The impact of radiotherapy on the quality of life in patients with early-stage clinical head and neck cancer

Abstract

Radiotherapy (RT) for patients with head and neck squamous cell carcinoma (HNSCC) affects vital functions related to the irradiation volume of the head and neck region and, in addition, has a negative impact on social functioning, thereby significantly impairing patients’ quality of life (QoL). The aim of this study was to assess changes in the quality of life in patients with head and neck cancer treated with curative RT at 12 months after completion of RT. The aim of this study was to assess the differences between the baseline QoL of patients with early clinical stage HNSCC and at 12 months after curative/radical RT. The prospective clinical study included 92 patients in good general condition (ECOG 0–1 – Eastern Cooperative Oncology Group performance status), without regional or distant metastases, diagnosed with pathomorphologically confirmed early-stage head and neck squamous cell carcinoma treated with definitive RT. All patients participating in the study signed an informed consent form. QoL was assessed using the standard EORTC QLQ-C30 and QLQH&N35 questionnaires. In addition, information on clinical aspects and data relating to socio-demographic factors were obtained from each patient. Statistical analysis was performed using a statistical package (SPSS 17.0). T-test was used for dependent and independent samples. A general linear model was used for repeated measures. Patients’ QoL deteriorated significantly after definitive RT. Worse QoL Core-30 scores in patients 12 months after the end of RT, compared with baseline QoL, before the start of RT, were observed in domains such as physical performance, fulfillment of life roles, cognitive functioning, loss of appetite, fatigue and constipation. For the QLQ-H&N35 questionnaires, patients 12 months after the end of RT reported problems in relation to aspects of life such as senses, mouth opening, dry mouth, thick saliva, pain, and weight loss. RT, even in early clinical stage head and neck cancer, has a negative impact on QoL, despite modern treatment techniques.

Quality of Life, Psychological Distress, and Nutritional Status of Polish Patients with Head and Neck Cancer Treated with Radiotherapy

“…In terms of the QLQ-H&N35 questionnaire, the authors reported a statistically significant deterioration in the QoL for scales of “dry mouth”, “weight loss”, “senses” “sticky saliva”, “opening mouth”, and “painkillers”. The effect of tumour location on QoL deterioration was statistically significant on the scales “speech” (higher deterioration in patients whose tumour was located in the larynx and hypopharynx) and “opening mouth” (higher deterioration when tumour was located in the oral cavity) [ 37 ].…”

The impact of working on health-related quality of life in patients with head and neck cancers: a cross-sectional study

“…Fatigue is the most common reason for patients with HNC to leave their work [11,14], and it is more likely to appear with multimodality therapy than with single-modality therapy [4]. Moreover, dysphasia is often reported as a side effect of radiotherapy [31,32], one of the common reasons for quitting working after treatment [4] and signi cantly decreased HRQOL [26,33]. Thus, patients who were able to work might not receive adjuvant therapy and had fewer symptoms that would be a barrier to work.…”

Effectiveness of Comprehensive Intervention Programme on Quality of life, fatigue, self-efficacy, and psychosocial distress among head and neck cancer patients receiving radiotherapy

“…Despite advanced treatment methods in RT, the QOL is negatively impacted by HNC, even at early clinical stages [ 6 ]. QOL is important for HNC survivors and today as a study endpoint it is increasingly considered [ 7 ].…”