Treatment modality impact on quality of life for human papillomavirus-associated oropharynx cancer.
Oropharynx carcinoma
complications
gastrostomy tube rates
human papillomavirus
oropharyngeal carcinoma
outcomes
quality of life
squamous cell carcinoma
treatment effect
Journal
The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378
Informations de publication
Date de publication:
02 2020
02 2020
Historique:
received:
12
11
2018
revised:
05
01
2019
accepted:
27
02
2019
pubmed:
29
3
2019
medline:
31
7
2020
entrez:
29
3
2019
Statut:
ppublish
Résumé
Compare treatment-related quality of life (QOL) impact for early-stage human papillomavirus-associated oropharynx squamous cell carcinoma (HPV+ OPSCC) patients. Retrospective cohort at a tertiary center. Stage I (T0-2/N0-1) HPV+ OPSCC patients (n = 76) with pretreatment Karnofsky scores ≥80 reported QOL after surgery alone (n = 17, 22%), surgery with adjuvant radiation ± chemotherapy (S-a[C]XRT) (n = 23, 30%), or definitive radiation ± chemotherapy (d[C]XRT) (n = 36, 47%) with the University of Washington QOL version 4 (UW-QOL); European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, Core Module (EORTC QLQ-C30) and Head and Neck Module (EORTC QLQ-HN35); University of Michigan Xerostomia, and Neck Dissection Impairment Index questionnaires (median follow-up = 2.2 years, interquartile range = 1.0-4.2 years). Treatment adverse events and gastrostomy tube rates were assessed. Over 87% of each treatment group reported good or better overall QOL. Each group had low gastrostomy tube and treatment-specific complication rates. S-a(C)XRT and d(C)XRT patients had similar mean scores with wide ranges for most individual and all composite categories. S-a(C)XRT compared to d(C)XRT patients reported significantly fewer dental problems (EORTC QLQ-C30/HN35 means = 10.1 vs. 34.3, P = .007), worse appearance (UW-QOL means = 72.8 vs. 82.6, P = .02), and worse coughing (EORTC QLQ-C30/HN35 means = 31.9 vs. 15.7, P = .007). Surgery alone compared to d(C)XRT and S-a(C)XRT patients reported significantly better salivary/taste/oral functions and less pain, financial, oral/dental, and sexual problems. For early-stage HPV+ OPSCC, patients usually achieve acceptable QOL regardless of treatment. S-a(C)XRT and d(C)XRT patients report generally similar QOL including neck/shoulder pain/function, but with a wide range in a limited patient sample. Surgery alone should be considered, when oncologically and functionally safe, given the better associated QOL. 4 Laryngoscope, 130:E48-E56, 2020.
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
E48-E56Informations de copyright
© 2019 The American Laryngological, Rhinological and Otological Society, Inc.
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