Optimizing the assessment of quality of life after laryngeal cancer treatment
|V. Lee-Preston a1, I. N. Steen a2, A. Dear a1, C. G. Kelly a3, A. R. Welch a1, D. Meikle a1, F. W. Stafford a1 and J. A. Wilson a1|
a1 Department of Otolaryngology, Freeman Hospital, Newcastle upon Tyne, UK.
a2 Centre for Health Services Research, University of Newcastle upon Tyne, Newcastle General Hospital, Newcastle upon Tyne, UK.
a3 Northern Centre for Cancer Treatment, Newcastle General Hospital, Newcastle upon Tyne, UK.
Reports of the impact of larynx cancer treatment modality on quality of life are conflicting, in part due to varying study methodology. The aims of this study were to (1) provide preliminary comparisons of quality of life following radiotherapy or combination therapy; (2) evaluate a number of measures of quality of life and thereby (3) inform future prospective studies. Thirty-six laryngeal cancer patients, 24 following radiotherapy, 12 following radiotherapy and laryngectomy completed the Functional Assessment of Cancer Therapy (FACT) - General/Head and Neck subscale; Nottingham Health Profile (NHP); and the Hospital Anxiety and Depression scale (HAD), three to 12 months post-treatment. Results showed trends towards a less good quality of life in the combined therapy group over a wide range of outcomes, significant for the disease specific FACT head and neck subscale, NHP emotion (p = 0.04) and isolation (p = 0.027). To the authors' knowledge, however, this is the first demonstration of greater impact of laryngeal cancer on quality of life in younger subjects, who had lower scores among others on emotional wellbeing (p = 0.015) and anxiety (p = 0.035). Younger patients thus appear more likely to need more intensive support through treatment. Many of the physical and psychosocial domains derived from the three tools used were highly correlated. In other words, given the known high morbidity of the disease and its treatment, the selection of tools for head and neck quality of life assessment may be much less important than their universal application.
Key Words: Head and Neck Neoplasms; Laryngeal Neoplasms; Quality of Life; Head Disorders.