Individualised quality of life as a measure to guide treatment choices in squamous cell carcinoma of the head and neck

In patients with advanced squamous cell carcinoma of the head and neck (SCCHN), aggressive treatment is effective, but can significantly impact their health-related quality of life (HRQoL), particularly if there is damage to the structures involved in swallowing, breathing, speech or physical appearance. Long-term psychosocial support may be required for patients whose basic functioning and social interactions are affected. In randomised clinical trials in SCCHN, HRQoL has not been routinely reported and, with a number of different HRQoL tools available, data for many of the parameters that patients consider important in their day-to-day lives are not widely available to clinicians. In addition, the assessment of HRQoL outside of the clinical trial setting is even scarcer. In an era of personalised medicine, an individualised approach to assessing QoL (iQoL) is of paramount importance when treating and monitoring patients with SCCHN; by responding to QoL concerns, appropriate treatment regimens that result in meaningful improvements in clinical outcomes and quality of survival (QoS) for patients can be adopted. In this review we describe the tools available for assessing HRQoL in cancer patients and provide an overview of the HRQoL data currently available in head and neck cancer. How this information can be used to individualise treatment to optimise clinical outcomes, maximise the patient's day-to-day living and minimise healthcare spending in SCCHN is discussed.