Preservation of quality of life after intensity-modulated radiotherapy for early-stage nasopharyngeal carcinoma: results of a prospective longitudinal study.
BACKGROUND
Xerostomia is a ubiquitous complication after conventional radiotherapy for nasopharyngeal carcinoma (NPC) that seriously impairs patient quality of life (QOL). The effect on QOL of parotid-sparing intensity-modulated radiotherapy (IMRT) for early-stage NPC was assessed prospectively.


METHODS
Thirty-two patients with T1-2,N0-1,M0 NPC received IMRT. Saliva flow was measured, and the Medical Outcomes Short Form 36 (SF-36), European Organization for Research and Treatment of Cancer (EORTC) core, and EORTC head and neck module (QLQ-H&N35) questionnaires were completed at baseline and 2, 6, and 12 months after IMRT.


RESULTS
Saliva flow recovered to at least 25% of baseline in most cases after 1 year. Physical function, fatigue, and vitality were problems at 2 months and then resolved (p < or = .002). Global health scales showed continuous improvement in QOL after treatment (p < or = .004). Xerostomia and sticky saliva were problems 2 months after treatment; thereafter, continuous improvement occurred (p < or = .001). Xerostomia scores correlated with general aspects of QOL (p < or = .044).


CONCLUSIONS
IMRT for early-stage disease preserved key aspects of QOL, and a reduction in xerostomia symptoms enhanced broader aspects of QOL.
Oral Rehabilitation, Faculty of Dentistry, the University of Hong Kong, 34 Hospital Road, Hong Kong, SAR. annemcmillan@hku.hk
Anne S
AS
McMillan
Edmond H N
EH
Pow
Dora L W
DL
Kwong
May C M
MC
Wong
Jonathan S T
JS
Sham
Lucullus H T
LH
Leung
W Keung
WK
Leung
D000328:Adult; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D009367:Neoplasm Staging; D010306:Parotid Gland / Q000528:radiation effects; D011446:Prospective Studies; D011788:Quality of Life; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated; D012472:Salivation / Q000528:radiation effects; D014987:Xerostomia / Q000517:prevention & control