• E R Gritz, C L Carmack, C de Moor, A Coscarelli, C W Schacherer, E G Meyers, and E Abemayor.
• Department of Behavioral Science, University of Texas M.D. Anderson Cancer Center, Houston, TX 77030-4095, USA. egritz@notes.mdacc.tmc.edu
• J. Clin. Oncol. 1999 Jan 1; 17 (1): 352-60.

PurposeTreatment regimens for head and neck cancer patients profoundly affect several quality-of-life domains. Rehabilitative needs have been identified through cross-sectional analyses; however, few studies have prospectively assessed quality of life, included assessment of psychosocial variables, and identified predictors of long-term follow-up.Participants And MethodsThe present study addresses these limitations through a prospective assessment of 105 patients with a newly diagnosed first primary squamous cell carcinoma of the oral cavity, pharynx, or larynx. Participants were enrolled onto a larger randomized controlled trial comparing a provider-delivered smoking cessation intervention with a usual-care-advice control condition. Participants completed a battery of self-report measures after diagnosis and before treatment and additional quality-of-life instruments at 1 and 12 months after initial smoking cessation advice.ResultsParticipants displayed improvements at 12 months in functional status (P = .006) and in the areas of eating, diet, and speech; however, the latter three represent areas of continued dysfunction, and the changes were not statistically significant. Despite these improvements, patients reported a decline in certain quality-of-life domains, including marital (P = .002) and sexual functioning (P = .017), as well as an increase in alcohol use (P < .001). Predictors of quality of life at 12 months included treatment type, the Vigor subscale of the Profile of Mood States instrument, and quality-of-life scores obtained 1 month after initial smoking cessation advice.ConclusionResults reinforce the need for rehabilitation management through the integration of psychologic and behavioral interventions in medical follow-up.

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