Objective: Since last 10 years intensity modulated radiotherapy (IMRT) came into practice in HNC management. The randomized data supported benefit regarding long term side effects of radiotherapy. However patients controlled on their disease beyond 2 years and expecting probable cure has other concerns. This study aims at assessing these concerns through an indigenous ILEA scale combining quality of life (QOL) and organs at risk (OAR) specific late toxicities.
Materials and methods: This single institution study was conducted upon HNC patients on routine follow up and disease free for at least 2 years. Indigenous ILEA questionnaire with10 topics were used. The most troublesome response was selected. Total 18 patients were analyzed based on the 10 topics like skin,oral cavity, dental status, swallowing, speech, nutrition, general physical aspects, personal life, professional life and other specific aspects.
Results: There were 18 patients (15 male and 3 female) with median age 62.5 years with both early (7) and advanced (11) stages. As perceived from the ILEA scale major responses were sub cutaneous edema, dryness of mouth and sticky saliva,dental sensitivity, increased time to swallow, change in voice quality,dietary modifications and fatigue. The most troublesome though was either dryness in mouth or sticky saliva resulting in modifications in diet, swallowing and speech abilities.
Conclusion: The study with small sample size and indigenous ILEA scale could indicate major concerns with HNC IMRT beyond 2 years of disease control. Even after 2 years xerostomia and its sequelae troubles patient. With experience in IMRT OAR’s like dysphagia structures, minor salivary glands, laryngeal architecture, CNS structures or brachial plexus are equally important in reducing late toxicities and a better QOL. The non-availability of IMRT specific scales for late toxicity and QOL along with future validation and prospective documentation would resolve issues pertaining to IMRT specific late toxicities and QOL.