RT Journal
A1 Funk GF, Karnell L, Christensen AJ
T1 LOng-term health-related quality of life in survivors of head and neck cancer
JF Archives of Otolaryngology–Head & Neck Surgery
JO Archives of Otolaryngology–Head & Neck Surgery
YR 2012
FD February 1
VO 138
IS 2
SP 123
OP 133
DO 10.1001/archoto.2011.234
UL http://dx.doi.org/10.1001/archoto.2011.234
AB Objective 
                  To examine health-related quality of life (HRQOL) reported by 5-year head and neck cancer survivors and factors that predicted these long-term scores.Design 
                  Prospective, observational outcomes study.Setting 
                  Tertiary care institution.Patients 
                  A total of 337 patients diagnosed as having head and neck carcinoma between January 1995 and December 2004, who enrolled in the Outcomes Assessment Project and survived at least 5 years.Interventions 
                  While participating in the longitudinal Outcomes Assessment Project, patients filled out surveys measuring HRQOL at numerous points in time.Main Outcome Measures 
                  Outcomes included 5-year scores in eating, speech, aesthetics, social disruption, physical and mental health, depressive symptoms, and overall quality of life (QOL). In addition to analyzing patients' 5-year HRQOL outcomes, multivariate analyses were performed to determine which patient, clinical, treatment, and 1-year HRQOL factors independently predicted these 5-year outcomes.Results 
                  Overall, the cohort's long-term general health was similar to that to age-matched norms from the general population. But over 50% of these survivors had problems eating, 28.5% reported depressive symptoms, and 17.3% reported substantial pain. At long-term follow-up, 13.6% continued to smoke, and 38.9% used alcohol. Multivariate analyses demonstrated that 1-year pain and diet were the strongest independent predictors of 5-year HRQOL outcomes.Conclusions 
                  Eating problems due to poor oropharyngeal functioning and persistent pain are the most prevalent problems that these survivors face. Early interventions addressing eating issues, swallowing problems, and pain management will be a crucial component in improving this patient population's long-term QOL, especially in those who are functioning poorly 1 year after diagnosis.