Mehmet Turan Cicek, Mehmet Aslan

A comparative analysis of long-term life qualities of head and neck cancer (nasopharyngeal, hypopharyngeal and laryngeal cancers) patients who were treated with the intensity-modulated radiation therapy (IMRT): Expectations and outcomes

The long-term quality of life outcomes of head-neck cancer patients who were treated with Intensity-modulated radiation therapy (IMRT) are not well known. The aim of this study was to determine the long-term quality of life and problems in patients undergoing IMRT in head-neck cancers. The study was conducted at a high-volume tertiary care setting. Patients who have received IMRT for head and neck cancers in our clinic, who completed at least one year following the completion of their therapy, and who are being followed up for the present, were included in the study. To assess patients’ quality of life and problems they experience, the updated(revised) version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck Module (EORTC QLQ-H&N43) and The Arizona Sexual Experience Scale (ASEX) were administered to patients by the same clinician, using the face-to-face interview method. The study included 18,28,30 patients who received IMRT for hypopharyngeal, nasopharyngeal, and laryngeal cancer, respectively. Given the EORTC QLQ-H&N43 results of patient groups; contrary to expectations, mucosal dryness, sense and voice problems were observed as common problems in all patient groups. Thanks to protection of body integrity, good social contact and communication, a high level of satisfaction was observed in all patient groups. In conclusion; a high level of satisfaction was observed in patient groups treated with IMRT, despite long-term mucosal dryness, voice disturbances and sense problems, thanks to the preservation of body integrity and good social communication.

PDF

___

1. Singer S, Araújo C, Arraras JI, et al. Measuring quality of life in patients with head and neck cancer: Update of the EORTC QLQ-H&N Module, Phase III. Head & neck. 2015;37:1358-67.
2. Singer S, Arraras JI, Baumann I, et al. Quality of life in patients with head and neck cancer receiving targeted or multimodal therapy--update of the EORTC QLQ-H&N35, Phase I. Head & neck. 2013;35:1331-8.
3. Op de Coul BM, Ackerstaff AH, van As CJ, et al. Quality of life assessment in laryngectomized individuals: do we need additions to standard questionnaires in specific clinical research projects? Clin Otolaryngol. 2005;30:169-75.
4. Hanna E, Sherman A, Cash D, et al. Quality of life for patients following total laryngectomy vs chemoradiation for laryngeal preservation. Arch Otolaryngol Head Neck Surg. 2004;130:875-9.
5. Guntinas-Lichius O, Rühlow S, Veelken F, et al. Quality of life during first-line palliative chemotherapy for recurrent and metastatic head and neck cancer with weekly cisplatin and docetaxel. J Cancer Res Clin Oncol. 2009;135:901-8.
6. Pignon JP, le Maître A, Maillard E, et al. Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients. Radiother Oncol. 2009;92:4-14.
7. Nutting CM, Morden JP, Harrington KJ, et al. Parotid-sparing intensity modulated versus conventional radiotherapy in head and neck cancer (PARSPORT): a phase 3 multicentre randomised controlled trial. Lancet Oncol. 2011;12:127-36.
8. Bhide SA, Nutting CM. Advances in radiotherapy for head and neck cancer. Oral Oncol. 2010;46:439-41.
9. Bjordal K, Ahlner-Elmqvist M, Tollesson E, et al. Development of a european organization for research and treatment of cancer (EORTC) questionnaire module to be used in quality of life assessments in head and neck cancer patients. EORTC Quality of Life Study Group. Acta Oncol. 1994;33:879-85.
10. Bjordal K, Hammerlid E, Ahlner-Elmqvist M, et al. Quality of life in head and neck cancer patients: validation of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-H&N35. J Clin Oncol. 1999;17:1008-19.
11. Bjordal K, de Graeff A, Fayers PM, et al. A 12 country field study of the EORTC QLQ-C30 (version 3.0) and the head and neck cancer specific module (EORTC QLQ-H&N35) in head and neck patients. EORTC Quality of Life Group. Eur J Cancer. 2000;36:1796-807.
12. Singer S, Amdal CD, Hammerlid E, et al. International validation of the revised european organisation for research and treatment of cancer head and neck cancer module, the EORTC QLQ-HN43: Phase IV. Head Neck. 2019;41:1725-37.
13. Elnazer HY, Baldwin DS. Structured review of the use of the Arizona sexual experiences scale in clinical settings. Hum Psychopharmacol. 2020;35:e2730.
14. McGahuey CA, Gelenberg AJ, Laukes CA, et al. The Arizona Sexual Experience Scale (ASEX): reliability and validity. J Sex Marital Ther. 2000;26:25-40.
15. Zrnc TA, Tomic J, Tomazic PV, et al. Complex mandibular reconstruction for head and neck squamous cell carcinoma-the ongoing challenge in reconstruction and rehabilitation. Cancers. 2020;12.
16. Puri DR, Chou W, Lee N. Intensity-modulated radiation therapy in head and neck cancers: dosimetric advantages and update of clinical results. Am J Clin Oncol. 2005;28:415-23.
17. Intensity Modulated Radiation Therapy Collaborative Working Group. Intensity-modulated radiotherapy: current status and issues of interest. Int J Radiat Oncol Biol Phys. 2001;51:880-914.
18. Moreno AC, Frank SJ, Garden AS, et al. Intensity modulated proton therapy (IMPT) - The future of IMRT for head and neck cancer. Oral oncology. 2019;88:66-74.
19. Abel E, Silander E, Nyman J, et al. Long-term aspects of quality of life in head and neck cancer patients treated with intensity modulated radiation therapy: A 5-year longitudinal follow-up and comparison with a normal population cohort. Adv Radiat Oncol. 2020;5:101-10.
20. The World Health Organization Quality of Life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med. 1995;41:1403-9.
21. Dietz A, Meyer A, Singer S. Measuring quality of life in head and neck cancer. Current status and future needs. Hno. 2009;57:857-65.
22. Karimi M, Brazier J. Health, health-related quality of life, and quality of life: what is the difference? Pharmacoeconomics. 2016;34:645-9.
23. Chen AM, Daly ME, Farwell DG, et al. Quality of life among longterm survivors of head and neck cancer treated by intensity-modulated radiotherapy. JAMA Otolaryngol Head Neck Surg. 2014;140:129-33.
24. Vainshtein JM, Moon DH, Feng FY, et al. Long-term quality of life after swallowing and salivary-sparing chemo-intensity modulated radiation therapy in survivors of human papillomavirus-related oropharyngeal cancer. Int J Radiat Oncol Biol Phys. 2015;91:925-33.
25. Kraaijenga SA, Oskam IM, van Son RJ, et al. Assessment of voice, speech, and related quality of life in advanced head and neck cancer patients 10-years+ after chemoradiotherapy. Oral Oncol. 2016;55:24-30.
26. Kraaijenga SA, Oskam IM, van der Molen L,et al. Evaluation of long term (10-years+) dysphagia and trismus in patients treated with concurrent chemo-radiotherapy for advanced head and neck cancer. Oral Oncol. 2015;51:787-94