title: Assessment of quality of life of nasopharyngeal carcinoma patients with EORTC QLQ-C30 and H&N-35 modules.
abstract: OBJECTIVE
  The current study reports on long-term quality of life (QoL) status after conventional radiotherapy in 187 nasopharyngeal carcinoma patients from 14 centers in Turkey.
  
  
  METHODS
  Patients with the diagnosis of nasopharyngeal carcinoma, who were treated in 14 centers in Turkey with minimum 6 months of follow-up and were in complete remission, were asked to complete Turkish versions of EORTC QLQ-C30 questionnaire and the HN-35 module. Each center participated with the required clinical data that included age at diagnosis, gender, symptoms on admission, follow-up period, treatment modalities, radiotherapy dose, and AJCC 1997 tumor stage. Each patient's 33 QoL scores, which included function, global health status, and symptoms, were calculated as instructed in EORTC QLQ-C30 scoring manual. All of the scales and single-item measures range from 0 to 100. A high score represents a higher response level. Kruskal-Wallis and Mann-Whitney U nonparametric tests were used for comparisons.
  
  
  RESULTS
  One hundred eighty-seven patients with median age of 46 years (range, 16-79 years) participated and completed the questionnaires. Median follow-up time was 3.4 years (range, 6 months-24 years). All patients have received external-beam radiotherapy. Beside external-beam radiotherapy, 59 patients underwent brachytherapy boost, 70 patients received concomitant chemotherapy, and 95 patients received adjuvant/neoadjuvant chemotherapy. Most of the patients in the analysis (75%) were in advanced stage (Stage III, n = 85 [45.4%]; Stage IV, n = 55 [29%]). Mean global health status was calculated as 73. Parameters that increased global health status were male gender, early-stage disease, and less than 4-year follow-up (p < 0.05). Functional parameters were better in males and in early-stage disease. Factors that yielded better symptom scores were short interval after treatment (10 scores), male gender (7 scores), and lower radiation dose (6 scores). Neoadjuvant or adjuvant chemotherapy did not have any effect on QoL, whereas concomitant chemotherapy adversely affected 5 symptom scores.
  
  
  CONCLUSIONS
  Quality of life is adversely affected in our nasopharyngeal carcinoma patients treated with combined therapies. The factors that adversely affect quality of life are advanced tumor stage, female gender, and long-term follow-up. Further controlled studies to evaluate both preradiotherapy and postradiotherapy status are necessary to clarify the contribution of each treatment modality to QoL.
authors.affiliation: Turkish Oncology Group (TOG)--Head and Neck Cancer Working Party, Hacettepe University, Sihhiye, Ankara, Turkey. mcengiz@hacettepe.edu.tr
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cengiz
authors.forename: Enis
authors.initials: E
authors.lastname: Ozyar
authors.forename: Mustafa
authors.initials: M
authors.lastname: Esassolak
authors.forename: Musa
authors.initials: M
authors.lastname: Altun
authors.forename: Müge
authors.initials: M
authors.lastname: Akmansu
authors.forename: Mehmet
authors.initials: M
authors.lastname: Sen
authors.forename: Omer
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authors.lastname: Uzel
authors.forename: Aydin
authors.initials: A
authors.lastname: Yavuz
authors.forename: Gamze
authors.initials: G
authors.lastname: Dalmaz
authors.forename: Cem
authors.initials: C
authors.lastname: Uzal
authors.forename: Ayşe
authors.initials: A
authors.lastname: Hiçsönmez
authors.forename: Süreyya
authors.initials: S
authors.lastname: Sarihan
authors.forename: Bünyamin
authors.initials: B
authors.lastname: Kaplan
authors.forename: Beste Melek
authors.initials: BM
authors.lastname: Atasoy
authors.forename: Cüneyt
authors.initials: C
authors.lastname: Ulutin
authors.forename: Ufuk
authors.initials: U
authors.lastname: Abacioğlu
authors.forename: Ayşe Nur
authors.initials: AN
authors.lastname: Demiral
authors.forename: Mutlu
authors.initials: M
authors.lastname: Hayran
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D011788:Quality of Life; D012737:Sex Factors; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014421:Turkey