Long-term quality of life after definitive treatment of sinonasal and nasopharyngeal malignancies

Matthew A Tyler; Abdallah S R Mohamed; Joshua B Smith; Jeremy M Aymard; Clifton D Fuller; Jack Phan; Steven J Frank; Renata Ferrarotto; Michael E Kupferman; Ehab Y Hanna; Gary B Gunn; Shirley Y Su

doi:10.1002/lary.27849

Long-term quality of life after definitive treatment of sinonasal and nasopharyngeal malignancies

Laryngoscope. 2020 Jan;130(1):86-93. doi: 10.1002/lary.27849. Epub 2019 Feb 1.

Authors

Affiliations

¹ Department of Otorhinolaryngology-Head and Neck Surgery, McGovern Medical School at the University of Texas Health Science Center.
² the Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, Houston.
³ Abilene Christian University, Abilene, Texas, U.S.A.
⁴ the Department of Thoracic/Head and Neck Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston.
⁵ Department of Head and Neck Surgery, the University of Texas MD Anderson Cancer Center, Houston.

PMID: 30706478
DOI: 10.1002/lary.27849

Abstract

Objective: To evaluate long-term global and site-specific health-related quality of life (HRQoL) in patients treated for sinonasal and nasopharyngeal malignancies.

Study design: Cross-sectional.

Methods: One hundred fourteen patients with sinonasal and nasopharyngeal malignancies received surgery, radiation, systemic chemotherapy, or a combination thereof, with curative intent. Validated global ([EuroQol-5D] Visual Analogue Scale [EQ-5D VAS]) and disease-specific instruments (MD Anderson Symptom Inventory-Head and Neck [MDASI-HN], Anterior Skull Base Questionnaire [ASBQ]) were administered to patients who were both free of disease and had completed treatment at least 12 months previously. Associations between instruments, instrument domains, and specific clinical parameters were analyzed.

Results: The median age was 55 years. The mean EQ-5D VAS, MDASI-22 composite score, and ASBQ score were 74 (standard deviation [SD] 21), 48 (SD 36), and 130 (SD 27), respectively. The most frequently reported high-severity items in MDASI-HN were dry mouth and difficulty tasting food. The most frequently reported high-severity items in ASBQ were difficulty with smell and nasal secretions. Advanced Tumor (T) classification was associated with worse overall ASBQ sum score (P = 0.02). ASBQ performance at home and MDASI-HN drowsy symptom items independently predicted worse global HRQoL as measured by the EQ-5D VAS (P < 0.001).

Conclusion: Global HRQoL for survivors of sinonasal and nasopharyngeal malignancies after multimodality treatment approximates that of the U.S. population for the same age group. ASBQ and MDASI-HN correlate well with global HRQoL outcomes as measured by EQ-5D VAS. MDASI-HN and ASBQ elicited unique symptoms, highlighting the complex symptom burden experienced by these patients. Further studies should identify patients predisposed to reduced long-term QOL.

Level of evidence: 3 Laryngoscope, 130:86-93, 2020.

Keywords: Nasopharyngeal cancer; quality of life; sinonasal cancer.

MeSH terms

Adolescent
Adult
Aged
Combined Modality Therapy
Cross-Sectional Studies
Female
Humans
Male
Middle Aged
Nasopharyngeal Carcinoma / therapy*
Nasopharyngeal Neoplasms / therapy*
Paranasal Sinus Neoplasms / therapy*
Quality of Life*
Surveys and Questionnaires