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Clinical Predictors of Quality of Life in Patients With Head and Neck Cancer
Jeffrey E. Terrell, MD;
David L. Ronis, PhD;
Karen E. Fowler, MPH;
Carol R. Bradford, MD;
Douglas B. Chepeha, MD;
Mark E. Prince, MD;
Theodoros N. Teknos, MD;
Gregory T. Wolf, MD;
Sonia A. Duffy, PhD, RN
Arch Otolaryngol Head Neck Surg. 2004;130:401-408.
Objective To identify clinical predictors of quality of life (QoL) in a head and neck cancer patient population.
Design, Patients, and Setting A convenience sample of 570 patients with upper aerodigestive tract cancers were surveyed at a tertiary care oncology clinic and Veterans Affairs otolaryngology clinic.
Interventions A self-administered health survey was constructed to collect demographic, health, smoking, alcohol, depression symptom, and QoL information. Tumor site and tumor stage, clinical, and treatment data were abstracted from the patient medical records.
Main Outcome Measures Quality of life was assessed using the Medical Outcomes Study Short-Form 36-Item Health Survey (SF-36) and the Head and Neck QoL (HNQoL) instrument.
Results Of the 570 eligible respondents, the presence of a feeding tube had the most negative impact on QoL, with significant decrements in 6 of the 8 SF-36 scales and all 4 HNQoL scales (P<.01). In descending order of severity, medical comorbid conditions, presence of a tracheotomy tube, chemotherapy, and neck dissection were also associated with significant (P<.05) decrements in QoL domains. Patients who took the survey more than 1 year after diagnosis had improved QoL in 7 of 12 domains. Hospital site, age, education level, sex, race, and marital status were also significant predictors of QoL.
Conclusion There are at least 13 demographic and clinical characteristics that are significant predictors of QoL in patients with head and neck cancer, which should be considered when treating patients and conducting QoL studies in the future.
From the Department of Otolaryngology, University of Michigan (Drs Terrell, Bradford, Chepeha, Prince, Teknos, Wolf, and Duffy); Ann Arbor Veterans Affairs Hospital, Center of Practice Management and Outcomes Research (Drs Terrell, Ronis, and Duffy, and Ms Fowler), Ann Arbor, Mich. The authors have no relevant financial interest in this article.
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