Quality of Life and Return to Work After Radiotherapy in Young Adults With Head-and-Neck Cancer-A Bicentric Cross-Sectional Observational Study.

Charlotte Pannenbecker, Clemens Seidel, Jiadai Zou, Daniel Schnell, Gunnar Wichmann, Christoph Becker, Sabine Klagges, Henning Schäfer, Andreas Knopf, Andreas Dietz, Anca-Ligia Grosu, Anja Mehnert-Theuerkauf, Nils H Nicolay, Alexander Rühle

Journal: Cancer medicine 2025;15(1):e71502

PMID: 41457852

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Abstract

OBJECTIVE

Young adults (18-45 years) with head-and-neck cancer represent a unique population with limited data on quality of life (QoL) and return-to-work after radiotherapy. This bicentric study aimed to evaluate these outcomes.

METHODS

Conducted at two comprehensive cancer centers, the study included young head-and-neck cancer survivors treated with curative radiotherapy between 2003 and 2023. QoL was assessed with EORTC QLQ-C30 and HN43; distress, depression, and anxiety with the NCCN Distress Thermometer, PHQ-9, and GAD-7; fear of cancer progression and work ability with FoP-Q-SF and WAI.

RESULTS

Out of 83 eligible patients, 58 (70%) participated. The median age at radiotherapy was 41 years, with a balanced gender distribution (40% female, 60% male). The median time from radiotherapy to questionnaire completion was 82.5 months. Mean global QoL was 65.0, comparable to the age- and gender-matched reference population (67.2). Clinically relevant distress was reported by 52%, severe depressive symptoms by 12%, moderate-to-severe anxiety by 21%, and strong fear of cancer progression by 38%. At the time of the study, 66% had returned to work. Those who returned to work reported lower symptom scores, and less depression, anxiety, and distress. In the multiple regression analysis, gender was significantly associated with return to work, with females showing higher odds of returning.

CONCLUSIONS

While overall QoL was comparable to the general population, young head-and-neck cancer survivors face psychological and work reintegration challenges. Returning to work is associated with improved QoL and reduced psychological symptoms, highlighting the need for tailored survivorship care.

Address: Department of Radiation Oncology, University Medical Center Leipzig, Leipzig, Germany.; Comprehensive Cancer Center Central (CCCG) Germany, Partner Site Leipzig, Leipzig, Germany.; Department of Radiation Oncology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.; Comprehensive Cancer Center Central (CCCG) Germany, Partner Site Leipzig, Leipzig, Germany.; Clinic for Otorhinolaryngology and Head and Neck Surgery, Department of Head Medicine and Oral Health, University of Leipzig, Leipzig, Germany.; Department of Otorhinolaryngology, Head and Neck Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.; Clinical Cancer Registry Leipzig Region (CCRL), Leipzig, Germany.; Comprehensive Cancer Center Central (CCCG) Germany, Partner Site Leipzig, Leipzig, Germany.; Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany.; Department of Radiation Oncology, University Medical Center Leipzig, Leipzig, Germany.; Comprehensive Cancer Center Central (CCCG) Germany, Partner Site Leipzig, Leipzig, Germany.; Department of Radiation Oncology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

DOI: 10.1002/cam4.71502

MeSH Terms: Humans, Quality of Life, Male, Female, Adult, Head and Neck Neoplasms, Return to Work, Cross-Sectional Studies, Young Adult, Cancer Survivors, Middle Aged, Adolescent, Anxiety, Depression, Surveys and Questionnaires