Impact of Adjuvant Radiotherapy Setting on Quality‐of‐Life in Head and Neck Squamous Cell Carcinoma

Abstract

ObjectiveTo determine differences in post‐treatment QoL across treatment settings in patients receiving adjuvant radiation therapy for head and neck squamous cell carcinoma (HNSCC).MethodsThis was a prospective observational cohort study of patients with HNSCC initially evaluated in a head and neck surgical oncologic and reconstructive clinic at an academic medical center (AMC). Participants were enrolled prior to treatment in a prospective registry collecting demographic, social, and clinical data. Physical and social–emotional QoL (phys‐QoL and soc‐QoL, respectively) was measured using the University of Washington‐QoL questionnaire at pre‐treatment and post‐treatment visits.ResultsA cohort of 177 patients, primarily male and White with an average age of 61.2 ± 11.2 years, met inclusion criteria. Most patients presented with oral cavity tumors (n = 132, 74.6%), had non‐HPV‐mediated disease (n = 97, 61.8%), and were classified as Stage IVa (n = 72, 42.8%). After controlling for covariates, patients treated at community medical centers (CMCs) reported a 7.15‐point lower phys‐QoL compared with those treated at AMCs (95% CI: −13.96 to −0.35, p = 0.040) up to 12 months post‐treatment. Additionally, patients who were treated at CMCs had a 5.77‐point (−11.86–0.31, p = 0.063) lower soc‐QoL score compared with those treated at an AMC, which was not statistically significant.ConclusionThis study revealed that HNSCC patients treated with radiation at AMCs reported significantly greater phys‐QoL in their first‐year post‐treatment compared to those treated at CMCs, but soc‐QoL did not differ significantly. Further observational studies are needed to explore potential factors, including treatment planning and cancer resource engagement, behind disparities between AMCs and CMCs.Level of Evidence3 Laryngoscope, 134:3645–3655, 2024