The impact of radiotherapy on quality of life -- a survey of 1411 patients with oral cancer]

PURPOSE: The therapy of patients with oral cancer often requires a combination of surgery and radiotherapy. This leads to trauma of healthy tissue. The impact of this side effect on quality of life was investigated. Additionally the impairment of 19 factors was determined (comprehension of speech for unknown others, comprehension of speech for familiar others, eating/swallowing, mobility of the tongue, opening range of the mouth, mobility of lower jaw, mobility of neck, mobility of arms and shoulders, sense of taste, sense of smell, appearance, strength, appetite, respiration, pain, swelling, xerostomia, halitosis). METHODS: This retrospective multicenter study was conducted under the auspices of DOESAK (a German, Austrian and Swiss cooperative group on tumors of the maxillofacial region). The Bochum Questionnaire on Rehabilitation was used to determine 147 items. 3894 questionnaires where sent to 43 clinics in Germany, Austria and Switzerland. 1761 questionnaires where returned, while 1411 of them included all of the answers necessary for this study. RESULTS: 686 of 1411 patients where irradiated. Before the beginning of therapy the impairment of the 19 factors was not significantly higher in the group that later received radiotherapy. After therapy there is a significantly higher impairment of the irradiated patients. The factors that are especially worse are xerostomia, swallowing and understanding of speech. The quality of life was not significantly lower. CONCLUSIONS: Although radiotherapy leads to trauma of healthy tissue this method is indicated as it has no significant impact on quality of life. During the rehabilitation physiotherapists should relieve the impairment of speech, eating and swallowing.