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Erschienen in: Strahlentherapie und Onkologie 8/2018

07.05.2018 | Original Article

Socioeconomic status and quality of life in patients with locally advanced head and neck cancer

verfasst von: S. Tribius, MD, PhD, M. S. Meyer, C. Pflug, H. Hanken, C.-J. Busch, A. Krüll, C. Petersen, C. Bergelt

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 8/2018

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Abstract

Purpose

Socioeconomic aspects play an important role in health care. Patients with locally advanced head and neck cancer (LAHNC) experience detrimental effects on their quality of life (QoL). This prospective study examines QoL differences between patients with different socioeconomic status (SES) after intensity-modulated radiation therapy (IMRT).

Patients and methods

In all, 161 patients were questioned at the end of IMRT and at 12 and 24 months follow-up using the questionnaires of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-30 and QLQ-HN35. Patients’ QoL 2 years after IMRT was compared to a population reference sample and QoL of patients from lower, middle, and higher social class 2 years after IMRT was analyzed by ANCOVA using baseline QoL (end of radiation treatment) as a covariate.

Results

Patients with high SES report worse QoL at the end of IMRT in the domains global health status (−15.2; p = 0.005), role function (−23.8; p = 0.002), and social function (−19.4; p = 0.023) compared to patients with middle and low SES. QoL improved during the first 12 and 24 months. However, 2 years after IMRT, middle and low SES patients report lower QoL in the domains global health status, physical function, and role function, and report a higher general (fatigue, pain, dyspnea) and head and neck cancer-specific symptom burden (pain, swallowing, senses, speech, social eating, opening mouth, and felt ill) than patients with high SES.

Conclusion

After IMRT for LAHNC, patients with high SES report worse QoL compared to patients with middle or low SES. There is a marked improvement within the first 24 months in many domains. However, the magnitude of improvement in patients with middle or low SES is significantly smaller compared to patients with high SES.
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Literatur
1.
Zurück zum Zitat Rogers SN, Ahad SA, Murphy AP (2007) A structured review and theme analysis of papers published on “quality of life” in head and neck cancer: 2000–2005. Oral Oncol 43:843–868CrossRefPubMed Rogers SN, Ahad SA, Murphy AP (2007) A structured review and theme analysis of papers published on “quality of life” in head and neck cancer: 2000–2005. Oral Oncol 43:843–868CrossRefPubMed
2.
Zurück zum Zitat Infante-Cossio P, Torres-Carranza E, Cayuela A, Hens-Aumente E, Pastor-Gaitan P, Gutierrez-Perez JL (2009) Impact of treatment on quality of life for oral and oropharyngeal carcinoma. Int J Oral Maxillofac Surg 38:1052–1058CrossRefPubMed Infante-Cossio P, Torres-Carranza E, Cayuela A, Hens-Aumente E, Pastor-Gaitan P, Gutierrez-Perez JL (2009) Impact of treatment on quality of life for oral and oropharyngeal carcinoma. Int J Oral Maxillofac Surg 38:1052–1058CrossRefPubMed
3.
Zurück zum Zitat Tribius S, Raguse M, Voigt C, Münscher A, Gröbe A, Petersen C et al (2015) Residual deficits in quality of life one year after intensity-modulated radiotherapy for patients with locally advanced head and neck cancer. Strahlenther Onkol 191:501–510CrossRefPubMed Tribius S, Raguse M, Voigt C, Münscher A, Gröbe A, Petersen C et al (2015) Residual deficits in quality of life one year after intensity-modulated radiotherapy for patients with locally advanced head and neck cancer. Strahlenther Onkol 191:501–510CrossRefPubMed
4.
Zurück zum Zitat Leung WS, Lee TF, Chien CY, Chao PJ, Tsai WL, Fang FM (2011) Health-related Quality of life in 640 head and neck cancer survivors after radiotherapy using EORTC QLQ-C30 and QLQ-H&N35 questionnaires. BMC Cancer 11:128CrossRef Leung WS, Lee TF, Chien CY, Chao PJ, Tsai WL, Fang FM (2011) Health-related Quality of life in 640 head and neck cancer survivors after radiotherapy using EORTC QLQ-C30 and QLQ-H&N35 questionnaires. BMC Cancer 11:128CrossRef
5.
Zurück zum Zitat Maurer J, Hipp M, Schäfer C, Kölbl O (2011) Dysphagia. Impact on quality of life after radio(chemo)therapy of head and neck cancer. Strahlenther Onkol 187:744–749CrossRefPubMed Maurer J, Hipp M, Schäfer C, Kölbl O (2011) Dysphagia. Impact on quality of life after radio(chemo)therapy of head and neck cancer. Strahlenther Onkol 187:744–749CrossRefPubMed
6.
Zurück zum Zitat Hwang E, Johnson-Obaseki S, McDonald JT, Connell C, Corsten M (2013) Incidence of head and neck cancer and socioeconomic status in Canada from 1992 to 2007. Oral Oncol 49:1072–1076CrossRefPubMed Hwang E, Johnson-Obaseki S, McDonald JT, Connell C, Corsten M (2013) Incidence of head and neck cancer and socioeconomic status in Canada from 1992 to 2007. Oral Oncol 49:1072–1076CrossRefPubMed
8.
Zurück zum Zitat McDonald JT, Johnson-Obaseki S, Hwang E, Connell C, Corsten M (2014) The relationship between survival and socio-economic status for head and neck cancer in Canada. J Otolaryngol Head Neck Surg 43:2CrossRefPubMedPubMedCentral McDonald JT, Johnson-Obaseki S, Hwang E, Connell C, Corsten M (2014) The relationship between survival and socio-economic status for head and neck cancer in Canada. J Otolaryngol Head Neck Surg 43:2CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Yost K, Perkins C, Cohen R, Morris C, Wright W (2001) Socioeconomic status and breast cancer incidence in California for different race/ethnic groups. Cancer Causes Control 12:703–711CrossRefPubMed Yost K, Perkins C, Cohen R, Morris C, Wright W (2001) Socioeconomic status and breast cancer incidence in California for different race/ethnic groups. Cancer Causes Control 12:703–711CrossRefPubMed
10.
Zurück zum Zitat Lampert T, Koch-Gromus U (2016) Soziale Ungleichheit und Gesundheit. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 59:151–152CrossRefPubMed Lampert T, Koch-Gromus U (2016) Soziale Ungleichheit und Gesundheit. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 59:151–152CrossRefPubMed
11.
Zurück zum Zitat Mackenbach JP, Meerding WJ, Kunst AE (2011) Economic costs of health inequalities in the European Union. J Epidemiol Community Health 65:412–419CrossRefPubMed Mackenbach JP, Meerding WJ, Kunst AE (2011) Economic costs of health inequalities in the European Union. J Epidemiol Community Health 65:412–419CrossRefPubMed
12.
Zurück zum Zitat Robert-Koch-Institut (2016) Bericht zum Krebsgeschehen in Deutschland 2016. Robert-Koch-Institut, Berlin Robert-Koch-Institut (2016) Bericht zum Krebsgeschehen in Deutschland 2016. Robert-Koch-Institut, Berlin
13.
Zurück zum Zitat Short PF, Mallonee E (2006) Income disparities in the quality of life of cancer survivors. Med Care 441:16–23CrossRef Short PF, Mallonee E (2006) Income disparities in the quality of life of cancer survivors. Med Care 441:16–23CrossRef
14.
Zurück zum Zitat Johnson S, McDonald JT, Corsten M (2012) Oral cancer screening and socioeconomic status. J Otolaryngol Head Neck Surg 41:102–107PubMed Johnson S, McDonald JT, Corsten M (2012) Oral cancer screening and socioeconomic status. J Otolaryngol Head Neck Surg 41:102–107PubMed
15.
Zurück zum Zitat Johnson S, Corsten MJ, McDonald JT, Gupta M (2010) Cancer prevalence and education by cancer site: logistic regression analysis. J Otolaryngol Head Neck Surg 39:555–560PubMed Johnson S, Corsten MJ, McDonald JT, Gupta M (2010) Cancer prevalence and education by cancer site: logistic regression analysis. J Otolaryngol Head Neck Surg 39:555–560PubMed
16.
Zurück zum Zitat Hodapp N (2012) Der ICRU-Report 83: Verordnung, Dokumentation und Kommunikation der fluenzmodulierten Photonenstrahlentherapie (IMRT). Strahlenther Onkol 188:97–100CrossRefPubMed Hodapp N (2012) Der ICRU-Report 83: Verordnung, Dokumentation und Kommunikation der fluenzmodulierten Photonenstrahlentherapie (IMRT). Strahlenther Onkol 188:97–100CrossRefPubMed
17.
Zurück zum Zitat Winkler J, Stolzenberg H (1999) Social class index in the Federal Health Survey. Gesundheitswesen 61(Spec No):S178–S183PubMed Winkler J, Stolzenberg H (1999) Social class index in the Federal Health Survey. Gesundheitswesen 61(Spec No):S178–S183PubMed
18.
Zurück zum Zitat Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376CrossRefPubMed Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376CrossRefPubMed
19.
Zurück zum Zitat Bjordal K, Ahlner-Elmqvist M, Tollesson E, Jensen AB, Razavi D, Maher EJ et al (1994) Development of a European Organization for Research and Treatment of Cancer (EORTC) questionnaire module to be used in quality of life assessments in head and neck cancer patients. EORTC Quality of Life Study Group. Acta Oncol 33:879–885CrossRefPubMed Bjordal K, Ahlner-Elmqvist M, Tollesson E, Jensen AB, Razavi D, Maher EJ et al (1994) Development of a European Organization for Research and Treatment of Cancer (EORTC) questionnaire module to be used in quality of life assessments in head and neck cancer patients. EORTC Quality of Life Study Group. Acta Oncol 33:879–885CrossRefPubMed
20.
Zurück zum Zitat Fayers PM, Aaronson NK, Bjordal K et al (2001) On behalf of the EORTC Quality of Life Study Group. The EORTC QLQ-C30 Scoring Manual, 3rd edn. European Organisation for Research and Treatment of Cancer, Brussels Fayers PM, Aaronson NK, Bjordal K et al (2001) On behalf of the EORTC Quality of Life Study Group. The EORTC QLQ-C30 Scoring Manual, 3rd edn. European Organisation for Research and Treatment of Cancer, Brussels
21.
Zurück zum Zitat King MT (1996) The interpretation of scores from the EORTC quality of life questionnaire QLQ-C30. Qual Life Res 5:555–567CrossRefPubMed King MT (1996) The interpretation of scores from the EORTC quality of life questionnaire QLQ-C30. Qual Life Res 5:555–567CrossRefPubMed
22.
Zurück zum Zitat Schwarz R, Hinz A (2001) Reference data for the quality of life questionnaire EORTC QLQ-C30 in the general German population. Eur J Cancer 37:1345–1135CrossRefPubMed Schwarz R, Hinz A (2001) Reference data for the quality of life questionnaire EORTC QLQ-C30 in the general German population. Eur J Cancer 37:1345–1135CrossRefPubMed
23.
Zurück zum Zitat Arraras JI, Arias F, Tejedor M, Pruja E, Marcos M, Martínez E et al (2002) The EORTC QLQ-C30 (version 3.0) Quality of Life questionnaire: validation study for Spain with head and neck cancer patients. Psychooncology 11:249–256CrossRefPubMed Arraras JI, Arias F, Tejedor M, Pruja E, Marcos M, Martínez E et al (2002) The EORTC QLQ-C30 (version 3.0) Quality of Life questionnaire: validation study for Spain with head and neck cancer patients. Psychooncology 11:249–256CrossRefPubMed
24.
Zurück zum Zitat Singer S, Wollbrück D, Wulke C, Dietz A, Klemm E, Oeken J et al (2009) Validation of the EORTC QLQ-C30 and EORTC QLQ-H&N35 in patients with laryngeal cancer after surgery. Head Neck 31:64–76CrossRefPubMed Singer S, Wollbrück D, Wulke C, Dietz A, Klemm E, Oeken J et al (2009) Validation of the EORTC QLQ-C30 and EORTC QLQ-H&N35 in patients with laryngeal cancer after surgery. Head Neck 31:64–76CrossRefPubMed
25.
Zurück zum Zitat Singer S, Arraras JI, Chie WC et al (2013) Performance of the EORTC questionnaire for the assessment of quality of life in head and neck cancer patients EORTC QLQ-H&N35: a methodological review. Qual Life Res 22:1927–1941CrossRefPubMed Singer S, Arraras JI, Chie WC et al (2013) Performance of the EORTC questionnaire for the assessment of quality of life in head and neck cancer patients EORTC QLQ-H&N35: a methodological review. Qual Life Res 22:1927–1941CrossRefPubMed
26.
Zurück zum Zitat Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd edn. Routledge Academic, Erlbaum, New York, Hillsdale Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd edn. Routledge Academic, Erlbaum, New York, Hillsdale
27.
Zurück zum Zitat Wells M, Swartzman S, Lang H, Cunningham M, Taylor L, Thomson J et al (2016) Predictors of quality of life in head and neck cancer survivors up to 5 years after end of treatment: a cross-sectional survey. Support Care Cancer 24:2463–2472CrossRefPubMed Wells M, Swartzman S, Lang H, Cunningham M, Taylor L, Thomson J et al (2016) Predictors of quality of life in head and neck cancer survivors up to 5 years after end of treatment: a cross-sectional survey. Support Care Cancer 24:2463–2472CrossRefPubMed
28.
Zurück zum Zitat Chu KP, Habbous S, Kuang Q et al (2016) Socioeconomic status, human papillomavirus, and overall survival in head and neck squamous cell carcinomas in Toronto, Canada. Cancer Epidemiol 40:102–112CrossRefPubMed Chu KP, Habbous S, Kuang Q et al (2016) Socioeconomic status, human papillomavirus, and overall survival in head and neck squamous cell carcinomas in Toronto, Canada. Cancer Epidemiol 40:102–112CrossRefPubMed
29.
Zurück zum Zitat Chu K, Shema S, Wu S, Gomez S, Chang E, Le Q (2011) Head and neck cancer specific survival based on socioeconomic status in Asians and Pacific Islanders. Cancer 117:1935–1945CrossRefPubMed Chu K, Shema S, Wu S, Gomez S, Chang E, Le Q (2011) Head and neck cancer specific survival based on socioeconomic status in Asians and Pacific Islanders. Cancer 117:1935–1945CrossRefPubMed
30.
Zurück zum Zitat Booth CM, Li G, Zhang-Salomons J, Mackillop WJ (2010) The impact of socioeconomic status on stage of cancer at diagnosis and survival: a population-based study in Ontario, Canada. Cancer 116:4160–4167CrossRefPubMed Booth CM, Li G, Zhang-Salomons J, Mackillop WJ (2010) The impact of socioeconomic status on stage of cancer at diagnosis and survival: a population-based study in Ontario, Canada. Cancer 116:4160–4167CrossRefPubMed
31.
Zurück zum Zitat Mackillop WJ, Zhang-Salomons J, Groome PA, Paszat L, Holowaty E (1997) Socioeconomic status and cancer survival in Ontario. J Clin Oncol 15:1680–1689CrossRefPubMed Mackillop WJ, Zhang-Salomons J, Groome PA, Paszat L, Holowaty E (1997) Socioeconomic status and cancer survival in Ontario. J Clin Oncol 15:1680–1689CrossRefPubMed
32.
Zurück zum Zitat Boyd C, Zhang-Salomons JY, Groome PA, Mackillop WJ (1999) Associations between community income and cancer survival in Ontario, Canada, and the United States. J Clin Oncol 17:2244–2255CrossRefPubMed Boyd C, Zhang-Salomons JY, Groome PA, Mackillop WJ (1999) Associations between community income and cancer survival in Ontario, Canada, and the United States. J Clin Oncol 17:2244–2255CrossRefPubMed
33.
Zurück zum Zitat Johnson S, McDonald JT, Corsten M, Rourke R (2010) Socio-economic status and head and neck cancer incidence in Canada: a case-control study. Oral Oncol 46:200–203CrossRefPubMed Johnson S, McDonald JT, Corsten M, Rourke R (2010) Socio-economic status and head and neck cancer incidence in Canada: a case-control study. Oral Oncol 46:200–203CrossRefPubMed
34.
Zurück zum Zitat Shavers VL (2007) Measurement of socioeconomic status in health disparities research. J Natl Med Assoc 99:1013–1023PubMedPubMedCentral Shavers VL (2007) Measurement of socioeconomic status in health disparities research. J Natl Med Assoc 99:1013–1023PubMedPubMedCentral
35.
Zurück zum Zitat Naghavi AO, Echevarria MI, Strom TJ et al (2016) Treatment delays, race, and outcomes in head and neck cancer. Cancer Epidemiol 45:18–25CrossRefPubMed Naghavi AO, Echevarria MI, Strom TJ et al (2016) Treatment delays, race, and outcomes in head and neck cancer. Cancer Epidemiol 45:18–25CrossRefPubMed
36.
Zurück zum Zitat Johnson S et al (2008) Socioeconomic factors in head and neck cancer. J Otolaryngol Head Neck Surg 37:597–601PubMed Johnson S et al (2008) Socioeconomic factors in head and neck cancer. J Otolaryngol Head Neck Surg 37:597–601PubMed
37.
Zurück zum Zitat Molina MA, Cheung MC, Perez EA, Byrne MM, Franceschi D, Moffat FL et al (2008) African American and poor patients have a dramatically worse prognosis for head and neck cancer. Cancer 113:2797–2806CrossRefPubMed Molina MA, Cheung MC, Perez EA, Byrne MM, Franceschi D, Moffat FL et al (2008) African American and poor patients have a dramatically worse prognosis for head and neck cancer. Cancer 113:2797–2806CrossRefPubMed
38.
Zurück zum Zitat Liederbach E, Kyrillos A, Wang C‑H, Liu JC, Sturgis EM, Bhayani MK (2017) The national landscape of human papillomavirus-associated oropharynx squamous cell carcinoma. Int J Cancer 140:504–512CrossRefPubMed Liederbach E, Kyrillos A, Wang C‑H, Liu JC, Sturgis EM, Bhayani MK (2017) The national landscape of human papillomavirus-associated oropharynx squamous cell carcinoma. Int J Cancer 140:504–512CrossRefPubMed
39.
Zurück zum Zitat Quabius ES, Haag J, Kühnel A et al (2015) Geographical and anatomical influences on human papillomavirus prevalence diversity in head and neck squamous cell carcinoma in Germany. Int J Oncol 46:414–422CrossRefPubMed Quabius ES, Haag J, Kühnel A et al (2015) Geographical and anatomical influences on human papillomavirus prevalence diversity in head and neck squamous cell carcinoma in Germany. Int J Oncol 46:414–422CrossRefPubMed
40.
Zurück zum Zitat World Health Organization Regional Office for Europe (2014) European tobacco control status report 2014. WHO, Copenhagen World Health Organization Regional Office for Europe (2014) European tobacco control status report 2014. WHO, Copenhagen
41.
Zurück zum Zitat Guo Y, Logan HL, Marks JG, Shenkman EA (2015) The relationships among individual and regional smoking, socioeconomic status, and oral and pharyngeal cancer survival: a mediation analysis. Cancer Med 4:1612–1619CrossRefPubMedPubMedCentral Guo Y, Logan HL, Marks JG, Shenkman EA (2015) The relationships among individual and regional smoking, socioeconomic status, and oral and pharyngeal cancer survival: a mediation analysis. Cancer Med 4:1612–1619CrossRefPubMedPubMedCentral
42.
Zurück zum Zitat van Nieuwenhuizen AJ, Buffart LM, Brug J, Leemans CR, Verdonck-de Leeuw IM (2015) The association between health related quality of life and survival in patients with head and neck cancer: a systematic review. Oral Oncol 51:1–11CrossRefPubMed van Nieuwenhuizen AJ, Buffart LM, Brug J, Leemans CR, Verdonck-de Leeuw IM (2015) The association between health related quality of life and survival in patients with head and neck cancer: a systematic review. Oral Oncol 51:1–11CrossRefPubMed
43.
Zurück zum Zitat Kypriotakis G, Vidrine DJ, Francis LE, Rose JH (2016) The longitudinal relationship between quality of life and survival in advanced stage cancer. Psychooncology 25:225–231CrossRefPubMed Kypriotakis G, Vidrine DJ, Francis LE, Rose JH (2016) The longitudinal relationship between quality of life and survival in advanced stage cancer. Psychooncology 25:225–231CrossRefPubMed
Metadaten
Titel
Socioeconomic status and quality of life in patients with locally advanced head and neck cancer
verfasst von
S. Tribius, MD, PhD
M. S. Meyer
C. Pflug
H. Hanken
C.-J. Busch
A. Krüll
C. Petersen
C. Bergelt
Publikationsdatum
07.05.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
Strahlentherapie und Onkologie / Ausgabe 8/2018
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-018-1305-3

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