Long-term functional and quality of life evaluation after treatment for advanced pharyngolaryngeal carcinoma

Abstract

Background: The purpose of this study was to compare total laryngectomy versus concurrent chemoradiotherapy (CRT) for functional and long-term quality of life (QOL) outcomes in patients with pharyngolaryngeal carcinoma.

Methods: Among 145 patients treated for advanced pharyngolaryngeal cancer by CRT or total laryngectomy between 2000 and 2008, 47 patients who had completed treatment for >1 year and were determined to be disease-free were evaluated for function and QOL using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30-questions (EORTC-QLQ-C30).

Results: No significant difference was observed between the total laryngectomy group (26 patients) and the CRT group (21 patients) concerning feeding tube (p = .72), oral supplements (p = .84), and pneumonia (p = 1.00). Laryngeal functional rate after CRT was 72% at 2 years. No significant difference was observed between the 2 groups when using EORTC-QLQ-C30 scales (p > .05). According to the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 Head and Neck 35-questions (EORTC-QLQ-C30-H&N35) questionnaire, surgical patients reported significantly greater difficulties with smell and taste (p = .005) and chemoradiation patients with dry mouth (p = .010) and weight loss (p = .022). Differences that seemed clinically meaningful but not statistically significant emerged on several other scales.

Conclusion: Both total laryngectomy and CRT led to a similar high rate of dysphagia-related morbidity (feeding tube, oral supplements, and pneumonia) and QOL alteration, but the groups differed in the specific QOL domains affected.

Keywords: chemoradiation; organ preservation; pharyngolaryngeal carcinoma; quality of life; total laryngectomy.