Longitudinal Financial Toxicity and Quality of Life in Head and Neck Cancer

作者：Leila J. Mady, Khalil Baddour, Maryanna S. Owoc, Lauren D. Kudrick, Alexzandra T. Gentsch, David Ebbott, Benjamin Skalla, Maria Amache, Wassim Najjar, Sudip Gupta, Seema Kacker, Angela L. Mazul, Carole Fakhry, Kristin L. Rising, Richard W. Hass, Laila A. Gharzai · 发表于：JAMA Otolaryngology–Head & Neck Surgery · 年份：2025 · DOI：10.1001/jamaoto.2025.1313 · 被引用次数：6 · 研究领域：Economic and Financial Impacts of Cancer、Cancer survivorship and care、Financial Literacy, Pension, Retirement Analysis

Importance: Patients with head and neck cancer (HNC) are disproportionately affected by financial toxicity (FT). Most research has evaluated FT at a single point. Objective: To evaluate longitudinal factors associated with FT and health-related quality of life in patients and caregivers to understand its progression and effect. Design, Setting, and Participants: This prospective cohort study was conducted at a single tertiary care center from October 2018 to December 2020. Data were analyzed from December 2020 to December 2024. Eligible participants included adult patients with HNC undergoing definitive treatment and their primary caregivers. Exposures: Surveys conducted at diagnosis, 3 months, and 6 months postdiagnosis. Instruments included the Comprehensive Score for Financial Toxicity, version 1, Financial Distress Questionnaire, University of Washington Quality of Life Scale (UWQOL), version 4 (with physical [PQOL] and social [SQOL] subscales), 19-Item Social Support Survey, and Three-Item Loneliness Scale. Semistructured qualitative interviews were performed at 6 months. Main Outcomes and Measures: Linear mixed-effects modeling assessed trends in FT (Comprehensive Score for Financial Toxicity), PQOL, and SQOL longitudinally. The McNemar tests compared Financial Distress Questionnaire score among dyads. Qualitative interviews were analyzed using a conventional content analysis. Results: Of 74 enrolled patients (median [range] age, 60 [32-81] years; 12 female individuals ...