Quality of Life of Oral Cancer Patients After Low-Dose-Rate Interstitial Brachytherapy

Purpose

To assess the quality of life (QOL) of oral cancer patients treated with low-dose-rate interstitial brachytherapy (LDR-BT) alone.

Methods and Materials

Between June 2005 and July 2006, a total of 56 patients with oral cancer were enrolled in this prospective study. QOL was assessed by means of the core questionnaire and head and neck questionnaire module of the European Organization for Research and Treatment of Cancer (EORTC Quality of Life Questionnaire-Core 30 [QLQ-C30] and QLQ Head and Neck 35 [H&N35]). The questionnaires were distributed to the patients before the start of treatment and 3 months, 6 months, and 12 months after the start of LDR-BT.

Results

It was possible to analyze the results for 20 of the initial 56 patients because they did not experience metastasis or recurrence during this study. No functions or symptoms asked about in the QLQ-C30 deteriorated during the first year. The emotional function score steadily and significantly increased. No symptoms in the QLQ-H&N35 significantly deteriorated. The scores for pain, trouble with social eating, and weight loss on the QLQ-H&N35 steadily and significantly decreased. Age, gender, and LDR-BT source had no effect on the change in QOL during the first year, but T-stage significantly affected the change in global health status, tumor site affected the changes in swallowing, sensory problems, sticky saliva, and complications affected the changes in pain, swallowing, and mouth opening.

Conclusions

QOL of oral cancer patients treated with LDR-BT is high. However, tumor stage, tumor site, and complications affected the changes in a few functions and symptoms during the first year.

Introduction

Whether the treatment of head-and-neck cancer is surgical or nonsurgical, it always involves a risk of pain and regional dysfunction that may affect some basic life functions, including speech, chewing, swallowing, social interaction, and respiration (1). Although the results of treatment strategies are usually expressed in terms of disease-free or overall survival, quality of life (QOL) has been increasingly used as an outcome parameter and is seriously considered when treatment is selected 2, 3, 4.

Because low-dose-rate interstitial brachytherapy (LDR-BT) delivers a high radiation dose to a limited volume while sparing the surrounding normal tissues, it is a very effective local treatment for early oral cancer and yields results comparable to those obtained by surgery 5, 6, 7, 8, 9. Moreover, the superiority of LDR-BT in terms of preservation of structure and function and a low incidence of complications has long been demonstrated 5, 6, 7, 8, 9, 10. However, there have been no reports of the results in terms of QOL assessed by means of self-administered questionnaires (1).

The purpose of this study was to prospectively assess the QOL of oral cancer patients treated by LDR-BT alone and to evaluate the changes in QOL after the start of LDR-BT.