Functional and psychological evaluation after flap reconstruction plus radiotherapy in oral cancer

BACKGROUND: Head and neck tumors and their treatments negatively affect speech, swallowing, body image, and quality of life (QOL). The purpose of this study was to allow us to evaluate the impact of flap reconstructive surgery with adjuvant radiotherapy (RT) on QOL and psychological functioning. METHODS: Thirty-six of 153 consecutive patients surgically treated for carcinoma of the oral cavity received adjuvant RT. Late effects of RT and psycho-oncological assessment were performed. RESULTS: In more than 50% of the cases examined, moderate to severe late toxicity was observed, regarding subcutaneous tissues, salivary function, dysphagia, and taste impairment. Patients with severe dysphagia showed higher levels of depression and anxiety (p < .05). Dysphagia and taste impairment were seen to be associated with lower global health and QOL. The Draw a Person Test (DAP) showed severe problems in self-perceived body image in 33% of the sample. CONCLUSION: Dysphagia and taste impairment are associated with QOL and depression; our data suggest a different evaluation between self-reported and clinician-rating scales. DAP is a provocative tool that merits further research