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Health-related Quality of life in 640 head and neck cancer survivors after radiotherapy using EORTC QLQ-C30 and QLQ-H&N35 questionnaires

Stephen Wan Leung12, Tsair-Fwu Lee3, Chih-Yen Chien4, Pei-Ju Chao35, Wen-Ling Tsai6 and Fu-Min Fang5*

Author Affiliations

1 Department of Radiation Oncology, Yuan's General Hospital, Kaohsiung City, Taiwan

2 Department of Radiological Technology, Central Taiwan University of Science and Technology, Taichung City, Taiwan

3 Medical Physics & Informatics Lab., Department of Electronics Engineering, National Kaohsiung University of Applied Sciences, Kaohsiung, Taiwan

4 Department of Otolaryngology, Chang Gung Memorial Hospital - Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan

5 Radiation Oncology, Chang Gung Memorial Hospital - Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan

6 Department of Biotechnical Cosmetology, Cheng Shiu University, Kaohsiung, Taiwan

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BMC Cancer 2011, 11:128  doi:10.1186/1471-2407-11-128

Published: 12 April 2011



With the advances in modern radiotherapy (RT), many patients with head and neck cancer (HNC) can be effectively cured, and their health-related quality of life (HR-QoL) has become an important issue. In this study, we evaluated the prognosticators of HR-QoL in a large cohort of HNC patients, with a focus on the result from technological advances in RT.


A cross-sectional investigation was conducted to assess the HR-QoL of 640 HNC patients with cancer-free survival of more than 2 years. Among them, 371 patients were treated by two-dimensional RT (2DRT), 127 by three-dimensional conformal RT (3DCRT), and 142 by intensity-modulated RT (IMRT). The EORTC QLQ-C30 questionnaire and QLQ-H&N35 module were used. A general linear model multivariate analysis of variance was used to analyze the prognosticators of HR-QoL.


By multivariate analysis, the variables of gender, annual family income, tumor site, AJCC stage, treatment methods, and RT technique were prognosticators for QLQ-C30 results, so were tumor site and RT technique for H&N35. Significant difference (p < 0.05) of HR-QoL outcome by different RT techniques was observed at 2 of the 15 scales in QLQ-C30 and 10 of the 13 scales in H&N35. Compared with 2DRT, IMRT had significant better outcome in the scales of global QoL, physical functioning, swallowing, senses (taste/smell), speech, social eating, social contact, teeth, opening mouth, dry mouth, sticky saliva, and feeling ill.


The technological advance of RT substantially improves the head-and-neck related symptoms and broad aspects of HR-QoL for HNC survivors.