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Quality of life in head and neck cancer patients: Impact of HPV and primary treatment modality
Author(s) -
Maxwell Jessica H.,
Mehta Vikas,
Wang Hong,
Cunningham Diana,
Duvvuri Umamaheswar,
Kim Seungwon,
Johnson Jonas,
Ferris Robert L.
Publication year - 2014
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.24508
Subject(s) - medicine , quality of life (healthcare) , head and neck cancer , swallowing , primary treatment , radiation therapy , surgery , nursing
Objectives/Hypothesis To determine posttreatment quality of life (QOL) in head and neck cancer patients, stratifying by human papillomavirus (HPV)/p16 status and primary treatment modality. Study Design Retrospective study. Methods One hundred and seventy‐seven patients (N = 177) with head and neck squamous cell carcinoma and known HPV/p16 status were included. All patients completed at least one baseline or posttreatment University of Washington QOL survey. QOL scores were averaged and compared across patients, stratifying by HPV/p16 status and primary treatment modality (surgical vs. nonsurgical). In the analysis, p16 was used as a surrogate marker for HPV. Results Of the 177 patients, 80 (45.2%) were p16‐positive and 49.7% of subsites were oropharyngeal. Nearly 60% (105/177) of patients underwent primary surgery, 26.7% (28/105) of patients with transoral robotic or laser techniques. The remainder 40.7% of patients underwent primary radiation and/or chemotherapy. Overall, QOL scores were better for p16‐positive patients compared to p16‐negative patients at baseline ( P = 0.008), at 6 months posttreatment ( P = 0.034), and at greater than 1 year posttreatment ( P = 0.013). P16‐positive patients had better QOL scores in speech ( P = 0.0009), chewing ( P = 0.0004), and swallowing ( P = 0.021) after 1 year posttreatment compared to p16‐negative patients. Primary treatment modality did not affect overall QOL or any of the 12 QOL categories in p16‐positive patients at any time point. At over 1 year posttreatment, QOL was at or above baseline in both p16‐positive treatment groups. Conclusion The p16‐positive patients had better baseline and posttreatment overall QOL compared to p16‐negative patients. The overall and category specific QOL scores for p16‐positive patients were not affected by primary treatment modality. Level of Evidence 4. Laryngoscope , 124:1592–1597, 2014