Health-related quality of life up to 1 year after radiotherapy in patients with head and neck cancer (HNC)

Abstract

Background: Detailed symptom specific descriptions of health-related quality of life (HRQOL), using validated questionnaires in patients with head and neck cancer (HNC) are sparse. The aim of the present study was to investigate HRQOL in patients with HNC up to 1 year after radiotherapy (RT), using two standardised questionnaires.

Methods: The data for the present study was originally collected in a randomised, prospective study. Forty-seven patients from two RT clinics in Sweden were included to investigate the secondary aim: HRQOL. Data was recorded at baseline, completion of RT, and 3, 6, 12 months after completed RT, using the questionnaire EORTC QLQ-C30-version 3 and the disease-specific module EORTC QLQ-H&N35.

Results: Most symptoms and functions deteriorated significantly by the end of RT, improved gradually by 3 and 6 months and reached baseline levels at 12 months after completed RT. However, 1 year after completed RT there were remaining significant problems in senses, dry mouth and sticky saliva.

Conclusions: Radiation therapy affects health-related quality of life in patients with head and neck cancer, both in the short and long term. Caregivers need management strategies for early detection and treatment of specific problems throughout the treatment period to help in the prevention of long-term symptoms.

Keywords: EORTC QLQ C30; Head and neck cancer; Health-related quality of life; QLQ-H&N35; Trismus.

Fig. 1

Functional scales of the EORTC QLQ C-30 (0–100 point scale) from baseline over a 12-month period. Mean values based on patients answering the questionnaire. Higher scores indicate a high level of function. Statistically significant differences compared to baseline: <0.001 at completion of RT in physical, role, and social scales; <0.05 at completion of RT in cognitive scale; <0.001 at 3 months after RT in physical scale; <0.05 at 3 months in role scale; <0.001 at 6 months in physical scale; <0.05 at 6 months in emotional scale; <0.05 at 12 months in emotional scale

Fig. 2

Symptom scales of the EORTC QLQ C-30 (0–100-point scale) from baseline over a 12-month period. Mean values based on patients answering the questionnaire. Higher scores indicate more severe symptoms or impairments. Statistically significant differences compared to baseline: <0.001 at completion of RT in fatigue, appetite loss, and constipation; <0.05 at completion of RT in nausea, pain, and dyspnoea; <0.001 at 3 months after RT in fatigue, and appetite loss; <0.05 at 3 months in dyspnoea, and diarrhoea; <0.05 at 6 months in fatigue, and appetite

Fig. 3

Symptom scales of the EORTC QLQ-H&N35 (0–100-point scale) from baseline over a 12-month period. Mean values based on patients answering the questionnaire. Higher scores indicate more severe symptoms or impairments. Statistically significant differences compared to baseline: <0.001 at completion of RT in pain, swallowing, senses, social eating, and sexuality; <0.05 at completion of RT in social contact, and speech; <0.001 at 3 months after RT in senses, and social eating; <0.05 at 3 months in sexuality; <0.001 at 6 months in senses; <0.05 at 6 months in social eating; <0.001 at 12 months in senses

Fig. 4

Symptom scales of the EORTC QLQ-H&N35 (0–100-point scale) from baseline over a 12-month period. Mean values based on patients answering the questionnaire. Higher scores indicate more severe symptoms or impairments. Statistically significant differences compared to baseline: <0.001 at completion of RT in dry mouth, sticky saliva, weight loss, and nutritional supplements; <0.05 at completion of RT in feeling ill, pain killers, feeding tubes, mouth opening, and coughing; <0.001 at 3 months after RT in dry mouth, and sticky saliva; <0.001 at 6 months in dry mouth, and sticky saliva; <0.05 at 6 months in pain killers; <0.001 at 12 months in dry mouth, and sticky saliva