Differences in quality of life in obese and normal weight head and neck cancer patients undergoing radiation therapy.

Abstract

The aim of this study was to evaluate health-related quality of life (HRQOL) in patients with different body mass indices (BMI, <25 vs ≥25) undergoing radiation treatment for head and neck cancer. HRQOL was examined by the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and the EORTC QLQ-H&N35, in the beginning and in the end of radiation treatment in 60 patients treated at University Hospital in Northern Norway. Information about nutritional status with weight loss, hemoglobin level (Hb), serum albumin, and a study-specific questionnaire also was filled out in the beginning and in the end of treatment. The patients' general condition, skin, and mucous membranes (CTCAE v.3.0) (grades 1 to 5 with unique clinical descriptions) were documented four times during radiation treatment. Changes in HRQOL were calculated and compared by paired sample t test. Multiple regression analyses were used to examine correlations between baseline BMI and changes in HRQOL, CTCAE v.3.0 toxicity, nutritional status, and information that radiotherapists provided to patients. Patients with BMI ≥ 25 had less mucosal changes after 2 weeks of radiation treatment than patients with BMI < 25 (p = 0.010). Differences regarding feeding tube use (p = 0.037) and intake of nutritional supplements before radiation treatment (p = 0.001) were also seen. Patients with overweight had more dyspnea (p = 0.033) before treatment and more problems with dry mouth (p = 0.042) after treatment. During treatment, patients with BMI ≥ 25 had more problems with opening mouth (p = 0.034) than patients with BMI < 25 and more changes in sexuality (p = 0.019). Patients with BMI ≥ 25 received less information about food and drink (p = 0.011) in the radiation treatment period than normal weight patients. BMI influences HRQOL and toxicity. Additional longitudinal studies should examine whether or not overweight patients persistently experience more problems with dry mouth and opening their mouth. Regardless of BMI, all patients should be informed about nutritional recommendations during treatment.