The effect of cancer stage and treatment modality on quality of life in oropharyngeal cancer

Authors

  • Justine Oates RN, BSc,

    Corresponding author
    1. Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital, Camperdown, Australia
    2. Cancer Nursing Research Unit, Sydney Nursing School, University of Sydney, Sydney, Australia
    • Send correspondence to Justine Oates, RN, Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital, Missenden Road, Camperdown NSW 2050 Australia. Email: justine.oates@sswahs.nsw.gov.au

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  • Sarah Davies RN, BSc,

    1. Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital, Camperdown, Australia
    2. Cancer Nursing Research Unit, Sydney Nursing School, University of Sydney, Sydney, Australia
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  • Jessica K. Roydhouse BA, MPH(Hons),

    1. Sydney Cancer Centre, Royal Prince Alfred Hospital, Missenden Road, Camperdown, Australia
    2. School of Nursing, Edith Cowan University, Joondalup, Australia
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  • Judith Fethney BA(Hons), BTeach,

    1. Cancer Nursing Research Unit, Sydney Nursing School, University of Sydney, Sydney, Australia
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  • Kate White RN, PhD

    1. Sydney Cancer Centre, Royal Prince Alfred Hospital, Missenden Road, Camperdown, Australia
    2. Cancer Nursing Research Unit, Sydney Nursing School, University of Sydney, Sydney, Australia
    3. School of Nursing, Edith Cowan University, Joondalup, Australia
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  • This work was performed at the Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital, Camperdown, Australia.

  • Presented at the Cancer Nurses Society of Australia 14th Winter Congress, Sydney, New South Wales, Australia, July 21–23, 2011; the Multinational Association of Supportive Care in Cancer International Symposium on Supportive Care, New York, New York, U.S.A., June 28–30, 2012; and the 17th International Conference on Cancer Nursing (Biennial Meeting of the International Society of Nurses in Cancer Care), Prague, Czech Republic, September 9–13, 2012.

  • The authors have no funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis

To examine changes in health-related quality of life among oropharyngeal cancer patients by stages and across treatment types among advanced cancer patients.

Study Design

Individual prospective cohort study.

Methods

All newly diagnosed patients with oropharyngeal cancer treated with curative intent were routinely assessed. The European Organization for Research and Treatment of Cancer (EORTC) both the Main Module quality-of-life questionnaire (QLQ-C30) and the Head and Neck Cancer (HNC) Module (QLQ-H&N35) were administered at diagnosis and 3, 6, and 12 months thereafter. Complete case analysis was used following assessment of missing data. The proportion of patients with clinically significant deterioration (changes of ≥10 points) from baseline were calculated for each follow-up time point and compared by stage (I/II vs. III/IV) and then treatment type (chemotherapy and radiotherapy [CRT] vs. surgery and postoperative radiotherapy [S&PORT]).

Results

Deterioration in most domains was most frequent for stage III/IV patients at 3 months (both modules), whereas stage I/II patients experienced this at 6 months (QLQ-C30) and 12 months (H&N35). Among stage III/IV patients, this happened at all time points for S&PORT patients (QLQ-C30) versus 12 months for CRT patients (H&N35). The number of patients reporting deterioration was lower for most domains at 12 months compared to earlier periods, although dry mouth remained a problem for most patients (60%–85% across treatment/stage groups).

Conclusions

Our preliminary findings suggest that general and disease-specific deterioration is of most concern for stage I/II patients at 6 and 12 months and at 3 months for advanced cancer patients. For stage III/IV patients receiving S&PORT, general deterioration remains a problem after diagnosis, whereas for CRT patients, disease-specific deterioration is of most concern at 12 months.

Level of Evidence

4. Laryngoscope, 124:151–158, 2014

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