TY - JOUR
T1 - Long-term health-related quality of life in head and neck cancer survivors
T2 - A large multinational study
AU - Taylor, Katherine J.
AU - Amdal, Cecilie D.
AU - Bjordal, Kristin
AU - Astrup, Guro L.
AU - Herlofson, Bente B.
AU - Duprez, Fréderic
AU - Gama, Ricardo R.
AU - Jacinto, Alexandre
AU - Hammerlid, Eva
AU - Scricciolo, Melissa
AU - Jansen, Femke
AU - Verdonck-de Leeuw, Irma M.
AU - Fanetti, Giuseppe
AU - Guntinas-Lichius, Orlando
AU - Inhestern, Johanna
AU - Dragan, Tatiana
AU - Fabian, Alexander
AU - Boehm, Andreas
AU - Wöhner, Ulrike
AU - Kiyota, Naomi
AU - Krüger, Maximilian
AU - Bonomo, Pierluigi
AU - Pinto, Monica
AU - Nuyts, Sandra
AU - Silva, Joaquim Castro
AU - Stromberger, Carmen
AU - Specenier, Pol
AU - Tramacere, Francesco
AU - Bushnak, Ayman
AU - Perotti, Pietro
AU - Plath, Michaela
AU - Paderno, Alberto
AU - Stempler, Noa
AU - Kouri, Maria
AU - Grégoire, Vincent
AU - Singer, Susanne
N1 - Publisher Copyright: © 2024 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.
PY - 2024
Y1 - 2024
N2 - Head and neck cancer (HNC) patients suffer from a range of health-related quality of life (HRQoL) issues, but little is known about their long-term HRQoL. This study explored associations between treatment group and HRQoL at least 5 years' post-diagnosis in HNC survivors. In an international cross-sectional study, HNC survivors completed the European Organization for Research and Treatment of Cancer (EORTC) quality of life core questionnaire (EORTC-QLQ-C30) and its HNC module (EORTC-QLQ-H&N35). Meaningful HRQoL differences were examined between five treatment groups: (a) surgery, (b) radiotherapy, (c) chemo-radiotherapy, (d) radiotherapy ± chemotherapy and neck dissection and (e) any other surgery (meaning any tumour surgery that is not a neck dissection) and radiotherapy ± chemotherapy. Twenty-six sites in 11 countries enrolled 1105 survivors. They had a median time since diagnosis of 8 years, a mean age of 66 years and 71% were male. After adjusting for age, sex, tumour site and UICC stage, there was evidence for meaningful differences (10 points or more) in HRQoL between treatment groups in seven domains (Fatigue, Mouth Pain, Swallowing, Senses, Opening Mouth, Dry Mouth and Sticky Saliva). Survivors who had single-modality treatment had better or equal HRQoL in every domain compared to survivors with multimodal treatment, with the largest differences for Dry Mouth and Sticky Saliva. For Global Quality of Life, Physical and Social Functioning, Constipation, Dyspnoea and Financial Difficulties, at least some treatment groups had better outcomes compared to a general population. Our data suggest that multimodal treatment is associated with worse HRQoL in the long-term compared to single modality.
AB - Head and neck cancer (HNC) patients suffer from a range of health-related quality of life (HRQoL) issues, but little is known about their long-term HRQoL. This study explored associations between treatment group and HRQoL at least 5 years' post-diagnosis in HNC survivors. In an international cross-sectional study, HNC survivors completed the European Organization for Research and Treatment of Cancer (EORTC) quality of life core questionnaire (EORTC-QLQ-C30) and its HNC module (EORTC-QLQ-H&N35). Meaningful HRQoL differences were examined between five treatment groups: (a) surgery, (b) radiotherapy, (c) chemo-radiotherapy, (d) radiotherapy ± chemotherapy and neck dissection and (e) any other surgery (meaning any tumour surgery that is not a neck dissection) and radiotherapy ± chemotherapy. Twenty-six sites in 11 countries enrolled 1105 survivors. They had a median time since diagnosis of 8 years, a mean age of 66 years and 71% were male. After adjusting for age, sex, tumour site and UICC stage, there was evidence for meaningful differences (10 points or more) in HRQoL between treatment groups in seven domains (Fatigue, Mouth Pain, Swallowing, Senses, Opening Mouth, Dry Mouth and Sticky Saliva). Survivors who had single-modality treatment had better or equal HRQoL in every domain compared to survivors with multimodal treatment, with the largest differences for Dry Mouth and Sticky Saliva. For Global Quality of Life, Physical and Social Functioning, Constipation, Dyspnoea and Financial Difficulties, at least some treatment groups had better outcomes compared to a general population. Our data suggest that multimodal treatment is associated with worse HRQoL in the long-term compared to single modality.
KW - cross-sectional
KW - head and neck cancer
KW - quality of life
KW - survivor
KW - treatment
UR - http://www.scopus.com/inward/record.url?scp=85184161443&partnerID=8YFLogxK
U2 - 10.1002/ijc.34861
DO - 10.1002/ijc.34861
M3 - Article
C2 - 38312044
SN - 0020-7136
VL - 154
SP - 1772
EP - 1785
JO - International journal of cancer
JF - International journal of cancer
IS - 10
ER -