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. 2021 Apr 1;13(7):1638.
doi: 10.3390/cancers13071638.

Change in Physical Performance Correlates with Decline in Quality of Life and Frailty Status in Head and Neck Cancer Patients Undergoing Radiation with and without Chemotherapy

Mark Farrugia  1 , Kayleigh Erickson  2 , Elizabeth Wendel  2 , Mary E Platek  1   2   3 , Wenyan Ji  4 , Kristopher Attwood  4 , Sung Jun Ma  1 , Fangyi Gu  2 , Anurag K Singh  1 , Andrew D Ray  2   5
Affiliations

Change in Physical Performance Correlates with Decline in Quality of Life and Frailty Status in Head and Neck Cancer Patients Undergoing Radiation with and without Chemotherapy

Mark Farrugia et al. Cancers (Basel). .

Abstract

Patient-reported quality of life (QoL) metrics, frailty status, and physical functioning are emerging concepts in head and neck cancer (HNC) with implications on both treatment decision-making and prognosis. The impact of treatment-related functional decline on QoL and frailty has not been well-characterized in HNC and was the focus of this investigation.

Methods: Patients who underwent radiation therapy for HNC from 2018 to 2020 were evaluated as a prospective observational cohort. Functional decline, QoL, and the frailty phenotype were measured via the Short Physical Performance Battery (SPPB), European Organization for Research and Treatment of Cancer (EORTC) qlq-C30, and Fried Frailty index, respectively.

Results: A total of 106 HNC patients were included, 75 of which received concurrent chemoradiation therapy (CCRT) and 31 received radiation alone, both with and without surgery. There was a decrease in SPPB overall (p < 0.001) from the beginning to the end of treatment in the CCRT group but not the radiation group (p = 0.43). Change in overall SPPB points following treatment correlated with the decline in physical QoL for both groups (p < 0.05) as well as transition frail status in the CCRT group (p < 0.001) with a trend in the radiation group (p = 0.08).

Conclusions: Change in SPPB correlates with QoL and transition to frailty status in patients undergoing definitive CCRT for HNC with similar trends in those receiving radiation alone. Decline in SPPB could potentially be useful in identification of those who may benefit from rehabilitation in future studies.

Keywords: cachexia; function; gait speed; performance; sarcopenia.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Short Physical Performance Battery (SPPB) scores in each category pre- (black) and post-treatment (white) for patients who received CCRT or radiation alone. Statistical significance indicated by * (p < 0.001), † (p = 0.009), and # (p = 0.01).
Figure 2
Figure 2
Correlation between the change in physical functional and global QOL and SPPB for patients who received CCRT or radiation alone (RT). CF = cognitive function, EF = emotional function, GQOL = global quality of life, PF = physical function, RF = role physical function, and SF = social function.
See this image and copyright information in PMC

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