Health-related quality of life and overall survival: a prospective study in patients with head and neck cancer treated w
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Health-related quality of life and overall survival: a prospective study in patients with head and neck cancer treated with radiotherapy A. J. van Nieuwenhuizen1 · L. M. Buffart2,3 · J. A. Langendijk4 · M. R. Vergeer5 · J. Voortman6 · C. R. Leemans1 · I. M. Verdonck‑de Leeuw1 Accepted: 18 November 2020 © The Author(s) 2020
Abstract Purpose We aimed to examine whether pre-treatment, post-treatment and change in health-related quality of Life (HRQoL) is associated with survival, in patients with head and neck cancer (HNC). Methods We included 948 newly diagnosed HNC patients treated with primary or adjuvant (chemo)radiotherapy with curative intent. The EORTC QLQ-C30 questionnaire was assessed pre-treatment and at 6 weeks, 6 months and 12 months posttreatment. Multivariable Cox regression analyses were performed to examine whether HRQoL at all time points and changes in HRQoL over time were associated with survival, after adjusting for demographic, clinical and lifestyle-related variables. Results Higher HRQoL scores were significantly associated with improved 5-year overall survival at all time points, except for the subscale global QoL at 6 weeks. Changes in HRQoL at 6 weeks post-treatment compared to pre-treatment were not significantly associated with survival. Changes in physical (HR: 0.88 95% CI: 0.82–0.96) and emotional functioning (HR: 0.90 95% CI: 0.85–0.96) from pre-treatment to 6 months post-treatment and changes in global QOL, and physical, emotional, and social functioning from pre-treatment to 12 months post-treatment were significantly associated with survival. Conclusion Higher HRQoL reported pre-treatment and post-treatment (6 weeks, 6 months and 12 months) are significantly associated with improved survival, as well as changes in HRQoL at 6 and 12 months compared to pre-treatment. Our results highlight the value of monitoring HRQoL and to identify those patients that report decreased or deteriorated HRQOL. This may help to further improve cancer care in a timely and efficient manner. Keywords Head and neck cancer · Health-related quality of life · Survival
* I. M. Verdonck‑de Leeuw [email protected] 1
Amsterdam University Medical Centers, Department of Otolaryngology-Head and Neck Surgery, Amsterdam, The Netherlands
2
Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, department of Epidemiology and Biostatistics, Amsterdam Public Health, Amsterdam, The Netherlands
3
Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, department of Medical Oncology, Cancer Center Amsterdam, Amsterdam, The Netherlands
4
University Medical Center Groningen, Department of Radiation Oncology, University of Groningen, Groningen, The Netherlands
5
Amsterdam University Medical Centers, Department of Radiation Oncology, Amsterdam, The Netherlands
6
Amsterdam University Medical Centers, Department of Medical Oncology, Amsterdam, The Netherlands
Abbreviations EORTC QLQ-C30 European Organization for Research and Treatment of Cancer Quality of Life Questionnai
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