Assessing Quality of Life in Patients With Head and Neck Cancer

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Abstract
THE SYMPTOMS and treatments associated with advanced head and neck cancer often have a devastating impact on quality of life, affecting multiple spheres of daily functioning. Patients frequently experience impairments in eating, speech, and respiration, often in conjunction with facial disfigurement. In view of these difficulties, oncologists have increasingly recognized the importance of assessing quality of life.1,2 There has been a growing call to include behavioral and functional outcomes in clinical trials, to supplement survival and toxicity measures.3 In the past decade, considerable efforts have been devoted to developing practical, psychometrically sound measures. Among the instruments available for patients with head and neck disease, performance measures focus on specific aspects of daily physical functioning such as speech and eating3 (eg, the Performance Status Scale for Head and Neck Cancer4). In contrast, measures of health-related quality of life assess a broader array of physical, psychological, and social functioning (eg, the Functional Assessment of Chronic Illness Therapy5 and the Functional Living Index–Cancer6). Most investigators agree that quality-of-life measures should be multidimensional, sensitive to changes over the course of treatment, and grounded in the patient's perspective.7,8