Evaluation of quality of life in patients definitively treated for squamous carcinoma of the head and neck.

This paper reviews quality-of-life (QOL) assessment in head and neck cancer with a focus on research and methodologic developments of the past year. Issues of QOL measurement, as well as the challenges to data synthesis in light of the heterogeneity of head and neck cancer and its treatment, are discussed briefly. Methodologic advances include increased use of validated measures, longitudinal study design, and attention to patients' attitudes. Although the majority of studies assessed multiple QOL domains, including both physical/functional and emotional/social, more focused areas of investigation included pain, organ preservation, and depression. Examinations of the relation among domains suggested that impaired function does not necessarily lead to poor QOL and that the best predictor of 12-month global QOL is pretreatment global QOL. Future challenges include the need for large multi-institutional studies, consensus about instrument selection, addressing the problem of missing data, and how to apply group OOL to individual patient decisions.