Abstract
BackgroundWith the advances in modern radiotherapy (RT), many patients with head and neck cancer (HNC) can be effectively cured, and their health-related quality of life (HR-QoL) has become an important issue. In this study, we evaluated the prognosticators of HR-QoL in a large cohort of HNC patients, with a focus on the result from technological advances in RT.MethodsA cross-sectional investigation was conducted to assess the HR-QoL of 640 HNC patients with cancer-free survival of more than 2 years. Among them, 371 patients were treated by two-dimensional RT (2DRT), 127 by three-dimensional conformal RT (3DCRT), and 142 by intensity-modulated RT (IMRT). The EORTC QLQ-C30 questionnaire and QLQ-H&N35 module were used. A general linear model multivariate analysis of variance was used to analyze the prognosticators of HR-QoL.ResultsBy multivariate analysis, the variables of gender, annual family income, tumor site, AJCC stage, treatment methods, and RT technique were prognosticators for QLQ-C30 results, so were tumor site and RT technique for H&N35. Significant difference (p < 0.05) of HR-QoL outcome by different RT techniques was observed at 2 of the 15 scales in QLQ-C30 and 10 of the 13 scales in H&N35. Compared with 2DRT, IMRT had significant better outcome in the scales of global QoL, physical functioning, swallowing, senses (taste/smell), speech, social eating, social contact, teeth, opening mouth, dry mouth, sticky saliva, and feeling ill.ConclusionsThe technological advance of RT substantially improves the head-and-neck related symptoms and broad aspects of HR-QoL for HNC survivors.
Highlights
With the advances in modern radiotherapy (RT), many patients with head and neck cancer (HNC) can be effectively cured, and their health-related quality of life (HR-QoL) has become an important issue
We have reported that HNC survivors had significantly poorer HR-QoL outcomes compared with Taiwanese norms [15,16]
Variables associated with HR-QoL outcomes In the first step of the general linear model (GLM)-multivariate analysis of variance (MANOVA), the association between the independent variables and the dependent variables (15 scales of QLQ-C30) was investigated
Summary
With the advances in modern radiotherapy (RT), many patients with head and neck cancer (HNC) can be effectively cured, and their health-related quality of life (HR-QoL) has become an important issue. The endpoints of medical care for cancer patients usually focused on the so-called survival rate, local control rate, or complication rate. These endpoints were usually assessed from the physician’s points of view. Three types of methods have been categorized They include the generic type, e.g. the Short Form-36 (SF-36), the cancer specific type, e.g. the Functional Assessment of Cancer Treatment (FACT-G), the European Organization of Research and Treatment of Cancer Quality of Life Core Questionnaire, version 3.0 (EORTC QLQC30), and the cancer site-specific type, e.g. the head and neck modules in EORTC (EORTC QLQ-HN35), and FACT (FACT-HN) [2,3,4,5,6]
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