Functional and psychological evaluation after exclusive chemoradiation therapy in oral and oropharyngeal cancer

Abstract

e17012 Purpose: The treatment of head and neck tumours often negatively affects speech, swallowing, body image and quality of life (QoL). Aim of this study was the evaluation of the impact of exclusive chemoradiation therapy (CH-RT) on QoL and psychological functioning. Patients and Methods: Twenty-eight patients, affected by a carcinoma of the oral cavity and oropharynx received exclusive CH-RT. Late effects of CH-RT and psycho-oncological assessment included: Radiation Therapy Oncology Group (RTOG) - European Organisation for Research and Treatment of Cancer (EORTC) late radiation morbidity scoring system, DISCHE morbidity recording scheme, Hospital Anxiety and Depression Scale (HADS), Montgomery Asberg Depression Rating Scale (MADRS), Mini Mental Adjustment to Cancer (MINI MAC), and EORTC QoL Head and Neck 35. Results: After a median follow-up of 42 months (range 12–60 months) moderate-severe late toxicity was as follows: taste impairment (89.20%), salivary function (82.12%), subcutaneous tissue (7.08%). Concerning dysphagia 39% of patients complained some discomfort, 28% had a more severe toxicity whereas 7% could not have an oral feeding; patients with severe dysphagia showed higher levels of anxiety (p < 0.05): dysphagia influences the QoL, fatigue and physical-social functioning. Rates of depression and anxiety were generally low: 78.6% of our sample did not show clinical relevant anxious symptoms and 82.1% of patients did not reach the threshold of an overt depression. Just a fair concordance in rate of depression between self- and hetero-evaluated scale was observed, with higher rates relieved by MADRS compare to HADS depression subscale using 8 or 10 cut-off (Cohen's k test = 0.401) Conclusions: Our data suggest low rates of anxiety and depression, in patients treated with CH-RT, with a different evaluation between self-evaluative and hetero-evaluative scales. No significant financial relationships to disclose.