DETAILED QUALITY-OF-LIFE ASSESSMENT IN PATIENTS TREATED WITH PRIMARY RADIOTHERAPY FOR SQUAMOUS-CELL CANCER OF THE BASE OF THE TONGUE

Background: This study was conducted to evaluate quality of life in pa tients treated with primary radiotherapy (RT) for cancer of the base o f tongue. Methods: From 1981 to 1990, 36 patients with primary squamou s cell cancer of the base of tongue we re managed with primary radioth erapy. Ages ranged from 35 to 71 years (median, 58 years). T Stage was : T1, n = 11; T2, n = 14; T3, n = 10; T4, n = 1. Thirty-one patients ( 86%) had palpable cervical lymph node metastases at initial examinatio n (N1, n = 16; N2, n = 11; N3, n = 4). Patients received external beam RT to their primary site and necks, followed by a brachytherapy boost to the tongue. Those with neck nodes also had a neck dissection. The median follow-up is 5 years (minimum, 3 years). Actuarial 5-year local control was 85%; regional control was 96%; distant metastases-free su rvival was 87.5%; and overall survival, 85%. Twenty-nine of the 30 lon g-term survivors completed (1) Memorial Symptom Assessment Scale (MSAS ), (2) Functional Assessment of Cancer Therapy (FACT), (3) Performance Status Scale for Head and Neck Cancer (PSS), and (4) a sociodemograph ic and economic questionnaire. At the time of cancer diagnosis, 62% we re employed full-time, and 21% were employed part-time; 83% were earni ng >$20,000/year, and 59% were earning >$60,000/year. Results: At foll ow-up, annual incomes were similar to those at initial examination. Of those who had been working full-time, 72% were still in full-time wor k, and of those who had been working part-time, 83% were still in part -time work. Average PSS scores were 90 for eating in public, 96 for un derstandability of speech, and 68 for normalcy of diet. On the MSAS, t he following symptoms had prevalence: >30% xerostomia, difficulty swal lowing, decreased energy, pain, worrying, insomnia, cough, drowsy, cha nge in taste, and irritability. Scores on the FACT exceeded published values collected for a mixed cancer population. Conclusions: The overw helming majority of patients achieved excellent functional status and quality of life and could maintain their prediagnosis earning potentia l and employment status after primary radiation for advanced base of t ongue cancer. (C) 1997 John Wiley & Sons, Inc.