QUALITY-OF-LIFE IN PATIENTS TREATED FOR HEAD AND NECK-CANCER - A FOLLOW-UP-STUDY 7 TO 11 YEARS AFTER RADIOTHERAPY

Purpose: To compare health-related quality of life factors in 845 head and neck cancer patients randomized to receive either conventional ra diotherapy (2 Gy, 5 days-a-week) or a hypofractionated regimen (2.35 G y, 4 days-a-week), a follow-up study was carried out 7 to 11 years aft er treatment in the surviving patients, representing 30% of the origin al patient number. Methods and Materials: The cancer-specific EORTC Co re Quality of Life Questionnaire (30 item version; the EORTC QLQ-CC30) and a 19 item head and neck cancer-specific questionnaire were mailed to the 245 surviving patients of the trial. The EORTC QLQ-C30 is comp rised of six multi-item function scales, three symptom scales, and six single items which assess both symptoms and economic consequences of the disease. Two hundred and four patients (83%) completed the questio nnaire. The two groups of patients (N = 103 and N = 101) treated by di fferent fractionating schedules, were comparable with regard to sociod emographic variables, tumor site, treatment variables (including diffe rent types of surgical treatment), and secondary primary cancers. Pati ents in the conventional group had more advanced disease and a higher recurrence rate compared to patients in the hypofractionated group. Re sults: Unexpectedly, patients in the hypofractionated group, reported similar or better quality of life compared to patients in the conventi onal fractionated group. Patients in both groups described a high leve l of symptoms, like dryness in the mouth and mucus production. Clinica l and sociodemographic variables did not explain variance in social fu nction, emotional function or fatigue, except for the type of surgery performed, which significantly influenced the patients' emotional func tion. Conclusion: Long-term survivors of head and neck cancer reported a high level of disease and treatment related symptoms. Emotional fun ction was significantly influenced by the type of surgical procedure. Strategies for future trials in head and neck cancer should continue t o attempt to stress conservative surgical approaches and coordinated a djuvant therapy to maximize local regional control and quality of life . Functional and emotional outcome are important parameters which shou ld prospectively be evaluated in future clinical trials in bead and ne ck cancer.