Impact of Treatment-Related Outcomes on the Quality of Life of Patients with Head and Neck Cancer
Quality of Life; Head and Neck Cancer; Oncology; Item Response Theory
Objective: To evaluate the impact of head and neck cancer, as well as treatment outcomes, on health-related quality of life (HRQoL) in patients with head and neck cancer who underwent different combinations of surgery, chemotherapy, and radiotherapy. Methods: Two prospective, multicentric studies were conducted in 18 Brazilian medical institutions. Included were patients diagnosed with squamous cell carcinoma of the head and neck in stages I to IVB, with primary tumors located in various regions, excluding patients with a history of prior radiotherapy and those with distant metastasis. Treatment protocols followed the guidelines of each participating institution, including surgeries, systemic therapies, and radiotherapy. Data collection occurred from June 2014 to December 2019, and patients provided written informed consent. HRQoL was assessed using the cancer-specific questionnaire from the European Organization for Research and Treatment of Cancer (EORTC QLQ-C30) and a specialized module for head and neck cancer patients (EORTC QLQ-H&N43). Results: The findings of this thesis emphasize the need for a holistic approach in treating head and neck cancer, which considers the need to adapt and evolve treatment strategies to not only extend survival but also to improve the quality of that survival, taking into account the socioeconomic context of patients. The choice of radiotherapy technique has direct implications on the HRQoL and, possibly, on the OS. Equitable access to advanced treatments is essential for improving health outcomes. Furthermore, recovery of HRQoL after treatment requires ongoing support and long-term monitoring. The studies presented provide evidence to support clinical and health policy decisions and reinforce the need to improve access to and the quality of radiotherapy treatments and care for patients with head and neck cancer in Brazil.