Quality of Life of Patients Treated for Oral and Oropharyngeal Squamous Cell Carcinoma at Kenyatta National Hospital and University of Nairobi Dental Hospital

Abstract

Background: The number of patients treated for oral cancer continues to rise. Most of these patients have to live with debilitating complications which adversely affect their quality of life (QOL). Rarely do clinicians assess and record quality of life of these patients routinely. Evaluation and documentation of this subjective feedback will help provide a baseline against which evidence-based effectiveness of a treatment intervention can be measured. Broad objective: To determine the quality of life of patients treated for oral and oropharyngeal carcinoma at Kenyatta National Hospital (KNH) and University of Nairobi Dental Hospital (UDH) Materials and Method: This study was a descriptive prospective study conducted at Kenyatta National Hospital and University of Nairobi Dental hospital from August 2018 to August 2019 involving patients diagnosed with oral and oropharyngeal squamous cell carcinoma. University of Washington Quality of Life Questionnaire version 4 was used. QOL assessment was scheduled before starting treatment and 3 months after treatment. Scores for each question in every patient were tabulated and the means for all relevant variables were calculated mainly for comparison purposes Results: Seventy-one patients were recruited in this study and most of them were presenting for treatment at advanced stage of cancer (98.6%). 37 were found suitable to participate in the second interview upon completing 3 months after treatment. 20 patients died within the course of this study and out of these 20 patients 6 had been interviewed 3 months after treatment. Nine patients were lost to follow up and the remaining eleven patients had not completed the required 3 months after treatment mainly due to treatment delays. The overall QOL mean score for the 71 patients before treatment was 61 points. The overall QOL mean score of the 37 patients who had been reviewed 3 months after treatment slightly improved from 68 points before treatment to 72 points after treatment although this change was not statistically significant (p value = 0.1645). There was significant improvement in emotional functions such as pain, mood and anxiety following treatment. Patients presenting with base of the tongue lesions had the worst QOL scores (54 points) before treatment compared to others Conclusion: There was overall slight improvement in QOL following treatment mainly due to better emotional functioning following treatment but this change was not statistically significant. Majority of the patients were presenting at advanced stage of cancer which translated to lower QOL as disease stage advanced. Patients treated at very advanced disease stage were more likely to get post-op complications and early mortality