Abstract
Simple SummaryPatients with head and neck cancer often suffer from multiple and severe functional impairments. Swallowing, voice impairment and pain are often mentioned as mostly relevant for patients’ quality of life after treatment. The course of these specific functional impairments and related problems are not sufficiently observed. In our retrospective single-center cohort analysis of “real-world data”, collected in daily routine practice, we present data regarding the patient-reported outcome parameters of swallowing and voice problems and pain. Independent of tumor site and treatment regimen, patients reported less problems over time. Nevertheless, oropharyngeal tumors led to significantly more self-reported swallowing problems, while patients with larynx tumors more often had patient-perceived voice impairments. In addition, other clinical and sociodemographic variables had an impact on patient-reported function. The acquisition of patient-reported outcome data is valuable and a sufficient way to explore patients’ problems in a better manner. These data can help to improve patient care.Background: Head and neck cancer (HNC)-specific symptoms have a substantial impact on health-related quality of life. The aim of this study was to determine whether self-reported dysphagia, voice problems and pain of HNC patients changed over time and whether specific clinical or sociodemographic variables were associated with these symptoms. Methods: HNC patients (n = 299) in an outpatient setting answered questionnaires (Eating Assessment Tool-10; questions from the EORTC QLQ-C30 and EORTC H&N35) on dysphagia, voice problems and pain, collected with the software “OncoFunction” at three different timepoints (t1–t3) after diagnosis. The mean score changes from t1 to t3 were expressed in terms of effect sizes d. The impact of sociodemographic and clinical factors on the course of the variables was tested with multivariate analyses of variance. Results: Dysphagia, voice impairment and pain in HNC survivors significantly improved over a period of approximately 14 months after diagnosis. Tumor site, stage, treatment modality, occupational state and ECOG state were significantly correlated with self-reported functional outcome. The pain level of the HNC patients was rather low. Conclusions: Patients suffer from functional impairments after HNC treatment, but an improvement in self-reported symptoms could be demonstrated within this time period.
Highlights
Recent advancements in the detection and treatment of head and neck cancer (HNC)and the changing epidemiology, especially due to the rise in HPV-positive oropharynx cancer, have resulted in an increase in Head and neck cancer (HNC) survivors
This study provided data regarding the symptoms dysphagia, voice impairment and pain in head and neck cancer survivors in a short-term follow-up
The findings revealed that over a period of approximately 14 months after diagnosis of HNC, dysphagia, voice problems and pain significantly improved in our patient cohort
Summary
Recent advancements in the detection and treatment of head and neck cancer (HNC)and the changing epidemiology, especially due to the rise in HPV-positive oropharynx cancer, have resulted in an increase in HNC survivors. The critical role of the head and neck in function as well as the partly complex treatment of HNC places survivors at high risk for HNC-specific symptoms that have a substantial impact on health-related quality of life. Voice impairment and pain are typical symptoms that are often associated with social and psychological problems These symptoms cause frustration and embarrassment, being common in the long term in HNC patients. The improvement of physical functioning and self-reported impairments over time is not well studied in HNC patients. Head and neck cancer (HNC)-specific symptoms have a substantial impact on health-related quality of life. The aim of this study was to determine whether self-reported dysphagia, voice problems and pain of HNC patients changed over time and whether specific clinical or sociodemographic variables were associated with these symptoms.
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