ACUTE AND CHRONIC CHANGES IN SWALLOWING AND QUALITY-OF-LIFE FOLLOWINGINTRAARTERIAL CHEMORADIATION FOR ORGAN PRESERVATION IN PATIENTS WITH ADVANCED HEAD AND NECK-CANCER

Background. Health-related quality of life (QOL) provides a measure of the patient's perception of his life after treatment. This study was undertaken to assess changes in QOL and swallowing in patients undergo ing concurrent chemoradiotherapy (CR) for head and neck cancer. The as sessment tools consisted of the Head and Neck Radiotherapy Questionnai re (HNRQ) and a swallowing questionnaire (SQ). Methods. The HNRQ and S Q were administered to a group of CR patients prior to treatment (n = 58), after the last week of treatment (n = 37), and 6 months after tre atment (n = 27). Weight change was monitored in treatment subjects. Re sults. The results indicate that QOL and swallowing function decrease acutely during CR (p < .05) but improvement begins shortly after the t reatment-related decline. At 6 months after CR, mean QOL exceeds pretr eatment level. The oropharynx patients have the poorest outcome when c ompared with aryngeal and hypopharyngeal patients. A stronger correlat ion exists between swallowing and QOL at 6 months post-CR than during treatment (R = .52 versus R = .30). Conclusions. Quality of life and s wallowing are compromised in advanced head and neck cancer patients pr ior to treatment. There was a further decrease in QOL and swallow func tion during CR. Organ-preservation programs in head and neck cancer re sult in improved QOL and swallowing 6 months after treatment. The degr ee of improvement is site-specific. (C) 1998 John Wiley & Sons, Inc.