Assessing oral and dental health-related quality of life in head and neck cancer patients at 1, 5, and 10 years: a comparison of the EORTC QLQ43, FACT H&N, and the Orthognathic-QLQ questionnaires.

PURPOSE

Numerous health-related quality of life (HRQoL) questionnaires are available to assess oral HRQoL in patients undergoing treatment for head and neck (H&N) cancer. These multidimensional instruments should have the capacity to detect meaningful clinical oral function/dental changes at different time points. However, the optimal instrument-or combination of instruments-for assessing oral health and dental needs is not clear. We administered three questionnaires (FACT H&N, EORTC QLQ-H&N43, Orthognathic-QLQ) to assess oral and dental HRQoL in a cohort of H&N cancer patients at 1-, 5- and 10-year post-treatment. A secondary aim was to compare these questionnaires to determine which provides the most useful assessment of oral HRQoL and dental care needs.

METHODS

Prospective, single-center study of patients (n = 82) with H&N cancer grouped according to the follow-up time (1, 5, or 10 years). HRQoL was assessed by telephone with the Functional Assessment of Cancer Therapy (FACT H&N), the European Organization for Research and Treatment (EORTC QLQ-H&N43), and the Orthognathic Questionnaire (OQLQ). Analyses were performed to assess differences between groups.

RESULTS

Eighty-two patients (fifty-nine men) were included. The mean age was 61.9 years. On the EORTC QLQ-H&N43, significant between-group differences (1 year vs. 5 and 10 years) were observed on five multi-item scales (mouth pain, senses, body image, anxiety, and shoulder problems) and on three single-item scales (neurological problems, neck swelling, and weight loss), indicating that QoL for those domains was more negatively impacted at 1-year post-treatment. Adjusted mean scores on most items on the EORTC QLQ-H&N43 were similar in the 5- and 10-year groups. On the other two scales (FACT H&N and OQLG), there were no significant between-group (1, 5, 10 years) differences in adjusted mean scores.

CONCLUSION

These results show that the negative impact of H&N cancer on HRQoL is most evident at 1-year versus 5- or 10-year post-treatment. The combined administration of the EORTC QLQ-H&N43 and the OQLQ appear to provide the most useful assessment of HRQoL.