Impact on quality of life of IMRT versus 3-D conformal radiation therapy in head and neck cancer patients: A case control study

Abstract

ObjectiveThe purpose of this study was to prospectively and longitudinally compare the health-related quality of life (HRQOL) outcomes between head and neck (HN) cancer patients treated with parotid-sparing intensity modulated radiation therapy (IMRT) and patients treated with 3-dimensional conventional radiation therapy (3D-CRT).Methods and materialsBefore and up to 12 months after treatment, HRQOL was recorded in patients with HN cancer who were referred to the Department of Oncology at Sahlgrenska University Hospital for curative IMRT. The study group's HRQOL was compared with a matched group of patients from previous descriptive HRQOL studies treated with 3D-CRT. Both groups' HRQOL was measured by the European Organization for Research and Treatment for Cancer QLQ-C30 and European Organization for Research and Treatment for Cancer QLQ-HN35 at 6 time points in the first year after diagnosis.ResultsTwo hundred and seven patients were included, 111 treated with IMRT and 96 matched controls treated with 3D-CRT. Both groups' HRQOL deteriorated during and after treatment. Just after treatment, worse HRQOL scores were observed in the IMRT group regarding insomnia (38 vs 27; P = .032), appetite loss (64 vs 50; P = .019), senses (54 vs 41; P = .017), and coughing (39 vs 26, P = .009). At 12 months, however, significantly better HRQOL scores were observed in the IMRT group regarding problems with dry mouth (72 vs 62; P = .018), pain (28 vs 20; P = .018), sexuality (37 vs 23; P = .016), social contacts (10 vs 6; P = .026), cognitive functioning (79 vs 87; P = .0057), and financial difficulties (12 vs 20; P = .0019).ConclusionsThis study further supports the hypothesis that the introduction of IMRT has improved the long-term quality of life of HN cancer patients who have been treated with radiation therapy, but might cause more acute side effects. Longer follow-up is needed to study late complications.

Very late xerostomia, dysphagia, and neck fibrosis after head and neck radiotherapy

“…[3][4][5] Long-term HNC survivors especially are significantly affected by late toxicities 6,7 ; yet the data on very late toxicity (VLT) (≥3 years after radiotherapy) remains sparse. Although associated with less acute xerostomia and an improved quality of life (QOL) as compared to conventional radiotherapy, 1,2 IMRT unfortunately still significantly impacts QOL via acute and late toxicity.…”

“…Although associated with less acute xerostomia and an improved quality of life (QOL) as compared to conventional radiotherapy, 1,2 IMRT unfortunately still significantly impacts QOL via acute and late toxicity. [3][4][5] Long-term HNC survivors especially are significantly affected by late toxicities 6,7 ; yet the data on very late toxicity (VLT) (≥3 years after radiotherapy) remains sparse. 3 Late toxicity-generally defined as occurring >90 days after radiotherapy 8 -has been shown to decrease during the first 2 years after IMRT, 1,[9][10][11] with a more prominent improvement during the first year.…”

Evaluation of quality of life of a patient with malignant tumor of the oropharyngeal area during antitumor treatment

“…2) [7,9,12,13,17,18]. Показатели пациентки В. по данному опроснику выше или соответствуют верхней границе приведенных интервалов, что свидетельствует о более высоком уров-не качества жизни по каждой из функциональных шкал.…”

“…[12,13]. *According to the Western studies of quality of life of patients with malignant tumors of the maxillofacial area [12,13].…”

“…Среди них шкалы Карновского (Karnovsky Performance Index) и Восточной коопера-тивной группы исследования рака (Eastern Cooperative Oncology Group) -ECOG Perfomance Status, анкета SF-36 (Short Form-36), опросник Европейской органи-зации по изучению и лечению рака (EORTC) QLQ-C30 (EORTC Quality of life) [9][10][11]. Некоторые из них мо-дифицированы для анализа качества жизни пациентов со злокачественными новообразованиями головы и шеи: FACT-H&N (Functional Assessment of Cancer Therapy -Head and Neck Cancer), EORTC -QLQ-C30 H&N35 (EORTC Quality of life -Head and Neck Cancer), OHIP-14 (Oral Health Impact Profile) [12][13][14], однако ни один не адаптирован для оценки состояния паци-ентов со злокачественными новообразованиями оро-фарингеальной зоны на этапах стоматологической реабилитации.…”