Quality of life in advanced oropharyngeal carcinoma after chemoradiation versus surgery and radiation

OBJECTIVE: The objective of this cohort study from a tertiary academic university practice was to identify differences in patients' perceived quality of life after either chemoradiation or surgery and radiation for advanced-stage oropharyngeal carcinoma. METHODS: From institutional databases, thirty-five patients were identified who had undergone either primary chemoradiation or primary surgery and postoperative radiation for advanced oropharyngeal cancer (stage II-IV). Patients voluntarily responded by mail using the University of Washington quality-of-life instrument version 4 (UW-QOL). Data were analyzed using χ and Wilcoxon tests. RESULTS: There were 17 patients who underwent chemoradiation and 18 patients who underwent surgery and postoperative radiation. All surgical patients had undergone free-flap reconstruction. Patients completed the UW-QOL an average of 25 months after treatment. There was no statistically significant difference between the two groups with regard to any specific domain, including pain, appearance, swallowing, chewing, speech, saliva, or mood. There was a trend toward significance for taste (P = .07) with chemoradiation patients reporting poorer taste function. The lack of difference in the patients' perception of appearance and swallowing was rather surprising given the vastly different treatment modalities. Respondents reported equivalent overall quality of life in response to global quality-of-life questions. CONCLUSION: Most patients with advanced oropharyngeal carcinoma report good quality of life after treatment, regardless of treatment modality. Although the short-term side effects of treatment may be different between the groups, long-term quality of life is remarkably similar whether the patients choose primary chemoradiation or surgery with postoperative radiation.