Health-related quality of life as a survival predictor for patients with localized head and neck cancer treated with radiation therapy
Meyer F et al. - Findings indicate that both baseline physical functioning (PF) and PF change provide added prognostic value for overall survival (OS) beyond established predictors in patients with head and neck cancer (HNC). Assessing health-related quality of life (HRQOL) could help better predict survival of cancer patients. Methods- Aim was to assess the added prognostic value for OS of baseline HRQOL and of early changes in HRQOL among pts with localized HNC treated with radiation therapy
- 540 pts completed 2 HRQOL instruments before radiation therapy:
- European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) and
- Head and Neck Radiotherapy Questionnaire
- 6 mo after the end of radiation therapy, 497 trial participants again completed the 2 HRQOL instruments
- During the f/u, 179 deaths were observed
- Multivariate Cox proportional hazards models were used to test whether HRQOL variables, baseline and change, provided additional prognostic value
Results- Baseline EORTC QLQ-C30 PF score was an independent predictor of OS
- Hazard ratio (HR) associated with a 10-point increment in baseline PF was 0.87
- Multivariate models: change in HRQOL was significantly associated with OS for most HRQOL dimensions
- Among these, PF change was the strongest predictor
- Magnitude of the association between PF change and survival decreased over time
- At 1 yr, the HR associated with a positive PF change of 10 points was 0.75
- After PF is taken into account, no other HRQOL variable was associated with survival
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