OBJECTIVE: The purpose of this study was to compare quality of life issues in patients with advanced laryngeal versus oropharyngeal cancer after treatment with chemoradiation.
DESIGN: A cohort study of 31 patients with laryngeal or oropharyngeal squamous cell carcinoma treated with chemoradiation completed the University of Washington quality of life instrument version 4 (UW-QOL v4). Statistical analysis was performed with Wilcoxon rank sum and chi-square tests.
SETTING: Academic tertiary care center.
RESULTS: Both groups reported similar impairment in the domains of swallowing, chewing, and taste. Oropharyngeal cancer patients reported significantly worse quality of life in the domain of saliva (P < 0.007).
CONCLUSION: Swallowing, chewing, and taste were adversely affected by chemoradiation for both groups. Oropharyngeal patients experienced significantly worse problems with saliva than laryngeal patients. These patients reported high levels of satisfaction with health-related quality of life issues.
SIGNIFICANCE: Specific head and neck subsites have different morbidities when treated with primary chemoradiation for advanced tumors.
Get full access to this article
View all access options for this article.
References
1.
The Department of Veterans Affairs Laryngeal Cancer Study Group.Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancerN Engl J Med1991;324:1685–90
2.
CalaisGAlfonsiMBurdetE. Randomized trial of radiation therapy versus comcomitant chemotherapy and radiation therapy for advanced-stage oropharynx carcinomaJ Natl Cancer Inst1999;91:2081–6
3.
ForastiereAKochWTrottiA. Head and neck cancerN Engl J Med2001;345(26):1890–900
4.
BrocksteinBHarafDJRademakerAW. Patterns of failure, prognostic factors and survival in locoregionally advanced head and neck cancer treated with concomitant chemoradiotherapy: a 9-year, 337-patient, multi-institutional experienceAnn Oncol2004;15(8):1179–86
5.
JemalAMurrayTWardE. Cancer statistics, 2005CA Cancer J Clin2005;55:10–30
6.
GilbertJForastiereA. Organ preservation trials for laryngeal cancerOtolaryngol Clin N Am2002;35:1035–54
7.
MachtayMRosenthalDIHershockD. Organ preservation therapy using induction plus concurrent chemoradiation for advanced respectable oropharyngeal carcinoma: a University of Pennsylvania phase II trialJ Clin Oncol2002;20:3964–71
8.
ListMASistonAHarafD. Quality of life and performance in advanced head and neck cancer patients on concomitant chemoradiotherapy: a prospective examinationJ Clin Oncol1999;17:1020–8
9.
NguyenNPSallahSKarlssonU. Combined chemotherapy and radiation therapy for head and neck malignancies: quality of life issuesCancer2002;94:1131–41
10.
TerrellJERonisDLFowlerKE. Clinical predictors of quality of life I patients with head and neck cancerArch Otolaryngol Head Neck Surg2004;130:401–7
11.
MortonRPIzzardME. Quality of life outcomes in head and neck cancer patientsWorld J Surg2003;27:884–9
12.
HammerlidEBjordalKAhlner-ElmqvistM. A prospective study of quality of life in head and neck cancer patients. Part I: At diagnosisLaryngoscope2001;111(4 Pt 1):669–80
13.
BjordalKAhlner-ElmqvistMHammerlidE. A prospective study of quality of life in head and neck cancer patients. Part II: Longitudinal dataLaryngoscope2001;111(8):1440–52
14.
WeymullerEAAlsarrafRYuehB. Analysis of the performance characteristics of the University of Washington quality of life instrument and its modification (UW-QOL-R)Arch Otolaryngol Head Neck Surg2001;127:489–93
15.
LevendagPNijdamWNoeverI. Brachytherapy versus surgery in carcinoma of tonsillar fossa and/or soft palate: late adverse sequelae and performance status: can we be more selective and obtain better tissue sparing?Int J Radiat Oncol Biol Phys2004;59(3):713–24
16.
RogersSNO'DonnellJPWilliams-HewitS. Health related quality of life measured by the UW-QOL-reference data from a general dental practiceOral Oncol2006;42:281–7
17.
DeleyiannisFWBWeymullerEAColtreraMD. Quality of life of disease free survivors of advanced oropharyngeal carcinomaHead Neck1997;19(6):466–73
18.
WeymullerEAYuehBDeleyiannisFWB. Quality of life in head and neck cancerArch Otolaryngol Head Neck Surg2000;126(3):329–35
19.
ShepherdKLFisherSE. Prospective evaluation of quality of life in patients with oral and oropharyngeal cancer: from diagnosis to three months post-treatmentOral Oncol2004;40:751–7
20.
MurryTMadasuRMartinA. Acute and chronic changes in swallowing and quality of life following intraarterial chemoradiation for organ preservation in patients with advanced head and neck cancerHead Neck1998;210:31–7
