A prospective evaluation of patient-reported quality-of-life after (chemo)radiation for oropharyngeal cancer: which patients are at risk of significant quality-of-life deterioration?

Abstract

Background and purpose: To prospectively investigate the impact of different patients' characteristics on quality-of-life (QoL) after (chemo)radiation for oropharyngeal cancer (OPC).

Materials and methods: Between 2008 and 2011, 207 patients were treated with 46-Gy of (chemo)-IMRT followed by a boost by means of IMRT, brachytherapy (BT), or Cyberknife (CK). QoL-assessment was performed using the EORTC QLQ-C30, and QLQ-H&N35-questionnaires at baseline, end of treatment, 2, 4, 6 weeks and 3, 6, 12, and 18 months after treatment. The correlation between patients' characteristics (AJCC-stage, tumor subsite, chemotherapy, neck dissection, unilateral neck irradiation, and boost technique), and changes in QoL over time were investigated.

Results: At 18months, improvements were seen in QLQ-C30 emotional functioning, insomnia, and pain and QLQ-H&N35 pain and speech. The scores on QLQ-H&N35 swallowing returned to baseline level while the scores on dry mouth, sticky saliva, opening mouth, and teeth were significantly deteriorated compared to baseline. Boost techniques and unilateral neck irradiation were significantly predictive for dry mouth, swallowing and opening mouth while chemotherapy was correlated with changes on swallowing and opening mouth scales.

Conclusions: The most significant deterioration was seen in patient-related xerostomia. Boost technique, unilateral neck irradiation and chemotherapy were significantly predictive for QoL-changes over time.