Top

Strahlentherapie und Onkologie

Published in:

01-08-2018 | Original Article

Socioeconomic status and quality of life in patients with locally advanced head and neck cancer

Authors: S. Tribius, MD, PhD, M. S. Meyer, C. Pflug, H. Hanken, C.-J. Busch, A. Krüll, C. Petersen, C. Bergelt

Published in: Strahlentherapie und Onkologie | Issue 8/2018

Abstract

Purpose

Socioeconomic aspects play an important role in health care. Patients with locally advanced head and neck cancer (LAHNC) experience detrimental effects on their quality of life (QoL). This prospective study examines QoL differences between patients with different socioeconomic status (SES) after intensity-modulated radiation therapy (IMRT).

Patients and methods

In all, 161 patients were questioned at the end of IMRT and at 12 and 24 months follow-up using the questionnaires of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-30 and QLQ-HN35. Patients’ QoL 2 years after IMRT was compared to a population reference sample and QoL of patients from lower, middle, and higher social class 2 years after IMRT was analyzed by ANCOVA using baseline QoL (end of radiation treatment) as a covariate.

Results

Patients with high SES report worse QoL at the end of IMRT in the domains global health status (−15.2; p = 0.005), role function (−23.8; p = 0.002), and social function (−19.4; p = 0.023) compared to patients with middle and low SES. QoL improved during the first 12 and 24 months. However, 2 years after IMRT, middle and low SES patients report lower QoL in the domains global health status, physical function, and role function, and report a higher general (fatigue, pain, dyspnea) and head and neck cancer-specific symptom burden (pain, swallowing, senses, speech, social eating, opening mouth, and felt ill) than patients with high SES.

Conclusion

After IMRT for LAHNC, patients with high SES report worse QoL compared to patients with middle or low SES. There is a marked improvement within the first 24 months in many domains. However, the magnitude of improvement in patients with middle or low SES is significantly smaller compared to patients with high SES.

Available only for authorised users

Rogers SN, Ahad SA, Murphy AP (2007) A structured review and theme analysis of papers published on “quality of life” in head and neck cancer: 2000–2005. Oral Oncol 43:843–868CrossRefPubMed

Infante-Cossio P, Torres-Carranza E, Cayuela A, Hens-Aumente E, Pastor-Gaitan P, Gutierrez-Perez JL (2009) Impact of treatment on quality of life for oral and oropharyngeal carcinoma. Int J Oral Maxillofac Surg 38:1052–1058CrossRefPubMed

Tribius S, Raguse M, Voigt C, Münscher A, Gröbe A, Petersen C et al (2015) Residual deficits in quality of life one year after intensity-modulated radiotherapy for patients with locally advanced head and neck cancer. Strahlenther Onkol 191:501–510CrossRefPubMed

Leung WS, Lee TF, Chien CY, Chao PJ, Tsai WL, Fang FM (2011) Health-related Quality of life in 640 head and neck cancer survivors after radiotherapy using EORTC QLQ-C30 and QLQ-H&N35 questionnaires. BMC Cancer 11:128CrossRef

Maurer J, Hipp M, Schäfer C, Kölbl O (2011) Dysphagia. Impact on quality of life after radio(chemo)therapy of head and neck cancer. Strahlenther Onkol 187:744–749CrossRefPubMed

Hwang E, Johnson-Obaseki S, McDonald JT, Connell C, Corsten M (2013) Incidence of head and neck cancer and socioeconomic status in Canada from 1992 to 2007. Oral Oncol 49:1072–1076CrossRefPubMed

Singer S, Bartels M, Briest S, Einenkel J, Niederwieser D, Papsdorf K et al (2016) Socio-economic disparities in long-term cancer survival-10 year follow-up with individual patient data. Support Care Cancer. https://doi.org/10.1007/s00520-016-3528-0 CrossRefPubMed

McDonald JT, Johnson-Obaseki S, Hwang E, Connell C, Corsten M (2014) The relationship between survival and socio-economic status for head and neck cancer in Canada. J Otolaryngol Head Neck Surg 43:2CrossRefPubMedPubMedCentral

Yost K, Perkins C, Cohen R, Morris C, Wright W (2001) Socioeconomic status and breast cancer incidence in California for different race/ethnic groups. Cancer Causes Control 12:703–711CrossRefPubMed

10.

Lampert T, Koch-Gromus U (2016) Soziale Ungleichheit und Gesundheit. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 59:151–152CrossRefPubMed

11.

Mackenbach JP, Meerding WJ, Kunst AE (2011) Economic costs of health inequalities in the European Union. J Epidemiol Community Health 65:412–419CrossRefPubMed

12.

Robert-Koch-Institut (2016) Bericht zum Krebsgeschehen in Deutschland 2016. Robert-Koch-Institut, Berlin

13.

Short PF, Mallonee E (2006) Income disparities in the quality of life of cancer survivors. Med Care 441:16–23CrossRef

14.

Johnson S, McDonald JT, Corsten M (2012) Oral cancer screening and socioeconomic status. J Otolaryngol Head Neck Surg 41:102–107PubMed

15.

Johnson S, Corsten MJ, McDonald JT, Gupta M (2010) Cancer prevalence and education by cancer site: logistic regression analysis. J Otolaryngol Head Neck Surg 39:555–560PubMed

16.

Hodapp N (2012) Der ICRU-Report 83: Verordnung, Dokumentation und Kommunikation der fluenzmodulierten Photonenstrahlentherapie (IMRT). Strahlenther Onkol 188:97–100CrossRefPubMed

17.

Winkler J, Stolzenberg H (1999) Social class index in the Federal Health Survey. Gesundheitswesen 61(Spec No):S178–S183PubMed

18.

Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376CrossRefPubMed

19.

Bjordal K, Ahlner-Elmqvist M, Tollesson E, Jensen AB, Razavi D, Maher EJ et al (1994) Development of a European Organization for Research and Treatment of Cancer (EORTC) questionnaire module to be used in quality of life assessments in head and neck cancer patients. EORTC Quality of Life Study Group. Acta Oncol 33:879–885CrossRefPubMed

20.

Fayers PM, Aaronson NK, Bjordal K et al (2001) On behalf of the EORTC Quality of Life Study Group. The EORTC QLQ-C30 Scoring Manual, 3rd edn. European Organisation for Research and Treatment of Cancer, Brussels

21.

King MT (1996) The interpretation of scores from the EORTC quality of life questionnaire QLQ-C30. Qual Life Res 5:555–567CrossRefPubMed

22.

Schwarz R, Hinz A (2001) Reference data for the quality of life questionnaire EORTC QLQ-C30 in the general German population. Eur J Cancer 37:1345–1135CrossRefPubMed

23.

Arraras JI, Arias F, Tejedor M, Pruja E, Marcos M, Martínez E et al (2002) The EORTC QLQ-C30 (version 3.0) Quality of Life questionnaire: validation study for Spain with head and neck cancer patients. Psychooncology 11:249–256CrossRefPubMed

24.

Singer S, Wollbrück D, Wulke C, Dietz A, Klemm E, Oeken J et al (2009) Validation of the EORTC QLQ-C30 and EORTC QLQ-H&N35 in patients with laryngeal cancer after surgery. Head Neck 31:64–76CrossRefPubMed

25.

Singer S, Arraras JI, Chie WC et al (2013) Performance of the EORTC questionnaire for the assessment of quality of life in head and neck cancer patients EORTC QLQ-H&N35: a methodological review. Qual Life Res 22:1927–1941CrossRefPubMed

26.

Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd edn. Routledge Academic, Erlbaum, New York, Hillsdale

27.

Wells M, Swartzman S, Lang H, Cunningham M, Taylor L, Thomson J et al (2016) Predictors of quality of life in head and neck cancer survivors up to 5 years after end of treatment: a cross-sectional survey. Support Care Cancer 24:2463–2472CrossRefPubMed

28.

Chu KP, Habbous S, Kuang Q et al (2016) Socioeconomic status, human papillomavirus, and overall survival in head and neck squamous cell carcinomas in Toronto, Canada. Cancer Epidemiol 40:102–112CrossRefPubMed

29.

Chu K, Shema S, Wu S, Gomez S, Chang E, Le Q (2011) Head and neck cancer specific survival based on socioeconomic status in Asians and Pacific Islanders. Cancer 117:1935–1945CrossRefPubMed

30.

Booth CM, Li G, Zhang-Salomons J, Mackillop WJ (2010) The impact of socioeconomic status on stage of cancer at diagnosis and survival: a population-based study in Ontario, Canada. Cancer 116:4160–4167CrossRefPubMed

31.

Mackillop WJ, Zhang-Salomons J, Groome PA, Paszat L, Holowaty E (1997) Socioeconomic status and cancer survival in Ontario. J Clin Oncol 15:1680–1689CrossRefPubMed

32.

Boyd C, Zhang-Salomons JY, Groome PA, Mackillop WJ (1999) Associations between community income and cancer survival in Ontario, Canada, and the United States. J Clin Oncol 17:2244–2255CrossRefPubMed

33.

Johnson S, McDonald JT, Corsten M, Rourke R (2010) Socio-economic status and head and neck cancer incidence in Canada: a case-control study. Oral Oncol 46:200–203CrossRefPubMed

34.

Shavers VL (2007) Measurement of socioeconomic status in health disparities research. J Natl Med Assoc 99:1013–1023PubMedPubMedCentral

35.

Naghavi AO, Echevarria MI, Strom TJ et al (2016) Treatment delays, race, and outcomes in head and neck cancer. Cancer Epidemiol 45:18–25CrossRefPubMed

36.

Johnson S et al (2008) Socioeconomic factors in head and neck cancer. J Otolaryngol Head Neck Surg 37:597–601PubMed

37.

Molina MA, Cheung MC, Perez EA, Byrne MM, Franceschi D, Moffat FL et al (2008) African American and poor patients have a dramatically worse prognosis for head and neck cancer. Cancer 113:2797–2806CrossRefPubMed

38.

Liederbach E, Kyrillos A, Wang C‑H, Liu JC, Sturgis EM, Bhayani MK (2017) The national landscape of human papillomavirus-associated oropharynx squamous cell carcinoma. Int J Cancer 140:504–512CrossRefPubMed

39.

Quabius ES, Haag J, Kühnel A et al (2015) Geographical and anatomical influences on human papillomavirus prevalence diversity in head and neck squamous cell carcinoma in Germany. Int J Oncol 46:414–422CrossRefPubMed

40.

World Health Organization Regional Office for Europe (2014) European tobacco control status report 2014. WHO, Copenhagen

41.

Guo Y, Logan HL, Marks JG, Shenkman EA (2015) The relationships among individual and regional smoking, socioeconomic status, and oral and pharyngeal cancer survival: a mediation analysis. Cancer Med 4:1612–1619CrossRefPubMedPubMedCentral

42.

van Nieuwenhuizen AJ, Buffart LM, Brug J, Leemans CR, Verdonck-de Leeuw IM (2015) The association between health related quality of life and survival in patients with head and neck cancer: a systematic review. Oral Oncol 51:1–11CrossRefPubMed

43.

Kypriotakis G, Vidrine DJ, Francis LE, Rose JH (2016) The longitudinal relationship between quality of life and survival in advanced stage cancer. Psychooncology 25:225–231CrossRefPubMed

Title: Socioeconomic status and quality of life in patients with locally advanced head and neck cancer
Authors: S. Tribius, MD, PhD
M. S. Meyer
C. Pflug
H. Hanken
C.-J. Busch
A. Krüll
C. Petersen
C. Bergelt
Publication date: 01-08-2018
Publisher: Springer Berlin Heidelberg
Published in: Strahlentherapie und Onkologie / Issue 8/2018
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-018-1305-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Socioeconomic status and quality of life in patients with locally advanced head and neck cancer

Abstract

Purpose

Patients and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Patients and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 8/2018

A feasibility study on adaptive 18F-FDG-PET-guided radiotherapy for recurrent and second primary head and neck cancer in the previously irradiated territory

Inclusion of dosimetric data as covariates in toxicity-related radiogenomic studies

Upregulated epithelial junction expression represents a novel parameter of the epithelial radiation response to fractionated irradiation in oral mucosa

Tumor volume as a prognostic marker in p16-positive and p16-negative oropharyngeal cancer patients treated with definitive intensity-modulated radiotherapy

Radiation-induced carotid artery lesions

Lokoregionale Tiefenhyperthermie verbessert das krankheitsspezifische Gesamtüberleben in Kombination mit einer neoadjuvanten Chemotherapie bei Hochrisiko-Weichteilsarkomen