Evaluation of the correlation between side effects to oral mucosa, salivary glands, and general health status with quality of life during intensity-modulated radiotherapy for head and neck cancer

Support Care Cancer. 2021 Jan;29(1):127-134. doi: 10.1007/s00520-020-05454-5. Epub 2020 Apr 21.

Abstract

Purpose: The aim of this study was to evaluate the distribution of acute clinical complications that involve the oral cavity (oral mucositis and salivary flow), general health status (Karnofsky performance status scale (KPS) and weight), and quality of life using the worst performance throughout radiotherapy treatment by intensity-modulated radiation therapy (IMRT) in the head and neck region and to evaluate the correlation between these variables.

Methods: This prospective, longitudinal study evaluated 32 patients who were undergoing IMRT for head and neck tumors. The measures were collected weekly through standardized protocols and a quality of life questionnaire (UW-QOL version 4).

Results: The worst performance for all variables was concentrated in treatment weeks 2 and 5. Regarding quality of life, the emotional dimensions were the most affected (pain 62.86; activity 55; recreation 43.57; mood 49.97; shoulder 57.06; anxiety 42.91). There were a higher number of moderate mucositis correlations with quality of life (mucositis × KPS 0.002; mucositis × weight loss 0.03; mucositis × pain 0.001; mucositis × activity 0.002; mucositis × recreation 0.001; mucositis × swallowing 0.002; mucositis × saliva 0.006; mucositis × mood 0.007; mucositis × anxiety 0.002).

Conclusions: IMRT treatment severely deteriorated the patients' quality of life. There were important correlations between the clinical variables and quality of life, especially mucositis.

Keywords: Head and neck neoplasms; Hyposalivation; Oral mucositis; Quality of life; Radiation effects; Radiotherapy.

MeSH terms

  • Adult
  • Aged
  • Female
  • Head and Neck Neoplasms / radiotherapy*
  • Humans
  • Karnofsky Performance Status
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Mouth Mucosa / pathology*
  • Prospective Studies
  • Quality of Life / psychology
  • Radiotherapy, Intensity-Modulated / adverse effects*
  • Salivary Glands / pathology*
  • Stomatitis / etiology*
  • Surveys and Questionnaires
  • Xerostomia / pathology*