Impact of chemotherapy with concurrent radiotherapy on quality of life in post-operative advanced head-and-neck cancer patients: A cross-sectional study

Abstract

Background: Patients with head-and-neck cancer (HNC) have various challenging symptoms due to their disease and treatment side effects which again complicate the disease progress as it has a direct implication toward their quality of life (QOL). Aims and Objective: The aim of this study is to assess the QOL in post-operative advanced stage HNC patients on concomitant chemoradiotherapy aimed at improving locoregional control, survival, and QOL. Materials and Methods: Thirty-two postoperative advanced HNC patients were assessed cross-sectionally for their QOL. Patients who were assessed were stable and were not in discomfort while filling the questionnaires. Assessment was done using University of Washington Version 4 QOL questionnaire, which was translated into local language (Kannada). For data analysis, patients were divided into 2 groups: Group A - patients not on chemoradiotherapy and Group B - patients on chemoradiotherapy (fluorouracil and cisplatin regimen). Mean scores were expressed as percentages. Results: Of the thirty-two patients, ten were receiving chemotherapy with concomitant radiotherapy. Twenty-two patients did not require chemotherapy or radiation at that time. Patients in both the groups reported problems with pain, appearance, swallowing, chewing, and speech, in similar magnitudes. Patients in Group B as compared to Group A displayed reduced mean scores in the following domains - activity (24% vs. 15%), recreation (49% vs. 28%), taste (42% vs. 20%), saliva (45% vs. 30%), mood (35% vs. 17%), and anxiety (37% vs. 8%). Scoring is scaled so that a score of 0 represents the worst subjective function and a score of 100% represents no subjective deficits. Conclusion: QOL reduces during chemoradiation largely due to psychological factors, and hence, these patients require pre- and intra-therapy counseling.