A prospective study of quality of life in head and neck cancer patients. Part II: Longitudinal data

Objectives: To evaluate the health-related quality of life (HRQL) of patien ts with head and neck cancer during and after treatment with radiotherapy, surgery, and chemotherapy. Study Design: Prospective, descriptive study. Me thods. All new patients in four institutions in Norway and Sweden were aske d to participate. Health-related quality of life was assessed at baseline a nd at 1, 2, 3, 6, and 12 months after start of treatment by means of the Eu ropean Organization for Research and Treatment of Cancer (EORTC) Core Quali ty of Life Questionnaire and the EORTC head and neck cancer-specific questi onnaire. Baseline results are described elsewhere; longitudinal results are presented in the current article. Three hundred fifty-seven patients with cancer in the oral cavity, pharynx, larynx, nose, sinuses, and salivary gla nds and neck node metastases from unknown primaries filled in the questionn aires at baseline. Results. Seventy-eight percent of the patients who were alive after 12 months filled in all questionnaires (218/280). The general t rend was that HRQL deteriorated significantly during treatment, followed by a slow recovery until the 12-month follow-up with few exceptions (senses, dry mouth, and sexuality). Patients who later died reported worse HRQL at e ach assessment point compared with patients who filled in all six questionn aires, whereas those who dropped out of the study for other reasons were qu ite similar to patients who filled in all questionnaires. The patients with pharyngeal cancer in general reported worse HRQL compared with the other g roups and did not reach pretreatment values in several domains. Stage was a lso an important factor for HRQL in patients with head and neck cancer. Con clusion: Detailed knowledge about the differences between groups and change s over time may aid us in the communication with patients and in the design of intervention studies focusing on improvement of the support and rehabil itation of patients with head and neck cancer.