口咽癌患者面临高风险的财务毒性（FT），但是初次放疗（RT）或手术后所经历FT的性质、程度和预测因素尚不清楚。我们使用德克萨斯癌症登记处的人群样本，对2006年至2016年诊断为I至III级口咽癌并接受初次RT或手术治疗的患者进行研究。1668名符合条件的患者中，抽样1600名，400名回复，并确认了396名口咽癌患者。测量指标包括安德森医学中心头颈症状清单、颈部切除瘤后障碍指数和根据个性化癌症护理（iCanCare）研究改编的财务毒性工具。多元逻辑回归评估了暴露与结果的关联性。在396名可分析的受访者中，269人（68％）接受了初次RT，127人（32％）接受了手术治疗。诊断到调查的中位时间为7年。由于口咽癌，54％的患者经历了物质上的牺牲（包括减少食品支出的28％和失去住所的6％），45％担心财务问题，29％经历了长期FT。与更多长期FT相关的独立因素包括女性（奥尔斯比1.72; 95％置信区间[CI]，1.23-2.40）、黑种人非西班牙裔种族（奥尔斯比2.98; 95％ CI, 1.26-7.09）、未婚状况（奥尔斯比1.50，95％ CI, 1.11-2.03）、使用喂食管（奥尔斯比3.98，95％ CI, 2.29-6.90）、与安德森医学中心头颈症状清单（奥尔斯比1.89，95％ CI, 1.23-2.90）和颈部切除瘤后障碍指数（奥尔斯比5.62，95％ CI, 3.79-8.34）最差四分位相比（奥尔斯比），与更少长期FT相关的因素包括年龄> 57岁（OR，0.54；95％ CI，0.41-0.71；P <.001）和家庭收入≥ $ 80,000（奥斯比0.60; 95％ CI, 0.44-0.82；P = .001）。与手术治疗相比，初次RT与长期FT无关（奥尔斯比0.92; 95％ CI,0.68-1.24）。口咽癌幸存者经历了高比率的物质上牺牲和长期FT，并且我们确定了重要的风险因素。慢性症状负担与长期财务状况显着恶化有关，支持毒性缓解策略可能减少长期FT的假设。

Patients with oropharyngeal squamous cell carcinoma (OPSCC) are at high risk for financial toxicity (FT), but the nature, extent, and predictors of FT experienced after primary radiation therapy (RT) or surgery are poorly understood.We used a population-based sample of patients from the Texas Cancer Registry with stage I to III OPSCC diagnosed from 2006 to 2016 and treated with primary RT or surgery. Of 1668 eligible patients, 1600 were sampled, 400 responded, and 396 confirmed OPSCC. Measures included the MD Anderson Symptom Inventory Head and Neck, Neck Dissection Impairment Index, and a financial toxicity instrument adapted from the Individualized Cancer Care (iCanCare) study. Multivariable logistic regression evaluated associations of exposures with outcomes.Of 396 analyzable respondents, 269 (68%) received primary RT and 127 (32%) surgery. The median time from diagnosis to survey was 7 years. Due to OPSCC, 54% of patients experienced material sacrifice (including 28% who reduced food spending and 6% who lost their housing), 45% worried about financial problems, and 29% experienced long-term FT. Independent factors associated with more long-term FT included female sex (odds ratio [OR], 1.72; 95% confidence interval [CI], 1.23-2.40), Black non-Hispanic race (OR, 2.98; 95% CI, 1.26-7.09), unmarried status (OR, 1.50; 95% CI, 1.11-2.03), feeding tube use (OR, 3.98; 95% CI, 2.29-6.90), and worst versus best quartile on the MD Anderson Symptom Inventory Head and Neck (OR, 1.89; 95% CI, 1.23-2.90) and Neck Dissection Impairment Index (OR, 5.62; 95% CI, 3.79-8.34). Factors associated with less long-term FT included age >57 years (OR, 0.54; 95% CI, 0.41-0.71; P < .001) and household income ≥$80,000 (OR, 0.60; 95% CI, 0.44-0.82; P = .001). Primary RT versus surgery was not associated with long-term FT (OR, 0.92; 95% CI, 0.68-1.24).Oropharynx cancer survivors experience high rates of material sacrifice and long-term FT, and we identified important risk factors. Chronic symptom burden was associated with significantly worse long-term financial status, supporting the hypothesis that toxicity mitigation strategies may reduce long-term FT.Copyright © 2022 Elsevier Inc. All rights reserved.