


RESULTS
Patients (n = 111) completing questionnaires at all five time points were included (baseline response rate: 99%; dropout rate between t0 and t4: 5%). QoL deteriorated in all domains during IMRT and improved slowly during the first year thereafter. Many domains recovered to baseline values after 1 year but problems with smelling and tasting, dry mouth, and sticky saliva remained issues at this time. Increases in problems with sticky saliva were greater after 1 year in patients with definitive versus adjuvant IMRT (F = 3.5, P = 0.05).


CONCLUSIONS
QoL in patients with LAHNC receiving IMRT takes approximately 1 year to return to baseline; some domains remain compromised after 1 year. Although IMRT aims to maintain function and QoL, patients experience long-term dry mouth and sticky saliva, particularly following definitive IMRT. Patients should be counseled at the start of therapy to reduce disappointment with the pace of recovery.
Department of Radiation Oncology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany, tribius@uke.uni-hamburg.de.
Silke
S
Tribius
Marieclaire
M
Raguse
Christian
C
Voigt
Adrian
A
Münscher
Alexander
A
Gröbe
Cordula
C
Petersen
Andreas
A
Krüll
Corinna
C
Bergelt
Susanne
S
Singer
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000523:psychology* / Q000532:radiotherapy*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011594:Psychometrics / Q000379:methods; D011788:Quality of Life / Q000523:psychology*; D011832:Radiation Injuries / Q000209:etiology / Q000523:psychology*; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000523:psychology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D013651:Taste Disorders / Q000209:etiology / Q000523:psychology*; D016896:Treatment Outcome; D014987:Xerostomia / Q000209:etiology / Q000523:psychology*