Long-term quality of life in head and neck cancer: the role of postdiagnosis smoking behavior
Menée auprès de 619 patients atteints d'un cancer de la tête et du cou, cette étude analyse l'impact, sur la qualité de vie à long terme (notamment sur les fonctions physiques, le bien-être émotionnel, le fonctionnement social, la douleur et la santé en général) du comportement tabagique après le diagnostic de la maladie
Purpose: Head and neck squamous cell carcinoma (HNSCC) significantly impacts patients’ quality of life (QoL). This study investigated long-term QoL outcomes among 619 patients with newly diagnosed HNSCC over five years.
Methods: QoL was assessed annually using the SF-36, covering physical functioning, emotional well-being, social functioning, pain, and general health. Patients were stratified by tumor subsite and smoking status.
Results: Significant improvements in QoL were observed at the 1-year follow-up, particularly among patients with pharyngeal [adjusted
β: 3.56 (95% CI: 1.69, 5.43)] and oral cavity cancers [adjusted β: 2.56 (95% CI: 0.52, 4.60)]. However, patients with laryngeal cancer showed no significant change at any follow-up [e.g., 1-year adjusted β: 0.93 (95% CI: -2.36, 4.24)]. Overall, QoL improved most notably in the early years post-treatment [adjusted β: 2.86 (95% CI: 1.56, 4.16)]. Smoking status significantly influenced QoL trajectories. Never-smokers showed the greatest improvement (from 53.11 at baseline to 59.29 at year 2, P
< 0.0001), followed by quitters (48.09 to 51.42, P = 0.04). Continued and intermittent smokers demonstrated no significant gains.
Conclusions: In this longitudinal study of HNSCC patients, quality of life significantly improved over time, particularly among those with pharyngeal and oral cavity tumors and those who never smoked or quit smoking after diagnosis.
Implications for Cancer Survivors: These findings highlight the importance of smoking cessation in survivorship care. Personalized care strategies addressing both physical and psychosocial challenges, particularly for continued smokers and those with laryngeal tumors, are essential to improving long-term QoL in HNSCC survivors.
Journal of Cancer Survivorship , article en libre accès, 2025