How do head and neck cancer patients prioritize treatment outcomes before initiating treatment?

Purpose: To determine, pretreatment, how head and neck cancer (HNC) patient s prioritize potential treatment effects in relationship to each other and to survival and to ascertain whether patients' preferences are related to d emographic or disease characteristics, performance status, or quality of li fe (QOL). Patients and Methods: One hundred thirty-one patients were assessed pretrea tment using standardized measures of QOL (Functional Assessment of Cancer T herapy-Head and Neck) and performance (Performance Status Scale for Head an d Neck Cancer). patients were also asked to rank a series of 12 potential H NC treatment effects. Results: Being cured was ranked top priority by 75% of patients; another 18 % ranked it second or third. Living as long as possible and having no pain were placed in the top three by 56% and 35% of patients, respectively. Item s that were ranked in the top three by 10% to 24% of patients included thos e related to energy, swallowing, voice, and appearance. Items related to ch ewing, being understood, tasting, and dry mouth were placed in the top thre e by less than 10% of patients. Excluding the top three rankings, there was considerable variability in ratings. Rankings were generally unrelated to patient or disease characteristics, with the exception that cure and living were of slightly lower priority and pain of higher priority to older patie nts compared with younger patients, Conclusion: The data suggest that, at least pretreatment, survival is of pr imary importance to patients, supporting the development of aggressive trea tment strategies. In addition, results highlight individual variability and warn against making assumptions about patients' attitudes vis-a-vis potent ial outcomes, Whether patients' priorities will change as they experience l ate effects is currently under investigation. (C) 2000 by American Society of Clinical Oncology.