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scores for QOL and symptoms were linearly converted to a
0-100 scale. Propensity Score (PS) correction and
weighting was used to reduce the risk of bias and balance
patient and treatment characteristics between the
treatment groups (Table). Linear regression analyses were
performed with IMRT as independent variable and the
patient rated outcome scores as dependent variables. All
models were corrected for PS and corresponding scores at
baseline.
Results
With IMRT, the mean PS-weighted QOL scores at 6 months
were 9.7 points higher than they were with 3D-CRT (79.5
vs. 69.8, p=0.011) and at 12 months they were 9.1 points
higher (83.1 vs. 74.1, p=0.014). This indicates a significant
improvement with IMRT. The lower mean PS-weighted
scores for xerostomia (6 months: 34.5 vs. 51.7, p=0.007,
and 12 months: 33.3 vs. 52.0, p=0.006) and sticky saliva (6
months: 27.4 vs. 39.6, p=0.003, and 12 months: 19.8 vs.
33.6, p=0.026) also indicate a significant improvement
with IMRT (lower symptom scores correspond with less
complaints). The mean PS-weighted scores for swallowing
problems were similar for IMRT and 3D-CRT (6 months:
19.5 vs. 22.1, p=0.532, and 12 months: 16.0 vs. 20.6,
p=0.252).
Conclusion
This study shows that IMRT significantly reduced patient-
reported xerostomia and sticky saliva which translated in
significantly improved patient rated QOL compared to 3D-
CRT. With IMRT, no significant reduction of swallowing
problems was observed.
PO-0608 Depression, anxiety and claustrophobia in
patients undergoing radiotherapy for head and neck
cancer
M.E. Pelland
1
, L. Lambert
1
, E. Filion
1
, H. Bahig
1
, M.P.
Beaudry
1
, A. Ouellette
1
, P. Bahary
1
, P. Nguyen-Tan
1
1
Centre Hospitalier de l'Université de Montréal, Radio-
oncology departement, Montréal, Canada
Purpose or Objective
To assess the prevalence of emotional distress, anxiety,
depression and claustrophobia in patients undergoing
radiation for head and neck cancer (HNC).
Material and Methods
This prospective study included patients oriented for
treatment for HNC within 6 weeks preceding radiotherapy.
Self-reported distress was assed using the
NCCN Distress
Thermometer
, anxiety and depression were assed using
the
Hospital Anxiety and Depression Scale
; and
claustrophobia was assessed using the
Claustrophobia
Questionnaire
. All questionnaires have been validated and
present good psychometric properties. Group differences
in outcomes were analysed using both student t-tests and
general linear models.
Results
1346 patients were accrued from May 2009 to April 2016.
Median age of patients was 63 years old (18-94). Men
represented 74% of patients. Nasal cavity represented 6%;
oral cavity represented 11%; oropharynx 49%; hypopharynx
4%; larynx 25% and unknown primary 5%. Of these patients,
46% presented emotional distress, 26% presented anxiety
and 9% presented with depression. Moreover, of these
patients, 52% presented sub-clinical claustrophobia and
27% presented moderate to severe claustrophobia. Both
emotional distress (p< 0.001) and depression (p < 0.001)
were affected by gender, with women scoring significantly
higher than men. In regards to anxiety: women were more
anxious than men (p< 0.001); patients with oral cavity
tumors were more anxious than other tumoral sites
(p<0.01) and patients with concurrent chemotherapy were
more anxious than those with adjuvant chemotherapy and
radiation alone (p< 0.05). Claustrophobia, in turn, was
influenced by gender and marginally impacted by tumor
localization, whereas women were more claustrophobic