ESTRO 2025 - Abstract Book

S938

Clinical – Head & neck

ESTRO 2025

Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, University of Freiburg, Freiburg, Germany. 6 Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany

Purpose/Objective: Young adults with head-and-neck cancer represent a unique population for whom limited information is available regarding their quality of life (QoL), psychological distress, fear of cancer recurrence (FCR), and return to work (RTW). This study aimed to assess these patient-reported outcomes in surviving young adults with head-and-neck cancer after (chemo)radiation. Material/Methods: This cross-sectional observational study, conducted at two comprehensive cancer centers, evaluated QoL and RTW among young adults (18–45 years) with head-and-neck cancer treated with (chemo)radiation between 2003 and 2023 and alive as of January 1, 2024. QoL was measured with the EORTC QLQ-C30 and HN43 questionnaires, psychological distress with the NCCN Distress Thermometer, and depression and anxiety with the PHQ-9 and GAD 7, respectively. FCR was analyzed using the 12-item FoP-Q-SF, and work ability was assessed with the short version of the WAI-R questionnaire. Results: Out of 83 eligible patients, 58 (70%) participated in the study. The median age at the time of radiotherapy was 41 years (IQR, 35–44), gender distribution was balanced (n=23 [40%] female and n=35 [60%] male), and the most common tumor sites were the oral cavity (n=19; 33%), oropharynx (n=14; 24%), and salivary glands (n=7; 12%). Fourty-five patients (78%) were treated with postoperative (chemo)radiation. The median time from the end of radiotherapy until questionnaire completion was 83.5 months (IQR, 48.0–134.5). The mean global QoL was 65 (SD, 21) points, which is comparable to the age- and sex-adjusted German population (1). Clinically relevant psychological distress (distress scale ≥5) was reported by 28 patients (48%), moderately severe or severe depressive symptoms (PHQ-9 score ≥15) by 7 patients (12%), and moderate-to-severe levels of anxiety (GAD-7 score ≥10) by 12 patients (21%). Strong FCR (≥34 points) was reported by 22 patients (38%). At the time of the study, 38 patients (66%) were employed, with a median weekly working time of 38.8 hours (IQR, 25–40). The median WAI-R score was 33 points (IQR, 27-38), indicating a moderate working ability. Patients returning to work reported better QoL ( p <0.001, Mann-Whitney-U-test) and lower levels of distress ( p <0.05), depression ( p <0.001), and anxiety ( p <0.01) compared to those who did not work. Conclusion: Psychological distress and FCR are present in a significant proportion of young adults with head-and-neck cancer after (chemo)radiation. RTW is associated with better QoL and less distress, depression, and anxiety. Our results highlight the importance of implementing multimodal programs for cancer survivorship in this patient community.

Keywords: Quality-of-life, patient-reported outcomes

References: 1. Nolte S, Waldmann A, Liegl G, Petersen MA, Groenvold M, Rose M. Updated EORTC QLQ-C30 general population norm data for Germany. European Journal of Cancer. 2020;137:161-70.

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