ABSTRACT
BACKGROUND: The purpose of this prospective study was to evaluate whether a relationship exists between malnutrition (> or =10% weight loss) and health-related quality of life (HRQL) in patients with head and neck cancer and whether weight loss can be predicted with HRQL questionnaires. METHODS: Weight and HRQL were monitored in 49 patients. HRQL was assessed longitudinally, using the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30), the EORTC Head and Neck Cancer module (QLQ-H&N35), and the Hospital Anxiety and Depression Scale (HADS). RESULTS: At diagnosis, those patients who had a weight loss greater than 10% (n = 20) after treatment scored significantly worse on 15 of 28 HRQL variables than did patients who lost less (n = 29). The largest difference (Delta > or =20) was found for role functioning, fatigue, loss of appetite, global quality of life, sticky saliva, and swallowing. Differences in HRQL persisted even after 3 years. The fatigue scale was the only significant predictor of weight loss (p = .005) at diagnosis. CONCLUSIONS: Patients with head and neck cancer who are at risk of severe weight loss developing during treatment may be detected with the aid of HRQL questionnaires at diagnosis.
Subject(s)
Head and Neck Neoplasms/psychology , Quality of Life , Weight Loss/physiology , Activities of Daily Living , Adult , Aged , Anxiety/psychology , Body Weight/physiology , Deglutition/physiology , Depression/psychology , Fatigue/physiopathology , Feeding and Eating Disorders/physiopathology , Female , Follow-Up Studies , Forecasting , Head and Neck Neoplasms/physiopathology , Humans , Longitudinal Studies , Male , Malnutrition/physiopathology , Malnutrition/psychology , Middle Aged , Prospective Studies , Saliva/metabolismABSTRACT
BACKGROUND: A longitudinal, prospective, case-control study evaluated if a psychosocial support program improved health-related quality of life (HRQL) in head and neck (H&N) cancer patients. METHODS: One hundred forty-four H&N cancer patients were included: 52 study patients and 92 controls. The study group met the support team repeatedly throughout the first year after diagnosis. HRQL was assessed three times during the first year and after 3 years using the EORTC QLQ-C30, EORTC QLQ-H&N35, and HADS. RESULTS: A few statistically significant differences were found, all favoring the controls. Controls reported better global quality of life after 1 year and felt less ill after 3 years. Depression and treatment-related side effects were prevalent in both groups. CONCLUSIONS: Our psychosocial support program did not improve HRQL in H&N cancer patients. Its effectiveness may be improved by evaluating and actively integrating HRQL assessments during the program, thereby enabling rapid and adequate symptomatic treatment and/or psychologic intervention.
