Stress and depression in head and neck cancer patients by primary surgery versus primary radiotherapy treatment modality.

Abstract

5597 Background: Primary surgery or radiotherapy are potential treatment options for many patients with head and neck cancer. Both have similar control and survival outcomes, but may have differences in health-related quality of life, including stress and depression. Methods: Between 2004-2009, 133 adults with curatively treated stage I-IVb head and neck cancer (squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx, free of locally recurrent or metastatic disease for 6 months to 3 years following primary treatment) were entered on a prospective randomized double-blind placebo-controlled chemoprevention study. All patients completed the 10-item perceived stress scale (PSS) and the 20-item Centers for Epidemiologic Studies Depression scale (CESD) both at baseline and 12 weeks after being randomized either to a fruit and vegetable concentrate intervention or placebo. Both scales are scored such that higher scores relate to worse quality of life, i.e. more stress or depression, respectively. For a general population, the mean PSS is 13.02. CESD scores >16 signal depression. Results: 89 patients had undergone primary surgery (PS), 44 had received primary radiotherapy (PRT). At baseline and twelve weeks, the mean PSS scores were 9.82 and 8.64 for the PRT group and were 11.09 and 10.31 for the PS group. At baseline and 12 weeks, the mean CESD scores were 7.48 and 9.47 for the PRT group and 9.30 and 8.89 for the PS group. Differences between the PRT and PS groups were not significantly different at baseline or 12 weeks, nor were differences within each group at the two time points. Conclusions: In patients with controlled head and neck cancer, stress, and depression scores as measured by the PSS and CESD did not differ significantly for patients treated with either primary surgery or primary radiotherapy. Mean PSS scores were not higher than those from a normal population and mean CESD scores were not indicative of depression. Twelve weeks of fruit and vegetable concentrate use did not cause any significant changes in mean PSS or CESD scores in either patient group. This study was supported by NSA, Inc. and NIH/NCI grants 3 U10 CA 81851 and R21 CA 106205. No significant financial relationships to disclose.