Lebensqualität von Patienten mit einem Oropharynxkarzinom nach primärer Strahlentherapie und/ oder kombinierter Radio- Chemotherapie im Vergleich zur operativen Therapie - Eine retrospektive Analyse der Jahre 2000 – 2009 der Tumorpatienten des Landes Brandenburg

Despite new strategies in therapy the prognosis of patients with oropharyngeal cancer did not sufficiently improve. In recent years quality of life became more important especially for patients with cancer in treatment planning. In oropharyngeal carcinoma, quality of life is strongly affected by the disease itself on the one hand and by the therapy on the other hand. The aim of this study was to evaluate quality of life of patients with oropharyngeal carcinoma and to compare differences between surgical therapy and radiation with or without chemotherapy. From 2000 to 2009, 1394 patients were treated for oropharyngeal carcinoma in Brandenburg. The basis of this study was a postal interview with two questionnaires concerning health-related quality of life from the EORTC, QLQ-C30 and QLQ-H&N35. 954 patients were mailed, 440 were deceased. 261 questionnaires were returned correctly completed. The most frequent tumor localisations were the tonsilla palatina and the base of tongue. 62,1 % of the patients had stage III or IV oropharyngeal carcinoma. About 75% of the patients received a combined therapy, which means surgery with adjuvant radiotherapy, adjuvant chemoradiation or chemoradiation. Except for one item, there were no differences in the assessment of quality of life between the four groups in the generic questionnaire QLQ-C30. In "financial difficulties”, patients with an operation had less problems than patients with a combined therapy. One reason for this phenomenon may be the longer duration of therapy in a combined approach. In general, the generic questionnaire QLQ-C30 is not as qualified as a disease-specific questionnaire to point out differences between several therapies in oropharyngeal carcinoma. In the disease-specific questionnaire QLQ-H&N35 patients treated with radiotherapy have statistically more trouble with swallowing, senses problems, social eating, mouth opening, dry mouth and sticky saliva. These are some of the typical side effects of radiotherapy in head and neck cancer. Patients with radiotherapy with or without chemotherapy are more often dependend on feeding tubes than patients in the other three groups. This effect is caused by the higher dose of radiation which consecutively damages the tissue in oropharynx. In all, patients who underwent surgery have a better health- related quality of life than patients with radiotherapy. These results have to be interpreted carefully because these patients, who were treated with surgery alone, present lower tumor stages than patients with a combined approach. It is more important to notice, that there is no difference in quality of life if radiotherapy is performed adjuvant or as primary therapy and if chemotherapy is added or not.