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Randomized Clinical Trial on Reduction of Radiotherapy Dose to the Elective Neck in Head and Neck Squamous Cell Carcinoma: Results on the Quality of Life

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Abstract

Purpose

A randomized trial was initiated to investigate whether a reduction of the dose to the elective nodal sites would result in less toxicity and improvement in Quality of Life (QoL) without compromising tumor control. This paper aimed to compare QoL in both treatment arms.

Methods

Two-hundred head and neck cancer patients treated with radiotherapy (RT) or chemo-RT were randomized (all stages, mean age: 60 years, M/F: 82%/18%). The elective nodal volumes of patients randomized in the experimental arm were treated up to a 40 Gy equivalent dose. In the standard arm, the elective nodal volumes were treated up to a 50 Gy equivalent dose. The QoL data were collected using The European Organization for Research and Treatment of Cancer (EORTC) core questionnaire QLQ-C30 and the EORTC Head and Neck Cancer module (H&N35).

Results

A trend toward less decline in QoL during treatment was observed in the 40 Gy arm compared to the 50 Gy arm. Statistically significant differences for global health status, physical functioning, emotional functioning, speech problems, and trouble with social eating in favor of the 40 Gy arm were observed. A clinically relevant better outcome in the 40 Gy arm was found for physical functioning at the end of therapy.

Conclusion

QoL during RT for head and neck cancer tends to be less impaired in the 40 Gy arm. However, reducing the dose only on the elective neck does not result in clinically relevant improvement of QoL. Therefore, additional treatment strategies must be examined to further improve the QoL of HNSCC patients.

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Acknowledgements

Study organization and data collection were performed by Rita Aerts. Statistical analysis was done in collaboration with Ann Belmans.

Funding

This project is supported by a grant from Stand up to Cancer (Kom op tegen Kanker), the Flemish Cancer Society.

Author information

Author notes

  1. J. F. Daisne

    Present address: Department of Radiation Oncology, KU Leuven - University of Leuven, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium

  2. D. Nevens

    Present address: Department of Radiation Oncology, Iridium Kanker Netwerk, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium

Authors and Affiliations

  1. Department of Radiation Oncology, KU Leuven - University of Leuven, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium

    S. Deschuymer, D. Nevens & S. Nuyts

  2. Department of Radiotherapy-Oncology, Ghent University Hospital, Ghent, Belgium

    F. Duprez & W. De Neve

  3. Department of Radiation Oncology, Université Catholique de Louvain, CHU-UCL-Namur, Site Ste-Elisabeth, Namur, Belgium

    J. F. Daisne

  4. Department of Radiation Oncology, UZ Brussel, Vrije Universiteit Brussel, Brussel, Belgium

    M. Voordeckers

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Correspondence to S. Nuyts.

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Deschuymer, S., Nevens, D., Duprez, F. et al. Randomized Clinical Trial on Reduction of Radiotherapy Dose to the Elective Neck in Head and Neck Squamous Cell Carcinoma: Results on the Quality of Life. Qual Life Res 30, 117–127 (2021). https://doi.org/10.1007/s11136-020-02628-w

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