Quality of life after radiation and transoral robotic surgery in advanced oropharyngeal cancer
Thomas M. Kaffenberger, Ankur Patel, Lingyun Lyu, Jinhong Li, Tamara Wasserman‐Wincko, Dan P. Zandberg, David A. Clump, Jonas T. Johnson, Marci L. Nilsen
Abstract
Abstract Objectives Oropharyngeal squamous cell carcinoma (OPSCC) treatment results in impaired swallowing and quality of life (QOL). We analyzed a cross‐section of advanced stage OPSCC patients treated with multimodal therapies at our Survivorship Clinic to investigate treatment factors associated with QOL. Methods Retrospective analysis of patient‐reported outcomes (PROMs) after primary OPSCC treatment using AJCC seventh edition staging. Results A total of 73 patients were included (90.1% human papillomavirus positive [HPV+]). There were no QOL differences between robotic surgery with radiation ± chemotherapy patients (n = 29) and those treated by radiation ± chemotherapy (n = 44). Radiation field analysis demonstrated significant correlations between increasing doses to larynx and contralateral parotid and submandibular gland and worse swallowing as measured by the Eating Assessment Tool‐10 ( P = .02; P = .01; P = .01). Conclusions In advanced, mostly HPV+, OPSCC, we did not find clinically significant differences between QOL PROMs between surgical and radiation ± chemotherapy treatment groups. This highlights the need for continued therapy de‐escalation along with improved interventions for treatment related toxicities. Level of evidence 4.