Assessment of Quality of Life in Patients With Upper Aerodigestive Tract Cancer

TL;DR

This study assesses how quality of life changes in Mexican patients with head and neck cancer before and after treatment using a specific questionnaire.

Contribution

The study provides insights into HRQOL changes in UADT cancer patients in Mexico, focusing on treatment modality impacts.

Findings

Physical Well-Being was the lowest HRQOL domain at baseline and three months.

Emotional Well-Being showed the greatest decline and remained low after treatment.

Surgery was associated with better Functional and Social/Family Well-Being but lower Emotional Well-Being.

Abstract

Introduction

Head and neck cancer can compromise swallowing, breathing, and speech, and may markedly reduce health-related quality of life (HRQOL), particularly because it often involves visible structures. This study evaluated HRQOL in Mexican patients with upper aerodigestive tract (UADT) cancer before and after unimodal or multimodal treatment using the Functional Assessment of Cancer Therapy-Head & Neck (FACT-H&N) questionnaire.

Materials and methods

This was an observational, analytical, longitudinal study of 68 patients. The validated Spanish version of the FACT-H&N was administered to patients treated at the “Dr. José Eleuterio González” University Hospital from July 2024 through July 2025. Demographic characteristics, tumor site and stage, histology, and treatment were recorded.

Results

A total of 68 patients with head and neck cancer were included (mean age 60.2 ± 12.7 years); 34 patients (50.0%) had at least one comorbidity. Moderately differentiated keratinizing squamous cell carcinoma predominated, occurring in 30 patients (44.1%), and most tumors presented at advanced stages (III-IV). The most frequent primary sites were the oral cavity in 29 patients (42.6%) and the larynx in 21 patients (30.9%). Treatment was predominantly multimodal: surgery was used alone or combined with chemotherapy and/or radiotherapy, and concurrent chemoradiotherapy was used in 11 patients (16.7%). Postoperatively, 33 patients (48.6%) had no complications, 19 (27.9%) developed complications, and in 16 (23.5%), this information was not recorded. Regarding HRQOL, Physical Well-Being was the lowest domain at baseline and at three months, whereas Social/Family Well-Being was the highest. Emotional Well-Being showed the greatest decline and remained low, while the Head & Neck (H&N) subscale decreased at one month and returned to baseline by three months; the global score did not change significantly. By treatment modality, surgery was associated with better Functional Well-Being and higher Social/Family Well-Being (both at baseline and three months) but with lower Emotional Well-Being at three months; non-surgical patients had better Physical Well-Being at three months. Radiotherapy did not alter the overall trajectory, although H&N subscale scores worsened after radiotherapy and at three months. Chemotherapy did not change the overall course but was associated with higher Physical Well-Being and lower Emotional Well-Being and H&N subscale scores.

Conclusion

HRQOL in patients with UADT cancer may improve in specific domains after treatment; however, overall scores may remain unchanged, highlighting the need for adjunct supportive interventions and follow-up protocols that extend beyond oncologic disease control.

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