Treatment Modality Impact on Patient‐Reported Quality of Life in Human Papilloma Virus‐Associated Oropharyngeal Carcinoma

Objective To prospectively compare the impact of treatment modality on patient‐reported quality of life (QOL) in human papillomavirus‐associated oropharynx squamous cell carcinoma (HPV + OPSCC). Study Design Prospective cohort study. Setting Academic medical center. Methods One hundred one patients with American Joint Committee on Cancer (AJCC) 8th edition T1‐3 N0‐2 HPV + OPSCC completed the European Organization for Research and Treatment of Cancer Quality of Life Core questionnaire and Head and Neck Module pretreatment and 3‐month and 1‐year posttreatment. Mean score changes were compared to published minimal clinically important differences. Results Patients underwent surgery alone (SA: N = 42, 42%), surgery with adjuvant radiation (S‐RT: N = 10, 10%), surgery with adjuvant chemoradiation (S‐CRT: N = 8, 8%), definitive radiation (RT: N = 11, 11%), or definitive chemoradiation (CRT: N = 30, 30%). SA, S‐[C]RT, and [C]RT patients all reported clinically significant difficulty with sense of taste/smell persisting at 1 year. S‐[C]RT and [C]RT patients reported statistically and clinically significant worse salivary dysfunction and problems with social eating at 1 year than SA. S‐[C]RT patients reported statistically and clinically significant worse fatigue and head and neck pain compared to [C]RT and SA patients at 3 months, but normalized at 1 year. S‐CRT compared to S‐RT had statistically and clinically worse physical and role functioning and swallowing difficulties at 3 months but this difference was resolved by 1‐year posttreatment. Conclusion HPV + OPSCC patients after SA report the lowest posttreatment QOL impact, whereas after S‐CRT report the highest symptom burden. Careful selection for definitive surgery is important given the possibility of adjuvant CRT. Patients can experience persistent sense taste and smell difficulties at 1 year with all treatment modalities. Level of Evidence 3 Laryngoscope , 134:1687–1695, 2024