Quality of life after different treatment modalities for carcinoma of the oropharynx

Objectives: To assess the long-term posttreatment quality of life of patients with carcinoma of the oropharynx treated with different treatment modalities. Study Design: Retrospective chart review and patient response to EORTC quality of life core questionnaire QLQ-C30 and EORTC quality of life core head and neck cancer module QLQ-H&N35 questionnaires. Methods: Two hundred and seventeen patients with carcinoma of the oropharynx were treated with curative intent between 1990 and 1998. In January 2001, a total of 111 disease-free survivors were identified and included in this study. The questionnaires were completed by 99 patients (89% completion rate). Results: Of 99 patients, 31 patients were treated with surgery alone, 19 with radiation therapy alone and 49 with surgery followed by postoperative irradiation. Median follow-up for the entire study group was 71 months. Physical, role, emotional, cognitive and social functioning reflected in the functional scale scores of the global EORTC QLQ-C30 were generally good and showed no significant differences for the different treatment modalities. Comparison of the head and neck specific EORTC QLQ-H&N35 scores revealed significantly less troubles with swallowing (P = 0.006), social eating (P = 0.007) and social contact (P = 0.008), dry mouth (P < 0.0001), sticky saliva (P = 0.0001) and mouth opening (P = 0.001) in non-irradiated patients versus those treated with any either primary or postoperative radiation therapy. Patients undergoing surgery (with and without postoperative irradiation) had less pain (P = 0.04), less problems with social eating (P = 0.009) and less restricted mouth opening (P = 0.03) than the nonsurgically treated patients. Conclusions: Quality of life after curative treatment of oropharyngeal carcinoma is generally good. Differences regarding quality of life between the different treatment modalities manifest themselves in the head and neck specific EORTC QLQ-H&N35 module, not in the global core questionnaire EORTC QLQ-C30.