Prospective evaluation of impact of adaptive radiotherapy on quality of life in patients with locally advanced head and neck cancers

Background: Intensity-modulated radiation therapy (IMRT) improves quality of life (QoL) by reducing doses to organs at risk (OARs); we, therefore, hypothesized that adaptive radiotherapy would improve QoL in head and neck cancer patients of locally advanced stages. The current study was planned to assess QoL in patients with head and neck cancer undergoing adaptive IMRT/Chemo-IMRT replanning. Methods: Eligible locally advanced Head and neck (H&N) Cancer patients were recruited in this prospective study between January 2021 and August 2022. They underwent adaptive radiotherapy at mid-treatment. European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-C 30 and EORTC QLQ-H&N35 questionnaires were filled at baseline, on the day of treatment completion, and subsequently at one month, three months & six months for each patient. Results: Thirty-four patients were analysed for QoL after adaptive radiotherapy replanning. Patients who underwent a replanning had statistical improvements in global QoL and social functioning (P=0.05), but in role functioning and cognitive functioning, there was no significant improvement. With improvement in QoL, there was a decrease in painkillers and nutritional supplement requirements. All patients had weight loss at baseline, but subsequently, there was steady, significant weight regain at three months and six months (P<0.001). Conclusions: In the present study, there was a decline in QoL in patients in the immediate post-treatment phase. However, there was an improvement in the QoL with the time-lapse. Further longitudinal follow-up of patients may further identify the effect of adaptive replanning on QoL of head and neck cancer patients.