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. 2020 Jan:142:133-139.
doi: 10.1016/j.radonc.2019.07.012. Epub 2019 Aug 17.

Xerostomia-related quality of life for patients with oropharyngeal carcinoma treated with proton therapy

Alexander F Bagley  1 , Rong Ye  2 , Adam S Garden  1 , Gary Brandon Gunn  1 , David I Rosenthal  1 , Clifton David Fuller  1 , William H Morrison  1 , Jack Phan  1 , Erich M Sturgis  3 , Renata Ferrarotto  4 , Richard Wu  5 , Amy Y Liu  5 , Steven J Frank  6
Affiliations

Xerostomia-related quality of life for patients with oropharyngeal carcinoma treated with proton therapy

Alexander F Bagley et al. Radiother Oncol. 2020 Jan.

Abstract

Purpose: We report longitudinal patient-reported quality-of-life (QoL) outcomes related to xerostomia in patients with oropharyngeal cancer treated with intensity-modulated proton therapy (IMPT).

Materials and methods: Patients treated from May 2012 through December 2016 at a single institution for AJCC7 stage III-IV, M0 oropharyngeal cancer were given the 15-item Xerostomia-Related QoL Scale (XeQoLS) before, during, and for up to 2 years after treatment. We evaluated the evolution of xerostomia-related QoL over that time, and examined potential associations between those measures with clinical characteristics.

Results: Sixty-nine patients had XeQoLS scores at baseline and at least once either during or after treatment. The mean (±SD) XeQoLS score (0-4) was 0.24 ± 0.57 at baseline. Subsequent scores were 2.00 ± 1.01 at 6 weeks on treatment, and 1.03 ± 0.76, 0.97 ± 0.78, 0.82 ± 0.69, and 0.70 ± 0.75 at 10 weeks, 6 months, 1 year, and 2 years after treatment, respectively. All were statistically different from baseline (p < 0.001). Univariate analyses demonstrated associations between XeQoLS score and time (p < 0.0001 for each interval), baseline XeQoLS score (p < 0.0001), stage (p = 0.008), N status (p = 0.006), and mean oral cavity dose (p = 0.038), but not for age, sex, T status, receipt of chemotherapy, smoking history, disease site, laterality of neck irradiation, mean parotid dose, or mean submandibular dose. Multivariate analysis suggested that baseline XeQoLS scores, phase of treatment, and N status were associated with XeQoLS scores measured during treatment and recovery.

Conclusions: Patients receiving IMPT reported the greatest xerostomia-related QoL impairment at 6 weeks on treatment, with a 49% improvement by 10 weeks after treatment; however, XeQoLS scores remained above baseline after 2 years. As we aim to establish the value of IMPT in oropharyngeal tumors to de-intensify treatment over conventional therapy, these data help inform discussions about xerostomia-related quality of life for patients with oropharyngeal cancer treated with IMPT.

Keywords: Oropharyngeal carcinoma; Proton therapy; Xerostomia.

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Conflict of interest statement

Declaration of Competing Interest None.

Figures

Fig. 1.
Fig. 1.
Global scores on the Xerostomia-Related Quality of Life Scale (XeQoLS). Box-and-whisker plots for patient-reported outcomes as measured by the XeQoLS score. T, on treatment; AR, acute recovery phase (up to 10 weeks after completing radiation); CR, chronic recovery phase (up to 2 years after treatment).
Fig. 2.
Fig. 2.
Individual subdomain scores from the XeQoLS including effects on the physical, personal, pain, and social domains. T, on treatment; AR, acute recovery phase (up to 10 weeks after completing radiation); CR, chronic recovery phase (up to 2 years after treatment).
Fig. 3.
Fig. 3.
Mean XeQoLS global scores stratified by baseline median XeQoLS score. Patients were categorized by baseline XeQoLS score as being either at or above the median. T, on treatment; AR, acute recovery phase (up to 10 weeks after completing radiation); CR, chronic recovery phase (up to 2 years after treatment).
See this image and copyright information in PMC

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