The effect of co‐morbidity on quality of life in patients treated with radiotherapy for head and neck squamous cell cancer

Abstract

Objective: To identify the impact of co‐morbidity on the quality of life (QoL) of patients suffering from head and neck squamous cell cancer (HNSCC) during radiation treatment.Methods: A total of 250 patients diagnosed with HNSCC between August 2001 and February 2003 underwent QoL and psychological profile assessment using the University of Washington QoL instrument (UWQoL) and the Hospital Anxiety and Depression Scale (HADS) respectively. The assessment was performed prospectively at the beginning and at two time points during radiation therapy. Co‐morbidity burden was assessed retrospectively by case note analysis of 112 patients using the Adult Co‐morbidity Evaluation 27 (ACE‐27) index, which is a previously described and validated instrument. Demographic and tumour data were obtained from prospective databases. Co‐morbidity burden and impact of co‐morbidity on QoL were the main outcome measures estimated.Results: All data was analysed using SPSS for Windows V 10. Mean co‐morbidity burden in this group was 1.10. Fifty eight percent of patients had some form of co‐morbid illness. Co‐morbidity grades did not influence the QoL and HADS scores before treatment (one way anova). QoL and HADS scores deteriorated during radiation treatment. The change in scores after treatment was not influenced by co‐morbidity in this population (one way anova).Conclusions: This study shows that the co‐morbidity burden seen in HNSCC bears no influence on the treatment related QoL and psychological profile during radiation therapy. Severe co‐morbidity may have a greater effect on patients QoL and HADS score, but small sample size does not make this statistically significant.