Analysis Of The Effect Of TPF Induction Chemotherapy On Quality Of Life In Advanced Oral Squamous Cell Carcinoma

PURPOSE To evaluate the effect of Quality of Life(QOL) on TPF induction chemotherapy(docetaxel, cisplatin, fluorouracil) followed by surgery and postoperative radiotherapy compared with up-front surgery and postoperative radiotherapy in patients with locally advanced resectable oral squamous cell carcinoma(OSCC).PATIENTS AND METHODS QOL of primary OSCC patients recruited from March 2008 to December 2010 was assessed with EORTC QLQ-C30 and QLQ-HN35 questionnaires, cross-sectional study was used to compare the difference between TPF arm and control arm and longitudinal study was used to investigate QOL before treatment, 3 months after treatment, 6 months after treatment, 1 year after treatment and 3 years after treatment.Data was analyzed with statistical software of SAS 9.2. The statistical significance was P<0.01.RESULTS1. 243 patients had at least one valid QOL form in the 256 eligible patients. The compliance rate was being above 85% at 3 years after treatment.2. Most QOL domains deteriorated until 3 months after treatment and then improved thereafter. It costed 1 year or more time to recover to the pretreatment level.3. Global health status in QLQ-C30 and pain, swallowing, senses problems,speech problems, trouble with social eating, trouble with social contact, less sexuality in QLQ-HN35 were not significantly different between TPF arm and control arm. The P value of these domains were global health status(P=0.25), pain(P=0.72),swallowing(P=0.68), senses problems(P=0.69), speech problems(P=0.44), trouble with social eating(P=0.78), trouble with social contact(P=0.45), less sexuality(P=0.24).4. Opening mouth in QLQ-HN35 was in favor of the control arm at 3 months after treatment, showing statistical(P=0.0006) and clinical(mean value difference=10.76) difference, but the global assessment of the treatment effect revealed the difference was not significant(P=0.07).CONCLUSION1. TPF induction chemotherapy has no significant effect on QOL in OSCC patients.2. Opening mouth problems in patients receiving TPF induction chemotherapy were worse than that in patients of the control group in the short term, but there was no significant difference between the two groups.3. QLQ-C30 and QLQ-HN35 are suitable tools to study QOL of Chinese OSCC patients, but need to be improved.