Quality Of Life Assessment in Head and Neck Cancer Patients Undergoing Radiation Therapy in a Tertiary Referral University Hospital
Abstract
Introduction: There is considerable post-treatment morbidity in survivors of head and neck cancer (HNC) despite improved survival following multimodality therapy. Assessment of health-related quality of life (HR-QoL) gives valuable information about functional and psychosocial sequelae of radiation therapy (RT), especially in less-studied populations like South Asians.
Methodology: A prospective observational study was conducted between August 2023 and December 2024, including biopsy-proven HNC patients receiving curative-intent RT (definitive or adjuvant). The EORTC QLQ-HN35 questionnaire (Urdu/English, interviewer-assisted) was administered at baseline and 12 ± 2 weeks post-RT. Mean ± SD were calculated for each domain. Pre- and post-treatment differences were analyzed using paired t-tests, while multivariate analysis (GLM-MANOVA) identified factors associated with HR-QoL outcomes.
Results: Fifty-six patients (mean age, 49 ± 13 years; male sex, 78.6%) were included in the analysis. There was a marked deterioration of xerostomia (p = 0.004), pain (p = 0.011) and taste/smell (p = 0.018), whereas social contacts (p = 0.048) and sexuality (p < 0.001) improved after therapy. Tumor site (p < 0.001), histological subtype (p < 0.001) and marital status (p < 0.001) were the main HR-QoL predictors detected. Both oropharyngeal/hypopharyngeal locations were related to more post-treatment pain and social-eating problems.
Conclusion: Within three months after curative-intent RT, HNC patients showed worsening of xerostomia, pain, and sensory loss, with improvement in social contact and sexuality. Tumor site, histopathology, and marital status were key predictors of HR-QoL, demonstrating anatomical, biological, and psychosocial influences. Targeted follow-up and supportive care are important for future studies integrating patient-reported and objective outcomes to personalize survivorship care.
Conflict of interests: The authors declare no conflict of interest.
Funding: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
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