ORIGINAL ARTICLE LARYNGEAL CANCER IN EGYPT: QUALITY OF LIFE MEASUREMENT WITH DIFFERENT TREATMENT MODALITIES Ossama A. Hamid, MD, 1 Lobna M. El Fiky, MD, 1 Medani M. Medani, MD, 1 Ayman AbdelHady, MBBCh, 2 Hanan H. Ali, MBBCh 3 1 Department of Otolaryngology, Ain Shams University, Cairo, Egypt. E-mail: elfikylobna@hotmail.com 2 Department of Otolaryngology, Military Medical Academy, Cairo, Egypt 3 Department of Pathology, Cairo University, Cairo, Egypt Accepted 27 July 2010 Published online 27 October 2010 in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/hed.21591 Abstract: Background. Quality of life (QOL) reflects the need to assess the patient’s overall sense of well-being. A non- randomized, prospective longitudinal study was conducted to evaluate QOL in Egyptian patients treated for laryngeal cancer. Methods. In all, 60 newly diagnosed patients with laryngeal cancer were divided into 3 groups: surgical resection, radio- therapy, and combined therapy. The European Organization for Research and Treatment of Cancer Quality of Life Question- naires (EORTC-QLQ) were administered to the patients at 4 points: prior to treatment, during active treatment, and at 3 and 6 months after completion of treatment. Results. All pretreatment scales were worse in the combined therapy group. The functional scales reached their lowest levels in all groups during active treatment. Radiotherapy group scales showed persistent slow recovery. There was striking prevalence of the financial difficulties score in all groups. Conclusion. QOL measurement provides information to guide clinical decision making in patients treated for laryngeal carcinoma. V V C 2010 Wiley Periodicals, Inc. Head Neck 33: 1162–1169, 2011 Keywords: quality of life; EORTC; laryngeal cancer; total laryngectomy; radiotherapy The main outcome measure in oncology is traditionally expressed in terms of survival, progression and other disease minded variables. Although these parameters remain essential, there is a general recognition of the need to assess the impact of cancer and its treatment on patient’s quality of life (QOL). 1–3 Quality of life measures seek to obtain a comprehensive, multidimensional picture of the patient’s ‘‘total health related experience.’’ To achieve this goal, QOL measures evaluate broad domains including emo- tional, physical, functional, social, financial, and spiritual well-being. 4 Vartanian et al 2 stated that a high proportion of patients with head and neck cancer in Brazil belong to low socioeconomic classes and have difficulties in accessing the health care system, with most cases even- tually diagnosed at advanced clinical stages. Low edu- cational level and limited income status were reported as important factors associated with a low level of QOL in these patients. 5 The same socioeconomic problems are also found in Egypt, with most of our patients pre- senting with advanced stages, mainly resulting from the lack of proper health care. Different QOL instruments are being widely used and validated across different countries worldwide. Cancer-specific QOL instruments are responsive to all patients with cancer and to the change in their health status over time. Site-specific cancer instruments are designed to be most sensitive to the functional deficits peculiar to the affected organ. 6 Head and neck cancer modules allow specific assessment of a patient’s abil- ity to eat, swallow, and communicate, as well as other sequelae that are unique to this disease and its treatment. 7 The same questionnaires may not be sensitive to cultural and ethnical difference across different coun- tries and civilizations. The objective of the present study was to assess QOL in patients receiving different treatment modalities for laryngeal cancer at a tertiary care hospital in Egypt. We assessed diverse domains of functioning, and changes over time, in an attempt to direct supportive treatment for such patients. In our study we used the European Organization for Research and Treatment of Cancer Quality of Life Questionnaires (EORTC-QLQ). EORTC QLQ-C30 core instrument is a widely used, validated multidimensional measure for cancer patients. This was combined with the head and neck module (QLQ-H&N35), which has demonstrated good reliability, validity, and responsiveness in studies of patients with head and neck cancer in Europe, the United States, India, as well as other countries. 1,8–10 PATIENTS AND METHODS Patients. In this nonrandomized prospective longitu- dinal study, 60 patients with newly diagnosed Correspondence to: L. M. El Fiky V V C 2010 Wiley Periodicals, Inc. 1162 Laryngeal Cancer in Egypt HEAD & NECK—DOI 10.1002/hed August 2011