Posttreatment Quality-of-Life Assessment in Patients With Head and Neck Cancer Treated With Intensity-modulated Radiation Therapy

Abstract

To evaluate patient-reported quality-of-life (QOL) domains in patients with head and neck cancer (HNC) treated with intensity-modulated radiotherapy (IMRT); specifically time-based QOL changes compared with baseline and correlation with independent variables. Between January 2002 and August 2006, we prospectively administered the University of Washington Quality of Life-Revised assessment to 143 patients with primary HNC treated with IMRT to investigate the impact of treatment on 12 QOL domains. We analyzed 108 patients with more than 6 months follow-up for correlation between QOL domains and independent variables. Patients were divided into 2 groups based on mean parotid gland dose with a 26-Gy threshold. We saw in general, an acute drop in all scores after starting treatment regardless of the degree of parotid sparing. If the parotid received a mean dose ≥26 Gy, then the acute decrease was larger than if the parotid received less than 26 Gy. Higher radiation dose to the parotid resulted in significantly lower QOL scores over 9 months (pain) and often more than 2 years (chewing and taste). No significance was found between the domains and the independent variables assessed. Patients with HNC treated with IMRT experienced an acute decrement in QOL across many domains despite parotid sparing. Lower radiation doses to the parotid corresponded to a smaller decrease in QOL and an earlier return to baseline compared with higher doses. Self-reported QOL and functional outcomes are important determinants of patient satisfaction and should be evaluated in future studies.