LONGITUDINAL ASSESSMENT OF QUALITY-OF-LIFE IN LARYNGEAL-CANCER PATIENTS

Background. Although quality of life (QL) and performance status are i mportant outcomes in head and neck (HN) cancer, there is little system atic inclusion of these parameters in treatment trials. Methods. Rate and recovery of function were evaluated over a 6-month period in 21 la ryngeal cancer patients, 7 in each of 3 treatment groups: total laryng ectomy (group 1), hemilaryngectomy (group 2), and radiotherapy only (g roup 3). Assessment included Performance Status Scale for Head and Nec k Cancer Patients (PSS-HN: Diet, Speech, and Eating in Public subscale s) and the FACT-HN, a multidimensional QL measure. Results. Groups dif fered in patterns of performance recovery over time in expected direct ions. Group 1 recovered most slowly, without achieving normal function ing by 6 months; most of group 2 returned to normal functioning by 3 m onths; group 3 showed little overall dysfunction. There was no differe nce in overall QL between groups or over time. Performance status was significantly correlated with the FACT head and neck subscale and some what with the Physical subscale. In contrast, ability to eat and/or sp eak was not associated with overall QL nor with any other specific QL dimension leg, emotional or social well-being). Conclusions. Results s upport the sensitivity and applicability of two site-specific performa nce/QL measures: PSS-HN and FACT-HN. Findings also emphasize the need to employ multidimensional tools to adequately evaluate the nonmedical outcomes in head and neck patients. (C) 1996 John Wiley & Sons, Inc.