Head and neck cancer, quality of life, and determinant factors: a novel approach using decision tree analysis

Objective. The goal of the present study was to investigate health-related quality of life (HRQoL) and oral health-related quality of life (OHRQoL) in patients under treatment for head and neck cancer and to identify the associated factors. Study Design. A cross-sectional study was conducted with 102 patients undergoing treatment for head and neck cancer at 2 medical centers. Participants answered a sociodemographic questionnaire and the Brazilian versions of the Medical Outcomes Study 36 (SF-36) and the Oral Health Impact Profile (OHIP-14) questionnaires to assess HRQoL and OHRQoL, respectively. Clinical aspects, cancer staging, and treatment approach were also investigated. Descriptive and multivariate analyses were performed by using decision tree analysis with the Chi-square Automatic Interaction Detector (CHAID) algorithm. Results. The decision tree revealed that reduced quality of life is associated with the clinical staging (adjusted P value = .035), patient's gender (adjusted P value = .028), and treatment approach (adjusted P value= .032). Female patients who are diagnosed with advanced head and neck cancer and undergo radiotherapy or chemotherapy are more likely to exhibit lower rates of quality of life. Conclusions. The results suggested that sociodemographic characteristics, clinical staging, and treatment approach can exert a significant influence on the quality of life of patients with head and neck cancer.