br contrasts studies which noted HNC patients become

contrasts studies which noted HNC patients become more depressed during and after their treatment course [37,38]. No statistically sig-nificant improvements in symptoms (MDASI) were noted in either group over time. HNC patients have been known to experience more physical symptoms during or after their treatment course [39,40].
Overall, this SYBR Safe DNA Gel Stain pilot study provides insight on the QoL and psycho-social aspects of HPV+ OPSCC patients and OCSCC smokers. The re-sults of this study demonstrate that both cohorts may benefit from supportive care interventions. Future larger scale studies are needed to further examine patterns of QoL over time. Additionally, future studies should more comprehensively examine QoL in HNC patients and assess functional status, social well-being, and other factors to guide inter-vention planning. Furthermore, the ability to longitudinally follow these patients beyond 12 months may provide further information re-garding their psychosocial or QoL needs over time.
Of note, our study has some limitations. First, study enrollment began before routine HPV testing was available and some patients re-ceived tissue-based HPV testing after treatment. In addition, our control cohort is an imperfect proxy for HPV− OPSCC. We chose OCSCC smokers because of the well-established difference in demographics and risk factors as compared to HPV+ OPSCC patients. However, treatment paradigms for OCSCC and oropharynx tumors are different. Oropharynx tumors, regardless of HPV status, are frequently treated with less in-tense regimens. This difference may influence patient-reported QoL outcomes based on the primary tumor site and HPV status [41]. Ad-ditionally, the AJCC 8 staging system was not utilized in this study. Changes in overall cancer stage may impact the psychosocial factors examined in this study. Furthermore, information was not collected regarding if patients received treatment for depression or symptoms from other healthcare providers. Finally, generalizations are limited due to the sample size of chemical equilibrium study. r> 5. Conclusion
This pilot study provides insight on the psychosocial needs of HPV+ OPSCC patients and OCSCC smokers. OCSCC smokers reported a pat-tern of higher levels of depression, cancer worry, and symptoms at di-agnosis. HPV+ OPSCC patients experienced improvements in depres-sion scores over time. Even though there is a clear survival advantage for patients with HPV-associated OPSCC, this study adds to the growing literature in this area and highlights that HNC patients face consider-able psychosocial and functional challenges. Cancer clinicians including physicians, dentists, mental health experts, speech therapists, and social workers should work proactively to address the QoL and psychosocial needs for each patient regardless of HPV status during all phases of care.
Acknowledgments
This research was supported by pilot funding and Biostatistics Core support from the Hollings Cancer Center at the Medical University of South Carolina (P30 CA138313), database support from the South Carolina Clinical and Translational Research Institute (UL1TR000062), and a Mentored Research Scholar Grant in Applied and Clinical Research to K.R. Sterba (MRSG-12-221-01-CPPB from the American Cancer Society). The authors acknowledge data collection and recruit-ment support from Rebecca Patten, OT, Lee Anne Tetrick, BS and Amy Buchanan, MPH, RD.
References
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