Elsevier

Radiotherapy and Oncology

Volume 97, Issue 2, November 2010, Pages 258-262
Radiotherapy and Oncology

Quality of life after radiotherapy
Quality of life as predictor of survival: A prospective study on patients treated with combined surgery and radiotherapy for advanced oral and oropharyngeal cancer

https://doi.org/10.1016/j.radonc.2010.02.005Get rights and content

Abstract

Background and purpose

The relation between health-related quality of life (HRQOL) and survival was investigated at baseline and 6 months in 80 patients with advanced oral or oropharyngeal cancer after microvascular reconstructive surgery and (almost all) adjuvant radiotherapy.

Materials and methods

Multivariate Cox regression analyses of overall and disease-specific survival were performed including sociodemographic (age, gender, marital status, comorbidity), and clinical (tumor stage and site, radical surgical, metastasis, radiotherapy) parameters, and HRQOL (EORTC QLQ-C30 global quality of life scale).

Results

Before treatment, younger age and having a partner were predictors of disease-specific survival; younger age predicted overall survival. At 6 months post-treatment, disease-specific and overall survival was predicted by (deterioration of) global quality of life solely. Global health-related quality of life after treatment was mainly influenced by emotional functioning.

Conclusion

Deterioration of global quality of life after treatment is an independent predictor of survival in patients with advanced oral or oropharyngeal cancer.

Section snippets

Patients

Patients diagnosed with advanced squamous cell carcinomas of the oral cavity or the oropharynx were recruited for this prospective study between January 1998 and December 2001. Patients were planned to be treated by composite resections with microvascular soft tissue transfer (i.e. radial forearm free flap (RFFF)) for the reconstruction of their surgical defects, supplemented by radiotherapy on indication. Exclusion criteria were age greater than 75 years, serious cognitive impairment and lack

Sample description

Patient characteristics are shown in Table 1. The patients’ age ranged from 23 to 74 years (mean = 58 years). Forty-one percent of the sample was female. Fifty-four patients (67%) had a partner. Oral cavity tumors represented 47% (n = 38) of the cases, and oropharynx tumors 53% (n = 42). Tonsil, mobile tongue, floor-of-mouth, and base-of-tongue were the most common subsites (30%, 23%, 20%, and 14%, respectively). One patient was treated for a recurrent tumor after transoral excision (1 year earlier) and

Discussion

The main objective of the present study was to assess prospectively whether deterioration of HRQOL after treatment contributes in predicting survival besides clinical and sociodemographic aspects, in a cohort of 80 patients with advanced oral or oropharyngeal cancer all treated by reconstructive surgery and postoperative radiotherapy.

Regarding clinical predictors, tumor stage and site were predictive of survival in univariate analyses but not in the multivariate model, probably because of the

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