Relationship among cancer treatment, quality of life, and oral function in head and neck cancer survivors: A cross-sectional study

Abstract

Abstract Purpose Treatment for head and neck cancer (HNC), such as surgery and chemoradiotherapy, can reduce oral function and affect quality of life (QoL). However, whether HNC treatment affects QoL via the decline of oral function remains unclear. This study aimed to investigate the relationship among cancer treatment, QoL, and actual oral function in HNC survivors. Methods A total of 100 HNC survivors were enrolled in this cross-sectional study. QoL was evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Core 30 summary score. Oral diadochokinesis (ODK), tongue pressure, moisture level on the mucosal surface, and mouth aperture size were measured. Information on age, sex, tumor site, tumor stage, history of HNC treatment, height, body weight, and lifestyle were collected from medical records. Structural equation modeling (SEM) was conducted to analyze the indirect/direct associations among HNC treatment, QoL, and oral function. Results In total, 100 HNC survivors (58 males and 42 females; age range, 30–81 years, median, 67 years) were analyzed. Overall, 63 patients (63.0%) contracted oral cancer, 66 (66.0%) developed advanced cancer (stage 3/4), and 58 underwent reconstruction surgery. The SEM results supported the hypothesized structural model (root mean square error of approximation = 0.044, comparative fit index = 0.990, Tucker–Lewis index = 0.986). Surgery with neck dissection and reconstruction for advanced cancer had indirect effects on lower QoL via ODK and mouth aperture size. Conclusion HNC treatment is indirectly associated with QoL via oral function in HNC survivors.