Quality of life in survivors of oropharyngeal cancer: A systematic review and meta-analysis of 1366 patients |
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| Affiliation: | 1. Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, University Hospital Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark;2. Department of Oncology, University Hospital Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark;1. Head and Neck Medical Oncology Unit, Cancer Medicine Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, Milan 20133, Italy;2. Medical Oncology Department, Catalan Institute of Oncology, Av. Gran Via de l’Hospitalet 199-203, L’Hospitalet de Llobregat, Barcelona, Spain;3. Charité Comprehensive Cancer Center, Charité – Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany;1. Robotic Surgery Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), France;2. Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium;3. Department of Otolaryngology-Head Neck Surgery, Foch Hospital, UFR Simone Veil, University Versailles Saint-Quentin-en Yvelines (University Paris Saclay), Paris, France;4. Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium;5. Department of Otorhinolaryngology—Head & Neck Surgery, APHM, Aix Marseille University, La Conception University Hospital, Marseille, France;6. Department of Otorhinolaryngology—Head & Neck Surgery, Hospital Universitario Donostia, San Sebastian, Spain;7. Unit of Otolaryngology, Hospital Morgagni Pierantoni, Forlì, Italy;8. Department of Otolaryngology-Head and Neck Surgery, Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon;9. Division of Phoniatrics and Audiology, Department of Mental and Physical Health and Preventive Medicine, University of Naples SUN, Naples, Italy;10. Centre Hospitalier de l''Université de Montréal, Department of Otolaryngology-Head & Neck Surgery, Montreal, Quebec, Canada;11. Department of Otorhinolaryngology and Head and Neck Surgery, CH Luxembourg, Luxembourg;1. Department of Head and Neck, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India;2. Department of Surgical Oncology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India;1. Department of Otolaryngology-Head & Neck Surgery, University of Ottawa, Ottawa, Canada;2. FRCSC, Department of Otolaryngology-Head & Neck Surgery, University of Ottawa, Ottawa, Canada;3. University of Ottawa, Ottawa, Canada;4. FRCSC, Department of Neurosciences/Otolaryngology-Head and Neck Surgery, Aurora St. Luke’s Hospital, Milwaukee, WI, United States;2. Department of Radiotherapy, Victoria Hospital, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India;1. Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands;2. Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands |
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| Abstract: | Human papillomavirus (HPV)-associated oropharyngeal cancer (OPC) is rapidly increasing in incidence and has a favourable prognosis compared with HPV-negative disease. Current combined therapies include significant risks of morbidity for the growing group of survivors. This systematic review and meta-analysis investigates how treatment affects quality of life (QoL) in survivors of oropharyngeal cancer. PubMed, EMBASE and the Cochrane Library were systematically searched for all studies reporting patient-assessed QoL at least 1 year after treatment for OPC. In a meta-analysis, weighted average QoL scores from the four most commonly utilised QoL instruments were compared with baseline and reference group scores using the concept of minimal clinically important difference. The meta-analysis included data from 1366 patients from 25 studies and 12 countries. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30) was answered by 704 patients, 644 patients answered the EORTC QLQ Head and Neck-35 (H&N-35), 474 patients answered the University of Washington Quality of Life Questionnaire, and 381 patients answered the M. D. Anderson Dysphagia Inventory. Moderate to large clinically important deteriorations in QoL were found in the domains dry mouth and sticky saliva for the EORTC QLQ-H&N35, saliva, chewing, swallowing, speech, taste, appearance and shoulder for the University of Washington Quality of Life Questionnaire, and the global, physical and emotional subscales for the M. D. Anderson Dysphagia Inventory. In conclusion, survivors of OPC face clinically important deteriorations in QoL that most markedly centre on xerostomia, dysphagia and chewing. These ailments indicate a potential for improvement in patient management. |
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| Keywords: | Oropharyngeal cancer Quality of life Long-term effects Survivors Review |
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