Long-term functional and quality of life evaluation after treatment for advanced pharyngolaryngeal carcinoma.

Abstract

The purpose of this study was to compare total laryngectomy versus concurrent chemoradiotherapy (CRT) for functional and long-term quality of life (QOL) outcomes in patients with pharyngolaryngeal carcinoma. Among 145 patients treated for advanced pharyngolaryngeal cancer by CRT or total laryngectomy between 2000 and 2008, 47 patients who had completed treatment for >1 year and were determined to be disease-free were evaluated for function and QOL using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30-questions (EORTC-QLQ-C30). No significant difference was observed between the total laryngectomy group (26 patients) and the CRT group (21 patients) concerning feeding tube (p = .72), oral supplements (p = .84), and pneumonia (p = 1.00). Laryngeal functional rate after CRT was 72% at 2 years. No significant difference was observed between the 2 groups when using EORTC-QLQ-C30 scales (p > .05). According to the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 Head and Neck 35-questions (EORTC-QLQ-C30-H&N35) questionnaire, surgical patients reported significantly greater difficulties with smell and taste (p = .005) and chemoradiation patients with dry mouth (p = .010) and weight loss (p = .022). Differences that seemed clinically meaningful but not statistically significant emerged on several other scales. Both total laryngectomy and CRT led to a similar high rate of dysphagia-related morbidity (feeding tube, oral supplements, and pneumonia) and QOL alteration, but the groups differed in the specific QOL domains affected.