The goal of management for cancar is giving the ptients to have a chance to elimmnate the disease process completely and to survive for a long time. Moreover to maintain the physical , mental health and social activities to the level of previous healthy state is desirable. But it is very diffcult to get both complete curability and good quality of life in head and neck cancer patients bacause the head and neck has very close relation to daily life for example eating, speaking and breathing etc. Indeed in early cancer, there is no difference in survival to treat with either surgery or radiotherapy and in advanced cancer, surgery can often offer a higher suvival rate than radiotherapy and chemotherapy up to date. But in advanced cases the wider the field of operation the poorer the quality of life. At present many patients with operable head and neck cancer tend to choose conservative management instead of radical surgery even though radical extensive surgery offers higher survival because they want to keep better healthy physical and mental status as long as they live. In laryngeal cancer, treatment modality may be changed from radical surgery to conservative management even in case of T3 and be focused voice rehabilitation after total laryngectomy in consideration of quality of life. I would like to assess the degree of satisfaction of life following various types of treatment for laryngeal cancer using questionnairs which was employed by Grogono and Woodgate (1971), Drettner and Ahlbom (1983). Among Patients who were treated radiotherapy (43 cases) or definitive surgery (63 cases) for laryngeal cancer at Pusan National University Hospital from Jan. 1987 to July 1990, 60 patients who were able to provide QOL ratings were evaluated. The results obtained were as follows : 1) The correlation between the four dichotomized health indexes were relatively high. 2) There were no significant differences between controls and all patients with regard to health status and health for age. 2) According to satisfaction, there were no differences between patients with radiotherapy and those with surgery. Comparison with controls, patients with surgery felt less satisfied than controls. 4) There was no significant difference between controls and patients with radiotherapy for total Grogono-Woodgate index. Patients with radiotherapy felt somewhat better than those with surgery. 5) With regard to communication, patients with total laryngectomy were poorer than those with conservation surgery and radiotherapy. 6) For eating, patients with surgery were poorer than those with radiotherapy and controls. It can be considered that the patients who received radiotherapy for laryngeal cancer were generally better than those who treated with conservation surgery or total laryngectomy in posttreatment quality of life. Among laryngectomies, ultimately there is no differences in quality of life between methods of communication.
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