Quality of Life and Return to Work After Radiotherapy in Young Adults With Head-and-Neck Cancer-A Bicentric Cross-Sectional Observational Study.

OBJECTIVE: Young adults (18-45 years) with head-and-neck cancer represent a unique population with limited data on quality of life (QoL) and return-to-work after radiotherapy. This bicentric study aimed to evaluate these outcomes. METHODS: Conducted at two comprehensive cancer centers, the study included young head-and-neck cancer survivors treated with curative radiotherapy between 2003 and 2023. QoL was assessed with EORTC QLQ-C30 and HN43; distress, depression, and anxiety with the NCCN Distress Thermometer, PHQ-9, and GAD-7; fear of cancer progression and work ability with FoP-Q-SF and WAI. RESULTS: Out of 83 eligible patients, 58 (70%) participated. The median age at radiotherapy was 41 years, with a balanced gender distribution (40% female, 60% male). The median time from radiotherapy to questionnaire completion was 82.5 months. Mean global QoL was 65.0, comparable to the age- and gender-matched reference population (67.2). Clinically relevant distress was reported by 52%, severe depressive symptoms by 12%, moderate-to-severe anxiety by 21%, and strong fear of cancer progression by 38%. At the time of the study, 66% had returned to work. Those who returned to work reported lower symptom scores, and less depression, anxiety, and distress. In the multiple regression analysis, gender was significantly associated with return to work, with females showing higher odds of returning. CONCLUSIONS: While overall QoL was comparable to the general population, young head-and-neck cancer survivors face psychological and work reintegration challenges. Returning to work is associated with improved QoL and reduced psychological symptoms, highlighting the need for tailored survivorship care.