Health-related quality of life in long-term head and neck cancer survivors: a comparison with general population norms

Abstract

To examine the health-related quality of life (HRQL) in long-term head and neck (H&N) cancer survivors compared with general population norms. HRQL was assessed with three standardized questionnaires: the SF-36 Health Survey (Short Form 36) and the EORTC QLQ-C30 and QLQ-H&N35 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, -Core 30 and -Head and Neck 35 cancer module). Altogether 135 H&N cancer patients (mean age 62 years, 31% females) of 151 survivors (89% acceptance) from a longitudinal HRQL study (n = 232) were included 3 years after diagnosis. The H&N cancer patients' SF-36 scores did not differ significantly from those of an age- and sex-matched sample (n = 871) from the Swedish normative population, except on the role-physical functioning scale. On the other hand, treatment-related side-effects and disease-specific problems (e.g., swallowing, local pain and dry mouth) measured by the H&N cancer module were, with few exceptions, significantly worse than norm values. Gender comparisons revealed that female H&N cancer patients generally scored better than the norms on both the SF-36 and the EORTC QLQ-C30, while the male patients scored significantly worse on most SF-36 scales. Patients > or =65 years more often scored worse than the norm than did patients <65. Clinically relevant differences were found on the majority of SF-36 scales in comparison of tumour sites, however, comparisons of patients with small (stage I+II) versus advanced (stage III+IV) tumours revealed few differences. Three years after diagnosis H&N cancer patients still suffer significant functional limitations/problems related to their disease and its treatment but these problems do not generally affect their overall HRQL. Tumour stage no longer differentiates HRQL at 3 years, however, factors related to the patients' age, gender and location of the tumour appear to have bearing on their reported health status.

References 38

1. 1.

   Aaronson N. K., Ahmedzai S., Bergman B., Bullinger M., Cull A., Duez N. J., Filiberti A., Flechtner H., Fleishman S. B., de Haes J. C. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993;85(5):365-376.

   Not in our library10.1093/jnci/85.5.365

2. 2.

   Bjordal K., Ahlner-Elmqvist M., Tollesson E., Jensen A. B., Razavi D., Maher E. J., Kaasa S. Development of a European Organization for Research and Treatment of Cancer (EORTC) questionnaire module to be used in quality of life assessments in head and neck cancer patients. EORTC Quality of Life Study Group. Acta Oncol. 1994;33(8):879-885.

   Not in our library10.3109/02841869409098450

3. 3.

   Bjordal K., Freng A., Thorvik J., Kaasa S. Patient self-reported and clinician-rated quality of life in head and neck cancer patients: a cross-sectional study. Eur J Cancer B Oral Oncol. 1995;31B(4):235-241.

   Not in our library10.1016/0964-1955(95)00010-f

4. 4.

   Bjordal K., Hammerlid E., Ahlner-Elmqvist M., de Graeff A., Boysen M., Evensen J. F., Biörklund A., de Leeuw J. R., Fayers P. M., Jannert M. Quality of life in head and neck cancer patients: validation of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-H&N35. J Clin Oncol. 1999;17(3):1008-1019.

   Not in our library10.1200/jco.1999.17.3.1008

5. 5.

   Bjordal K., Kaasa S., Mastekaasa A. Quality of life in patients treated for head and neck cancer: a follow-up study 7 to 11 years after radiotherapy. Int J Radiat Oncol Biol Phys. 1994;28(4):847-856.

   Not in our library10.1016/0360-3016(94)90104-x

6. 6.
   Psychological distress in head and neck cancer patients 7-11 years after curative treatment · 1995

   No notice
7. 7.

   Bjordal K., Kaasa S. Psychometric validation of the EORTC Core Quality of Life Questionnaire, 30-item version and a diagnosis-specific module for head and neck cancer patients. Acta Oncol. 1992;31(3):311-321.

   Not in our library10.3109/02841869209108178

8. 8.

   Chin M. H., Goldman L. Gender differences in 1-year survival and quality of life among patients admitted with congestive heart failure. Med Care. 1998;36(7):1033-1046.

   Not in our library10.1097/00005650-199807000-00010

9. 9.

   De Boer M. F., McCormick L. K., Pruyn J. F., Ryckman R. M., van den Borne B. W. Physical and psychosocial correlates of head and neck cancer: a review of the literature. Otolaryngol Head Neck Surg. 1999;120(3):427-436.

   Not in our library10.1016/s0194-5998(99)70287-1

10. 10.

    Deleyiannis F. W., Weymuller E. A., Coltrera M. D., Futran N. Quality of life after laryngectomy: are functional disabilities important? Head Neck. 1999;21(4):319-324.

    Not in our library10.1002/(sici)1097-0347(199907)21:4<319::aid-hed5>3.0.co;2-h

11. 11.

    Deleyiannis F. W., Weymuller E. A., Coltrera M. D. Quality of life of disease-free survivors of advanced (stage III or IV) oropharyngeal cancer. Head Neck. 1997;19(6):466-473.

    Not in our library10.1002/(sici)1097-0347(199709)19:6<466::aid-hed2>3.0.co;2-x

12. 12.

    Funk G. F., Karnell L. H., Dawson C. J., Means M. E., Colwill M. L., Gliklich R. E., Alford E. L., Stewart M. G. Baseline and post-treatment assessment of the general health status of head and neck cancer patients compared with United States population norms. Head Neck. 1997;19(8):675-683.

    Not in our library10.1002/(sici)1097-0347(199712)19:8<675::aid-hed5>3.0.co;2-2

13. 13.
    A prospective multicentre study in Sweden and Norway of mental distress and psychiatric morbidity in head and neck cancer patients · 1999

    No notice
14. 14.

    Hammerlid E., Bjordal K., Ahlner-Elmqvist M., Jannert M., Kaasa S., Sullivan M., Westin T. Prospective, longitudinal quality-of-life study of patients with head and neck cancer: a feasibility study including the EORTC QLQ-C30. Otolaryngol Head Neck Surg. 1997;116(6 Pt 1):666-673.

    Not in our library10.1016/s0194-59989770246-8

15. 15.

    Hammerlid E., Mercke C., Sullivan M., Westin T. A prospective quality of life study of patients with laryngeal carcinoma by tumor stage and different radiation therapy schedules. Laryngoscope. 1998;108(5):747-759.

    Not in our library10.1097/00005537-199805000-00023

16. 16.

    Hammerlid E., Mercke C., Sullivan M., Westin T. A prospective quality of life study of patients with oral or pharyngeal carcinoma treated with external beam irradiation with or without brachytherapy. Oral Oncol. 1997;33(3):189-196.

    Not in our library10.1016/s0964-1955(96)00069-3

17. 17.

    Hammerlid E., Persson L. O., Sullivan M., Westin T. Quality-of-life effects of psychosocial intervention in patients with head and neck cancer. Otolaryngol Head Neck Surg. 1999;120(4):507-516.

    Not in our library10.1053/hn.1999.v120.a90352

18. 18.

    Hammerlid E., Wirblad B., Sandin C., Mercke C., Edström S., Kaasa S., Sullivan M., Westin T. Malnutrition and food intake in relation to quality of life in head and neck cancer patients. Head Neck. 1998;20(6):540-548.

    Not in our library10.1002/(sici)1097-0347(199809)20:6<540::aid-hed9>3.0.co;2-j

19. 19.

    Hjermstad M. J., Fayers P. M., Bjordal K., Kaasa S. Health-related quality of life in the general Norwegian population assessed by the European Organization for Research and Treatment of Cancer Core Quality-of-Life Questionnaire: the QLQ=C30 (+ 3). J Clin Oncol. 1998;16(3):1188-1196.

    Not in our library10.1200/jco.1998.16.3.1188

20. 20.

    Hjermstad M. J., Fayers P. M., Bjordal K., Kaasa S. Using reference data on quality of life--the importance of adjusting for age and gender, exemplified by the EORTC QLQ-C30 (+3). Eur J Cancer. 1998;34(9):1381-1389.

    Not in our library10.1016/s0959-8049(98)00136-1

21. 21.

    Hjermstad M. J., Fossa S. D., Bjordal K., Kaasa S. Test/retest study of the European Organization for Research and Treatment of Cancer Core Quality-of-Life Questionnaire. J Clin Oncol. 1995;13(5):1249-1254.

    Not in our library10.1200/jco.1995.13.5.1249

22. 22.

    Jones E., Lund V. J., Howard D. J., Greenberg M. P., McCarthy M. Quality of life of patients treated surgically for head and neck cancer. J Laryngol Otol. 1992;106(3):238-242.

    Not in our library10.1017/s0022215100119152

23. 23.

    King M. T. The interpretation of scores from the EORTC quality of life questionnaire QLQ-C30. Qual Life Res. 1996;5(6):555-567.

    Not in our library10.1007/bf00439229

24. 24.

    List M. A., Ritter-Sterr C. A., Baker T. M., Colangelo L. A., Matz G., Pauloski B. R., Logemann J. A. Longitudinal assessment of quality of life in laryngeal cancer patients. Head Neck. 1996;18(1):1-10.

    Not in our library10.1002/(sici)1097-0347(199601/02)18:1<1::aid-hed1>3.0.co;2-7

25. 25.

    List M. A., Siston A., Haraf D., Schumm P., Kies M., Stenson K., Vokes E. E. Quality of life and performance in advanced head and neck cancer patients on concomitant chemoradiotherapy: a prospective examination. J Clin Oncol. 1999;17(3):1020-1028.

    Not in our library10.1200/jco.1999.17.3.1020

26. 26.

    Morton R. P. Laryngeal cancer: quality-of-life and cost-effectiveness. Head Neck. 1997;19(4):243-250.

    Not in our library10.1002/(sici)1097-0347(199707)19:4<243::aid-hed1>3.0.co;2-0

27. 27.

    Osborne M. L., Vollmer W. M., Linton K. L., Buist A. S. Characteristics of patients with asthma within a large HMO: a comparison by age and gender. Am J Respir Crit Care Med. 1998;157(1):123-128.

    Not in our library10.1164/ajrccm.157.1.9612063

28. 28.

    Osoba D., Rodrigues G., Myles J., Zee B., Pater J. Interpreting the significance of changes in health-related quality-of-life scores. J Clin Oncol. 1998;16(1):139-144.

    Not in our library10.1200/jco.1998.16.1.139

29. 29.

    Osoba D., Zee B., Pater J., Warr D., Kaizer L., Latreille J. Psychometric properties and responsiveness of the EORTC quality of Life Questionnaire (QLQ-C30) in patients with breast, ovarian and lung cancer. Qual Life Res. 1994;3(5):353-364.

    Not in our library10.1007/bf00451727

30. 30.

    This reference’s wording can’t be shown under the paper’s licence.

    Not in our library

31. 31.

    This reference’s wording can’t be shown under the paper’s licence.

    Not in our library

32. 32.

    Pruyn J. F., de Jong P. C., Bosman L. J., van Poppel J. W., van Den Borne H. W., Ryckman R. M., de Meij K. Psychosocial aspects of head and neck cancer--a review of the literature. Clin Otolaryngol Allied Sci. 1986;11(6):469-474.

    Not in our library10.1111/j.1365-2273.1986.tb00153.x

33. 33.

    Rogers S. N., Lowe D., Brown J. S., Vaughan E. D. The University of Washington head and neck cancer measure as a predictor of outcome following primary surgery for oral cancer. Head Neck. 1999;21(5):394-401.

    Not in our library10.1002/(sici)1097-0347(199908)21:5<394::aid-hed3>3.0.co;2-q

34. 34.

    Sullivan M., Karlsson J., Ware J. E. The Swedish SF-36 Health Survey--I. Evaluation of data quality, scaling assumptions, reliability and construct validity across general populations in Sweden. Soc Sci Med. 1995;41(10):1349-1358.

    Not in our library10.1016/0277-9536(95)00125-q

35. 35.

    Terrell J. E., Nanavati K., Esclamado R. M., Bradford C. R., Wolf G. T. Health impact of head and neck cancer. Otolaryngol Head Neck Surg. 1999;120(6):852-859.

    Not in our library10.1016/s0194-5998(99)70326-8

36. 36.

    Ware J. E., Sherbourne C. D. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473-483.

    Not in our library

37. 37.

    de Graeff A., de Leeuw J. R., Ros W. J., Hordijk G. J., Blijham G. H., Winnubst J. A. A prospective study on quality of life of patients with cancer of the oral cavity or oropharynx treated with surgery with or without radiotherapy. Oral Oncol. 1999;35(1):27-32.

    Not in our library10.1016/s1368-8375(98)00049-9

38. 38.

    de Graeff A., de Leeuw R. J., Ros W. J., Hordijk G. J., Battermann J. J., Blijham G. H., Winnubst J. A. A prospective study on quality of life of laryngeal cancer patients treated with radiotherapy. Head Neck. 1999;21(4):291-296.

    Not in our library10.1002/(sici)1097-0347(199907)21:4<291::aid-hed1>3.0.co;2-b

Cited by papers we hold 1

• Reliability and validity of the SF-36 Health Survey Questionnaire in patients with brain tumors: a cross-sectional study · 2017
  No notice

Reads

A person counts once a day per paper. We keep no cookie and no address: a reader is a hash that changes every day. Any month under five reads shows no number.