Skip to main content

Advertisement

SpringerLink
Log in

Predictive value of health-related quality of life on radiotherapy-related toxicities in patients with head and neck cancer

  • Research
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

A Comment to this article was published on 24 October 2023

Abstract

Purpose

Little is known about whether baseline health-related quality of life (HRQoL) scores also could predict occurrence radiotherapy-related toxicities, which we aim to assess in this study.

Methods

This study analyzed data from 200 patients enrolled in randomized study investigating the utility of HRQoL. HRQOL was assessed at baseline and during follow up using QLQ-C30 questionnaire and major toxicity was considered as adverse event ≥ 3 according to NCI-CTCAE classification. Cox regressions adjusting for clinical and sociodemographic data were used to assess prognostic significance of HRQOL scores.

Results

In multivariable analyses adjusted on clinical and sociodemographic data, every 10-point improvement in physical (HR = 0.74), role (HR = 0.87) and social (HR = 0.88) functioning was associated with 24%, 13% and 12% lower hazard of occurrence of major toxicity respectively while every 10 point-increase in dyspnea (HR = and loss appetite was associated with 15% and 16% increased hazard of major toxicity.

Conclusion

Certain baseline HRQoL scores were found to be significantly associated with the occurrence of major toxicity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data availability

Study data are available on request from corresponding author.

References

  1. Lo Nigro C, Denaro N, Merlotti A, Merlano M (2017) Head and neck cancer: improving outcomes with a multidisciplinary approach. Cancer Manag Res 9:363–71. https://doi.org/10.2147/CMAR.S115761

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Gillison ML, Chaturvedi AK, Anderson WF, Fakhry C (2015) Epidemiology of human papillomavirus-positive head and neck squamous cell carcinoma. J Clin Oncol Off J Am Soc Clin Oncol 33(29):3235–42. https://doi.org/10.1200/JCO.2015.61.6995

    Article  CAS  Google Scholar 

  3. Vokes EE, Agrawal N, Seiwert TY (2015) HPV-associated head and neck cancer. J Natl Cancer Inst 107(12):djv344. https://doi.org/10.1093/jnci/djv344

    Article  CAS  PubMed  Google Scholar 

  4. Shah JP, Gil Z (2009) current concepts in management of oral cancer – surgery. Oral Oncol 45:394–401. https://doi.org/10.1016/j.oraloncology.2008.05.017

    Article  PubMed  Google Scholar 

  5. Marur S, Forastiere AA (2016) Head and neck squamous cell carcinoma: update on epidemiology, diagnosis, and treatment. Mayo Clin Proc 91(3):386–396. https://doi.org/10.1016/j.mayocp.2015.12.017

    Article  PubMed  Google Scholar 

  6. Cooper JS, Zhang Q, Pajak TF, Forastiere AA, Jacobs J, Saxman SB et al (2012) Long-term follow-up of the RTOG 9501/intergroup phase III trial: postoperative concurrent radiation therapy and chemotherapy in high-risk squamous cell carcinoma of the head and neck. Int J Radiat Oncol Biol Phys 84(5):1198–205. https://doi.org/10.1016/j.ijrobp.2012.05.008

    Article  PubMed  PubMed Central  Google Scholar 

  7. Daiko H, Hayashi R, Sakuraba M, Ebihara M, Miyazaki M, Shinozaki T et al (2011) A pilot study of post-operative radiotherapy with concurrent chemotherapy for high-risk squamous cell carcinoma of the cervical esophagus. Jpn J Clin Oncol avr 41(4):508–513. https://doi.org/10.1093/jjco/hyr012

    Article  Google Scholar 

  8. Caudell JJ, Torres-Roca JF, Gillies RJ, Enderling H, Kim S, Rishi A et al (2017) The future of personalised radiotherapy for head and neck cancer. Lancet Oncol 18(5):e266–e273. https://doi.org/10.1016/S1470-2045(17)30252-8

    Article  PubMed  PubMed Central  Google Scholar 

  9. Pachman DR, Barton DL, Swetz KM, Loprinzi CL (2012) Troublesome symptoms in cancer survivors: fatigue, insomnia, neuropathy, and pain. J Clin Oncol Off J Am Soc Clin Oncol 30(30):3687–96. https://doi.org/10.1200/JCO.2012.41.7238

    Article  Google Scholar 

  10. Krebber AMH, Buffart LM, Kleijn G, Riepma IC, de Bree R, Leemans CR et al (2014) Prevalence of depression in cancer patients: a meta-analysis of diagnostic interviews and self-report instruments. Psychooncology 23(2):121–130. https://doi.org/10.1002/pon.3409

    Article  CAS  PubMed  Google Scholar 

  11. Efficace F, Fayers P, Pusic A, Cemal Y, Yanagawa J, Jacobs M et al (2015) Quality of patient-reported outcome (PRO) reporting across cancer randomized controlled trials according to the CONSORT PRO extension: a pooled analysis of 557 trials. Cancer 121(18):3335–42. https://doi.org/10.1002/cncr.29489

    Article  PubMed  Google Scholar 

  12. Beitz J, Gnecco C, Justice R (1996) Quality-of-life end points in cancer clinical trials: the U.S. Food and Drug Administration perspective. J Natl Cancer Inst Monogr (20):7–9

  13. Maisey NR, Norman A, Watson M, Allen MJ, Hill ME (2002) Cunningham D (2002) Baseline quality of life predicts survival in patients with advanced colorectal cancer. Eur J Cancer Oxf Engl 1990 38(10):1351–7. https://doi.org/10.1016/s0959-8049(02)00098-9

    Article  CAS  Google Scholar 

  14. Coates AS, Hürny C, Peterson HF, Bernhard J, Castiglione-Gertsch M, Gelber RD et al (2000) Quality-of-life scores predict outcome in metastatic but not early breast cancer. International Breast Cancer Study Group. J Clin Oncol Off J Am Soc Clin Oncol 18(22):3768–74. https://doi.org/10.1200/JCO.2000.18.22.3768

    Article  CAS  Google Scholar 

  15. Kaasa S, Mastekaasa A, Lund E (1989) Prognostic factors for patients with inoperable non-small cell lung cancer, limited disease. The importance of patients’ subjective experience of disease and psychosocial well-being. Radiother Oncol J Eur Soc Ther Radiol Oncol 15(3):235–42. https://doi.org/10.1016/0167-8140(89)90091-1

    Article  CAS  Google Scholar 

  16. Gourgou-Bourgade S, Bascoul-Mollevi C, Desseigne F, Ychou M, Bouché O, Guimbaud R et al (2013) Impact of FOLFIRINOX compared with gemcitabine on quality of life in patients with metastatic pancreatic cancer: results from the PRODIGE 4/ACCORD 11 randomized trial. J Clin Oncol Off J Am Soc Clin Oncol 31(1):23–9. https://doi.org/10.1200/JCO.2012.44.4869

    Article  CAS  Google Scholar 

  17. Meyer F, Fortin A, Gélinas M, Nabid A, Brochet F, Têtu B et al (2009) Health-related quality of life as a survival predictor for patients with localized head and neck cancer treated with radiation therapy. J Clin Oncol Off J Am Soc Clin Oncol 27(18):2970–6. https://doi.org/10.1200/JCO.2008.20.0295

    Article  Google Scholar 

  18. Efficace F, Collins GS, Cottone F, Giesinger JM, Sommer K, Anota A et al (2021) Patient-reported outcomes as independent prognostic factors for survival in oncology: systematic review and meta-analysis. Value Health J Int Soc Pharmacoeconomics Outcomes Res 24(2):250–67. https://doi.org/10.1016/j.jval.2020.10.017

    Article  Google Scholar 

  19. Liao K, Wang T, Coomber-Moore J, Wong DC, Gomes F, Faivre-Finn C et al (2022) Prognostic value of patient-reported outcome measures (PROMs) in adults with non-small cell Lung Cancer: a scoping review. BMC Cancer 22(1):1076. https://doi.org/10.1186/s12885-022-10151-z

    Article  PubMed  PubMed Central  Google Scholar 

  20. Gudmundstuen AM, Efficace F, Tjønnfjord GE, Skaarud KJ, Cottone F, Hjermstad MJ et al (2023) The prognostic value of patient-reported outcomes in allogeneic hematopoietic stem cell transplantation: exploratory analysis of a randomized nutrition intervention trial. Ann Hematol 102(4):927–935. https://doi.org/10.1007/s00277-023-05149-x

    Article  PubMed  PubMed Central  Google Scholar 

  21. Gotay CC, Kawamoto CT, Bottomley A, Efficace F (2008) The prognostic significance of patient-reported outcomes in cancer clinical trials. J Clin Oncol Off J Am Soc Clin Oncol 26(8):1355–63. https://doi.org/10.1200/JCO.2007.13.3439

    Article  Google Scholar 

  22. Quinten C, Coens C, Mauer M, Comte S, Sprangers MAG, Cleeland C et al (2009) Baseline quality of life as a prognostic indicator of survival: a meta-analysis of individual patient data from EORTC clinical trials. Lancet Oncol 10(9):865–871. https://doi.org/10.1016/S1470-2045(09)70200-1

    Article  PubMed  Google Scholar 

  23. Mierzynska J, Piccinin C, Pe M, Martinelli F, Gotay C, Coens C et al (2019) Prognostic value of patient-reported outcomes from international randomised clinical trials on cancer: a systematic review. Lancet Oncol 20(12):e685-98. https://doi.org/10.1016/S1470-2045(19)30656-4

    Article  PubMed  Google Scholar 

  24. Billa O, Bonnetain F, Chamois J, Ligey A, Ganansia V, Noel G et al (2021) Randomized trial assessing the impact of routine assessment of health-related quality of life in patients with head and neck cancer. Cancers 13(15):3826. https://doi.org/10.3390/cancers13153826

    Article  PubMed  PubMed Central  Google Scholar 

  25. 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(5):365–76. https://doi.org/10.1093/jnci/85.5.365

    Article  CAS  PubMed  Google Scholar 

  26. Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40(5):373–383. https://doi.org/10.1016/0021-9681(87)90171-8

    Article  CAS  PubMed  Google Scholar 

  27. Health UD of, Services H (2016) Common Terminology Criteria for Adverse Events (CTCAE). Version 4.0 Published: May 28, 2009 (v4. 03: June 14, 2010)

  28. Machtay M, Moughan J, Trotti A, Garden AS, Weber RS, Cooper JS et al (2008) Factors associated with severe late toxicity after concurrent chemoradiation for locally advanced head and neck cancer: an RTOG analysis. J Clin Oncol Off J Am Soc Clin Oncol 26(21):3582–9. https://doi.org/10.1200/JCO.2007.14.8841

    Article  CAS  Google Scholar 

  29. Osoba D, Rodrigues G, Myles J, Zee B, Pater J (1998) Interpreting the significance of changes in health-related quality-of-life scores. J Clin Oncol Off J Am Soc Clin Oncol 16(1):139–44. https://doi.org/10.1200/JCO.1998.16.1.139

    Article  CAS  Google Scholar 

  30. Harrell FE, Lee KL, Mark DB (1996) Multivariable prognostic models: issues in developing models, evaluating assumptions and adequacy, and measuring and reducing errors. Stat Med 15(4):361‑87. https://doi.org/10.1002/(SICI)1097-0258(19960229)15:4<361::AID-SIM168>3.0.CO;2-4

  31. Nolte S, Liegl G, Petersen MA, Aaronson NK, Costantini A, Fayers PM et al (2019) General population normative data for the EORTC QLQ-C30 health-related quality of life questionnaire based on 15,386 persons across 13 European countries, Canada and the Unites States. Eur J Cancer Oxf Engl 1990 107:153–63. https://doi.org/10.1016/j.ejca.2018.11.024

    Article  CAS  Google Scholar 

  32. Hammerlid E, Bjordal K, Ahlner-Elmqvist M, Boysen M, Evensen JF, Biörklund A et al (2001) A prospective study of quality of life in head and neck cancer patients. Part I: at diagnosis. Laryngoscope 111(4 Pt 1):669–80. https://doi.org/10.1097/00005537-200104000-00021

    Article  CAS  PubMed  Google Scholar 

  33. Citak E, Tulek Z (2013) Longitudinal quality of life in Turkish patients with head and neck cancer undergoing radiotherapy. Support Care Cancer Off J Multinatl Assoc Support Care Cancer 21(8):2171–83. https://doi.org/10.1007/s00520-013-1774-y

    Article  Google Scholar 

  34. Patterson JM, Lu L, Watson L-J, Harding S, Ness AR, Thomas S et al (2022) Associations between markers of social functioning and depression and quality of life in survivors of head and neck cancer: Findings from the Head and Neck Cancer 5000 study. Psychooncology 31(3):478–485. https://doi.org/10.1002/pon.5830

    Article  PubMed  Google Scholar 

  35. Rettig EM, D’Souza G (2015) Epidemiology of head and neck cancer. Surg Oncol Clin N Am 24(3):379–396

    Article  PubMed  Google Scholar 

  36. Groome PA, Rohland SL, Hall SF, Irish J, Mackillop WJ, O’Sullivan B (2011) A population-based study of factors associated with early versus late stage oral cavity cancer diagnoses. Oral Oncol 47(7):642–647. https://doi.org/10.1016/j.oraloncology.2011.04.018

    Article  PubMed  Google Scholar 

  37. Grignon LM, Jameson MJ, Karnell LH, Christensen AJ, Funk GF (2007) General health measures and long-term survival in patients with head and neck cancer. Arch Otolaryngol Head Neck Surg 133(5):471–476. https://doi.org/10.1001/archotol.133.5.471

    Article  PubMed  Google Scholar 

  38. de Graeff A, de Leeuw JR, Ros WJ, Hordijk GJ, Blijham GH, Winnubst JA (2001) Sociodemographic factors and quality of life as prognostic indicators in head and neck cancer. Eur J Cancer Oxf Engl 1990 37(3):332–9. https://doi.org/10.1016/s0959-8049(00)00385-3

    Article  Google Scholar 

Download references

Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

Author information

Authors and Affiliations

  1. Epidemiology and Quality of Life Unit, Georges-François Leclerc Cancer Centre-UNICANCER, 21000, Dijon, France

    Oumar Billa & Tienhan Sandrine Dabakuyo-Yonli

  2. Lipids, Nutrition, Cancer Research Center, U1231 INSERM, 21000, Dijon, France

    Oumar Billa & Tienhan Sandrine Dabakuyo-Yonli

  3. Methodology and Quality of Life in Oncology Unit, Inserm UMR 1098, University Hospital of Besancon, Besancon, France

    Franck Bonnetain

  4. Centre Hospitalier Saint Gregoire, 35760, Saint-Grégoire, France

    Jérôme Chamois

  5. Centre Hospitalier Fleriat, 01012, Bourg-en-Bresse, France

    Angeline Ligey

  6. Paul Strauss Cancer Centre-Unicancer, 67000, Strasbourg, France

    Valérie Ganansia, Pierre Truntzer & Georges Noel

  7. Institut de Cancérologie de Lorraine, 54519, Vandœuvre-lès-Nancy, France

    Sophie Renard

  8. Centre Bourgogne, 59000, Lille, France

    Sophie Maillard

  9. Radiotherapy Department, Georges-François Leclerc Cancer Centre-UNICANCER, 1 Rue Professeur Marion, 21000, Dijon, France

    Magali Quivrin, Noémie Vulquin & Philippe Maingon

  10. Radiotherapy Unit, Hôpital de la Pitié-Salpêtrière-APHP, 75013, Paris, France

    Philippe Maingon

  11. Epidemiology and Quality of Life Unit, Lipids, Nutrition, Cancer Research Center, U1231 INSERM, Georges-François Leclerc Cancer Centre-UNICANCER, 1 rue Professeur Marion BP 77980, 21079, Dijon Cedex, France

    Oumar Billa

  12. Institut de Cancerologie Strasbourg Europe, ICANS.eu, 67000, Strasbourg, France

    Georges Noel

Authors
  1. Oumar Billa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Franck Bonnetain
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jérôme Chamois
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Angeline Ligey
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Valérie Ganansia
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sophie Renard
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sophie Maillard
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Magali Quivrin
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Noémie Vulquin
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Pierre Truntzer
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Georges Noel
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Philippe Maingon
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Tienhan Sandrine Dabakuyo-Yonli
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by [Franck Bonnetain], [Philippe Maingon], [Tienhan Sandrine Dabakuyo-Yonli] and [Oumar Billa]. The first draft of the manuscript was written by [Oumar Billa] and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Oumar Billa.

Ethics declarations

Competing interests

The authors declare no competing interests.

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of EST I (protocol code 2009/10; date of approval 17 April 2009).

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Consent to publish

N/A

Conflicts of interest

The authors have no relevant financial or non-financial interests to disclose.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 31 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Billa, O., Bonnetain, F., Chamois, J. et al. Predictive value of health-related quality of life on radiotherapy-related toxicities in patients with head and neck cancer. Support Care Cancer 31, 268 (2023). https://doi.org/10.1007/s00520-023-07736-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00520-023-07736-0

Keywords

Search

Navigation