Surviving Elderly Patients with Head-and-Neck Squamous Cell Carcinoma-What Is the Long-Term Quality of Life after Curative Radiotherapy?

Alexander Rühle; Erik Haehl; Tobias Kalckreuth; Raluca Stoian; Simon K B Spohn; Tanja Sprave; Constantinos Zamboglou; Eleni Gkika; Andreas Knopf; Anca-Ligia Grosu; Nils H Nicolay

doi:10.3390/cancers13061275

Surviving Elderly Patients with Head-and-Neck Squamous Cell Carcinoma-What Is the Long-Term Quality of Life after Curative Radiotherapy?

Cancers (Basel). 2021 Mar 13;13(6):1275. doi: 10.3390/cancers13061275.

Authors

Alexander Rühle^{1

2}, Erik Haehl^{1

2}, Tobias Kalckreuth^{1

2}, Raluca Stoian^{1

2}, Simon K B Spohn^{1

2}, Tanja Sprave^{1

2}, Constantinos Zamboglou^{1

2}, Eleni Gkika^{1

2}, Andreas Knopf³, Anca-Ligia Grosu^{1

2}, Nils H Nicolay^{1

2}

Affiliations

¹ Department of Radiation Oncology, University of Freiburg-University Medical Center Freiburg, Robert-Koch-Str. 3, 79106 Freiburg, Germany.
² German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (dkfz), Neuenheimer Feld 280, 69120 Heidelberg, Germany.
³ Department of Otorhinolaryngology, University of Freiburg-University Medical Center Freiburg, Killianstr. 5, 79106 Freiburg, Germany.

Abstract

The effects of radiotherapy on the long-term quality of life (QoL) of surviving elderly HNSCC patients are not well understood, therefore, we analyzed QoL in this population. A cross-sectional analysis was performed at a tertiary cancer center to assess long-term QoL in elderly HNSCC patients. Eligible patients were ≥65 years at the time of treatment who had to be alive for ≥1 year after radiotherapy and without current anti-cancer treatment. QoL and patient satisfaction were assessed using the EORTC QLQ-C30, QLQ-H&N35 and ZUF-8 questionnaires, respectively, and treatment-related toxicities were graded according to CTCAE (Common Terminology Criteria of Adverse Effects) v.5.0. Seventy-four patients met the inclusion criteria, of which 50 consented to participate. Median time between radiotherapy and QoL assessment was 32 months (range 12-113). The QLQ-C30 global QoL median amounted to 66.7 points (interquartile range (IQR) 50.0-83.3), which was comparable to the age- and gender-adjusted German population (median 65.3). Median global QoL was similar between patients undergoing definitive (75.0, IQR 50.0-83.3) and adjuvant (chemo)radiotherapy (66.7, IQR 41.7-83.3, p = 0.219). HPV-positive HNSCC patients had superior global QoL after radiotherapy than their HPV-negative counterparts (p < 0.05), and concomitant chemotherapy did not influence the long-term QoL (p = 0.966). Median global QoL did not correspond with physician-assessed highest-graded chronic toxicities (p = 0.640). The ZUF-8 ranged at 29 points in median (IQR 27-31), showing high patient satisfaction. Surviving elderly HNSCC patients treated by radiotherapy exhibit a relatively high long-term global QoL which is a relevant information for clinicians treating elderly HNSCC patients.

Keywords: chemotherapy; elderly patients; geriatric patients; head-and-neck cancer; head-and-neck squamous cell carcinoma; patient-reported outcomes; quality of life; radiotherapy.