Qualidade de vida relacionada à saúde piora a curto prazo durante o tratamento em pacientes com câncer de cabeça e pescoço: um estudo prospectivo

Abstract

Background: Quality of life (QoL) is affected in head and neck cancer (HNC) patients by a set of factors related to diagnosis, treatment and tumor impacts. The aim of this study was to evaluate the QoL in HNC patients during the treatment at three times. Methods: QoL was evaluated prospectively in 63 HNC patients using the questionnaires from European Organization for Research and Treatment of Cancer (EORTC) QLQC30, H&N35 and H&N43 during radiotherapy and/or chemoradiotherapy in three moments: before or at the beginning (T0), in the middle (T1~ four weeks) and immediately at the end (T2 ~ eight weeks) of the treatment. The differences between the scores by times was verified by the Friedman's non-parametric test. Negative clinically significant changes was evaluated considering deltas by time ≥±10 points in the scales. Results: Role functional score became worsened comparing T0-T1 and T0-T2, while that for cognitive function was observed a improvement in scores. Several symptoms also worsened over time such as: fatigue, nausea and vomiting, dry mouth and sticky saliva, swallowing and skin, senses, and teeth problems. A high frequency of altered and clinically meaningful values was observed for most of the domains ranging 6 to 74%. Conclusions: The QoL became worse in approximately one month after the beginning of the treatment in HNC patients and this worsening remains until the end of the therapy. Preventive actions aiming to minimize the impairment of QoL are necessary to make this exhausting process, less traumatic and easier to complete.