Patient Reported Outcomes/Quality of Life

PV QA 4 - Poster Viewing Q&A 4

TU_42_3733 - Quality of Life differences in Male and Female Patients with Head and Neck Cancer

Tuesday, October 23
2:45 PM - 4:15 PM
Location: Innovation Hub, Exhibit Hall 3

Quality of Life differences in Male and Female Patients with Head and Neck Cancer
B. R. Page1, Y. Guo2, P. Han1, Z. Cheng1, J. Harkness1, C. Shen3, A. Choflet1, C. Hu4, E. Cecil1, N. C. Schmitt5,6, I. Shpitser7, A. P. Kiess1, T. R. McNutt1, and H. Quon1,5; 1Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 2Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 3Department of Radiation Oncology, University of North Carolina School of Medicine, Chapel Hill, NC, 4Johns Hopkins University School of Medicine Department of Biostatistics, Baltimore, MD, 5Johns Hopkins University Department of Otolaryngology-Head and Neck Surgery, Baltimore, MD, 6NIDCD, NIH, Bethesda, MD, 7Johns Hopkins University Department of Computer Science, Baltimore, MD

Purpose/Objective(s): Gender differences in head and neck cancer (HNC) patients and impact on treatment and toxicity are understudied, yet previous reports suggest differences in HNC incidence attributable to hormonal levels. To date, few studies have discussed differences with regard to quality of life (QOL), measurable toxicities, or differences in numerical lab data between men (M) and women (W) undergoing radiotherapy (RT) for HNC.

Materials/Methods: Utilizing prospectively collected data at the point of care, patients treated for HNC (oral cavity, oropharynx, nasopharynx, larynx, hypopharynx and cervical esophageal cancers) were queried from our analytic database. Patients with no missing clinician-assessed measures (mucositis, dermatitis, thrush, performance status) from on-treatment visits were included. Patient-reported outcomes (PRO) for QOL were reported including the Functional Assessment of Cancer Therapy (FACT) (General, Head and Neck) at baseline, during RT, and in followup. Analysis for significant differences in M v. W. lab values included hemoglobin, platelets and albumin were assessed for significant differences using a two sample t-test.

Results: From 2010-2017, 363 patients (86W) were included with a mean age of 59 years (M) and 56.2 (W), with cancers of oral cavity (37%, n=133), oropharynx (23%, n=84), larynx (11%, n=39) nasopharynx/sinonasal (5%, n=11), and upper aerodigestive (12%, n=44). M had higher FACT subscale scores than W at baseline and 1-year post-RT, reflecting higher reported QOL than W, with the exception of FACT-Social Well Being, which was not significantly different. Significant differences were prominent for patients with BMI > 30 kg/m2 regardless of gender. No significant difference was found in M v. W on FACT at 3–6 mos (45-180 days) and 6-12 mos after RT (180-360 days). Clinician assessed measures (KPS, mucositis grade, dermatitis grade, and presence of thrush), which could affect QOL, did not differ between genders. Lab values were available for 281 patients, (75% M). At baseline, W had lower Hgb (mean 11.6W, 13.1M, p>0.05), but there were no differences in baseline platelets (mean 268.9W, 248M, p=0.08), or Albumin (mean 4.01W, 4.1M, p=0.18). However, M experienced a greater decline in both hemoglobin (p<0.05) and albumin (p<0.05), but not platelets (p=0.96) from baseline and end-of-treatment levels. This difference persisted at the six-month followup, but resolved at the 12 month post-RT followup.

Conclusion: Significant differences in M v. W were found in QOL measures and laboratory values, suggesting that more studies are necessary to better understand gender differences in clinically relevant sequelae and QOL.

Author Disclosure: B.R. Page: None. Y. Guo: None. Z. Cheng: None. J. Harkness: None. C. Shen: None. A. Choflet: None. C. Hu: None. N.C. Schmitt: None. T.R. McNutt: Research Grant; Elekta Oncology Systems, Philips Radiation Oncology Systems, Toshiba. Patent/License Fees/Copyright; Accuray-Tomotherapy, Sun Nuclear. President Elect; AAPM-MAC.

Brandi Page, MD

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